Skilled nursing facility · CMS certification number 366093

PARK VILLAGE HEALTH CARE CENTER INC

DOVER, Ohio · Medicare and Medicaid

Certified beds, as filed in Care Compare: 90

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 27 February 2026.

Revenue and expenses, fiscal year 2024
Figure	As filed	Where it comes from
Total patient revenue	$8,577,435	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$814,128	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$7,763,307	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$7,435,047	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$328,260	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	−$47,208	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$281,052	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $281,052 (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%).

Beds, days and discharges, fiscal year 2024
Figure	As filed	Where it comes from
Total facility beds, all components	90	CMS-2540-10 worksheet S300001 line 800 column 100
Bed days available, all components	32,940	CMS-2540-10 worksheet S300001 line 800 column 200
Medicare (Title XVIII) patient days	1,607	CMS-2540-10 worksheet S300001 line 800 column 400
Medicaid (Title XIX) patient days	13,265	CMS-2540-10 worksheet S300001 line 800 column 500
Other-payer patient days	12,386	CMS-2540-10 worksheet S300001 line 800 column 600
Total patient days, all components	27,258	CMS-2540-10 worksheet S300001 line 800 column 700
Medicare discharges	49	CMS-2540-10 worksheet S300001 line 800 column 900
Medicaid discharges	75	CMS-2540-10 worksheet S300001 line 800 column 1000
Other-payer discharges	170	CMS-2540-10 worksheet S300001 line 800 column 1100
Total discharges, all components	294	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	32.8	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	176.87	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	92.71	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1448195, 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.

Revenue and expenses, fiscal year 2023
Figure	As filed	Where it comes from
Total patient revenue	$8,597,553	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$794,489	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$7,803,064	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$7,232,860	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$570,204	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$406,132	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$976,336	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $976,336 (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%).

Beds, days and discharges, fiscal year 2023
Figure	As filed	Where it comes from
Total facility beds, all components	90	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	26,448	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	224	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	27.74	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	310.11	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	118.07	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1403330, 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 14 July 2023.

Revenue and expenses, fiscal year 2022
Figure	As filed	Where it comes from
Total patient revenue	$7,192,027	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$650,817	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$6,541,210	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$6,450,914	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$90,296	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$382,541	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$472,837	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $472,837 (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%).

Beds, days and discharges, fiscal year 2022
Figure	As filed	Where it comes from
Total facility beds, all components	90	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	25,030	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	241	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	22.95	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	348.18	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	103.86	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1358872, read from the public cost report file SNF10FY2022.zip.

Fiscal year 2021, ended 31 December 2021

Cost report for 1 January 2021 to 31 December 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 22 July 2022.

Revenue and expenses, fiscal year 2021
Figure	As filed	Where it comes from
Total patient revenue	$6,616,991	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$576,813	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$6,040,178	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$5,960,096	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$80,082	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$266,178	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$346,260	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $346,260 (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%).

Beds, days and discharges, fiscal year 2021
Figure	As filed	Where it comes from
Total facility beds, all components	90	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	24,325	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	261	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	21.63	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	229.35	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	93.2	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1327277, 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 2 August 2021.

Revenue and expenses, fiscal year 2020
Figure	As filed	Where it comes from
Total patient revenue	$6,865,973	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$502,565	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$6,363,408	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$6,044,363	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$319,045	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$1,700,431	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$2,019,476	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $2,019,476 (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%).

Beds, days and discharges, fiscal year 2020
Figure	As filed	Where it comes from
Total facility beds, all components	90	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	28,151	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	184	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	21.86	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	408.74	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	152.99	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1291372, 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 30 July 2020.

Revenue and expenses, fiscal year 2019
Figure	As filed	Where it comes from
Total patient revenue	$6,531,146	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$543,212	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$5,987,934	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$5,779,089	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$208,845	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$55,257	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$264,102	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $264,102 (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%).

Beds, days and discharges, fiscal year 2019
Figure	As filed	Where it comes from
Total facility beds, all components	90	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	27,131	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	384	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	16.89	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	92.65	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	70.65	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1262057, 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 19 September 2019.

Revenue and expenses, fiscal year 2018
Figure	As filed	Where it comes from
Total patient revenue	$6,410,641	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$664,317	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$5,746,324	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$5,695,467	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$50,857	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$13,628	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$64,485	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $64,485 (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%).

Beds, days and discharges, fiscal year 2018
Figure	As filed	Where it comes from
Total facility beds, all components	90	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	26,857	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	373	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	26.24	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	113.82	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	72	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1243658, 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 27 June 2018.

Revenue and expenses, fiscal year 2017
Figure	As filed	Where it comes from
Total patient revenue	$6,424,144	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$722,163	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$5,701,981	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$5,861,441	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$159,460	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$29,515	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$129,945	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$129,945 (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%).

Beds, days and discharges, fiscal year 2017
Figure	As filed	Where it comes from
Total facility beds, all components	90	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	26,973	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	512	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	23.71	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	64.98	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	52.68	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1196427, 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 28 February 2018.

Revenue and expenses, fiscal year 2016
Figure	As filed	Where it comes from
Total patient revenue	$8,040,965	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$1,320,529	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$6,720,436	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$6,202,854	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$517,582	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$10,098	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$527,680	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $527,680 (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%).

Beds, days and discharges, fiscal year 2016
Figure	As filed	Where it comes from
Total facility beds, all components	90	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	32,050	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	302	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	26.65	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	357.27	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	106.13	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1184453, 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 23 March 2017.

Revenue and expenses, fiscal year 2015
Figure	As filed	Where it comes from
Total patient revenue	$8,295,057	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$1,830,367	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$6,464,690	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$5,703,614	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$761,076	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	−$3,508	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$757,568	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $757,568 (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%).

Beds, days and discharges, fiscal year 2015
Figure	As filed	Where it comes from
Total facility beds, all components	100	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	32,421	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	307	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	24.63	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	558.1	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	105.61	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1155144, 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.

Revenue and expenses, fiscal year 2014
Figure	As filed	Where it comes from
Total patient revenue	$8,534,836	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$1,833,919	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$6,700,917	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$5,798,893	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$902,024	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$43,741	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$945,765	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $945,765 (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%).

Beds, days and discharges, fiscal year 2014
Figure	As filed	Where it comes from
Total facility beds, all components	100	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	33,613	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	332	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	23.99	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	610.25	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	101.24	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1124736, 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 6 August 2015.

Revenue and expenses, fiscal year 2013
Figure	As filed	Where it comes from
Total patient revenue	$8,081,221	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$1,466,644	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$6,614,577	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$5,508,099	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$1,106,478	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	−$40,516	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$1,065,962	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $1,065,962 (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%).

Beds, days and discharges, fiscal year 2013
Figure	As filed	Where it comes from
Total facility beds, all components	100	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	32,751	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	374	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	21.45	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	409.71	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	87.57	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1106941, 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 28 October 2014.

Revenue and expenses, fiscal year 2012
Figure	As filed	Where it comes from
Total patient revenue	$7,793,484	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$1,394,107	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$6,399,377	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$5,541,705	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$857,672	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	−$7,779	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$849,893	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $849,893 (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%).

Beds, days and discharges, fiscal year 2012
Figure	As filed	Where it comes from
Total facility beds, all components	100	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	30,666	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	402	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	21.37	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	304.73	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	76.28	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1079483, 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 27 June 2013.

Revenue and expenses, fiscal year 2011
Figure	As filed	Where it comes from
Total patient revenue	$7,658,507	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$933,667	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$6,724,840	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$5,565,522	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	$1,159,318	CMS-2540-10 worksheet G300000 line 500 column 100
Net income after other income	$1,159,318	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $1,159,318 (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%).

Beds, days and discharges, fiscal year 2011
Figure	As filed	Where it comes from
Total facility beds, all components	100	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	33,470	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	337	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	24.26	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	441.91	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	99.32	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1040027, 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 28 September 2012.

Revenue and expenses, fiscal year 2010
Figure	As filed	Where it comes from
Net patient revenue	$6,841,805	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$5,540,652	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	$1,301,153	CMS-2540-96 worksheet G300000 line 500 column 100

Net income, stated at moderate confidence: $1,301,153 (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.

Beds, days and discharges, fiscal year 2010
Figure	As filed	Where it comes from
Total facility beds, all components	100	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	32,778	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	361	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	22.95	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	565.66	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	90.8	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 432649, 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 24 February 2011.

Revenue and expenses, fiscal year 2009
Figure	As filed	Where it comes from
Net patient revenue	$6,402,497	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$5,167,709	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	$1,234,788	CMS-2540-96 worksheet G300000 line 500 column 100

Net income, stated at moderate confidence: $1,234,788 (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.

Beds, days and discharges, fiscal year 2009
Figure	As filed	Where it comes from
Total facility beds, all components	100	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	31,358	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	421	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	21.74	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	321.81	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	74.48	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 394436, read from the public cost report file SNFFY2009.zip.

Fiscal year 2008, ended 31 December 2008

Cost report for 1 January 2008 to 31 December 2008 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 27 April 2010.

Revenue and expenses, fiscal year 2008
Figure	As filed	Where it comes from
Net patient revenue	$6,321,934	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$5,093,905	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	$1,228,029	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$116	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income, stated at moderate confidence: $1,228,145 (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.

Beds, days and discharges, fiscal year 2008
Figure	As filed	Where it comes from
Total facility beds, all components	100	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	32,314	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	398	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	23.41	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	302.17	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	81.19	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 368260, 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 13 August 2008.

None of these figures is carried on this report.

CMS report record 323855, 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 December 2007.

None of these figures is carried on this report.

CMS report record 298987, read from the public cost report file SNFFY2006.zip.

Fiscal year 2005, ended 31 December 2005

Cost report for 1 January 2005 to 31 December 2005 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 1 May 2007.

None of these figures is carried on this report.

CMS report record 276395, read from the public cost report file SNFFY2005.zip.

Fiscal year 2004, ended 31 December 2004

Cost report for 1 January 2004 to 31 December 2004 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 23 January 2006.

None of these figures is carried on this report.

CMS report record 241090, read from the public cost report file SNFFY2004.zip.

Fiscal year 2003, ended 31 December 2003

Cost report for 1 January 2003 to 31 December 2003 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 8 February 2005.

Revenue and expenses, fiscal year 2003
Figure	As filed	Where it comes from
Net patient revenue	$5,070,171	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$3,917,149	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	$1,153,022	CMS-2540-96 worksheet G300000 line 500 column 100

Net income, stated at moderate confidence: $1,153,022 (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.

Beds, days and discharges, fiscal year 2003
Figure	As filed	Where it comes from
Total facility beds, all components	100	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	33,539	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	292	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	26.86	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	440.53	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	114.86	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 206626, 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.

Revenue and expenses, fiscal year 2002
Figure	As filed	Where it comes from
Net patient revenue	$4,910,905	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$3,721,028	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	$1,189,877	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$58,943	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income, stated at moderate confidence: $1,248,820 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.

Beds, days and discharges, fiscal year 2002
Figure	As filed	Where it comes from
Total facility beds, all components	100	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	34,683	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	267	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	27.13	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	482.18	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	129.9	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 178767, 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 12 May 2003.

Revenue and expenses, fiscal year 2001
Figure	As filed	Where it comes from
Net patient revenue	$4,271,608	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$3,401,423	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	$870,185	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$1,271	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income, stated at moderate confidence: $871,456 (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.

Beds, days and discharges, fiscal year 2001
Figure	As filed	Where it comes from
Total facility beds, all components	100	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	34,871	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	195	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	27.88	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	694.85	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	178.83	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 144624, 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 8 February 2002.

Revenue and expenses, fiscal year 2000
Figure	As filed	Where it comes from
Net patient revenue	$3,901,540	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$2,974,865	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	$926,675	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$1,346	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income, stated at moderate confidence: $928,021 (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.

Beds, days and discharges, fiscal year 2000
Figure	As filed	Where it comes from
Total facility beds, all components	100	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	33,701	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	189	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	28.73	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	656.08	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	178.31	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 49944, 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 13 September 2001.

Revenue and expenses, fiscal year 1999
Figure	As filed	Where it comes from
Net patient revenue	$3,435,008	CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses	$2,730,873	CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients	$704,135	CMS-2540-96 worksheet G300000 line 500 column 100
Total other income	$6,914	CMS-2540-96 worksheet G300000 line 2600 column 100

Net income, stated at moderate confidence: $711,049 (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.

Beds, days and discharges, fiscal year 1999
Figure	As filed	Where it comes from
Total facility beds, all components	100	CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components	33,698	CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components	185	CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days	32.08	CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days	755.9	CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days	182.15	CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 49942, read from the public cost report file SNFFY1999.zip.

Fiscal year 1998, ended 31 December 1998

Cost report for 1 January 1998 to 31 December 1998 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 1 March 2000.

Net income, stated at moderate confidence: $645,596 (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 49940, read from the public cost report file SNFFY1998.zip.

Fiscal year 1997, ended 31 December 1997

Cost report for 1 January 1997 to 31 December 1997 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 23 February 1999.

Net income, stated at moderate confidence: $505,496 (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 49938, read from the public cost report file SNFFY1997.zip.

Fiscal year 1996, ended 31 December 1996

Cost report for 1 January 1996 to 31 December 1996 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 1 April 1998.

None of these figures is carried on this report.

CMS report record 49937, 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.

The staffing record →

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
ODONNELL, ROBERT	5% OR GREATER DIRECT OWNERSHIP INTEREST	Individual	49%	since 03/01/1993
ODONNELL, THOMAS	5% OR GREATER DIRECT OWNERSHIP INTEREST	Individual	21%	since 01/01/1997
ROBERT J. O'DONNELL IRREVOCABLE BUSINESS TRUST	5% OR GREATER DIRECT OWNERSHIP INTEREST	Organization	26%	since 12/31/2016
HOHMAN, MICHAEL	ADP OF THE SNF	Individual	NOT APPLICABLE	since 11/18/2018
MCCLAIN, BRIAN	ADP OF THE SNF	Individual	NOT APPLICABLE	since 05/31/2019
ROBERT J. O'DONNELL IRREVOCABLE BUSINESS TRUST	ADP OF THE SNF	Organization	NOT APPLICABLE	since 12/16/2016
SHUTT, MARCINA	ADP OF THE SNF	Individual	NOT APPLICABLE	since 12/18/2000
TUCKER, JEFFREY	ADP OF THE SNF	Individual	NOT APPLICABLE	since 01/01/2015
ODONNELL, ROBERT	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 03/01/1993
TUCKER, JEFFREY	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 01/01/2015
ODONNELL, ROBERT	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 03/01/1993
ODONNELL, THOMAS	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 01/01/1997
TUCKER, JEFFREY	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 01/01/2015
HOHMAN, MICHAEL	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 11/18/2018
ODONNELL, ROBERT	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 12/17/1992
ODONNELL, THOMAS	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 01/01/1997
SHUTT, MARCINA	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 12/18/2000
TUCKER, JEFFREY	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 01/01/2015

Medicare enrollment

As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of PARK VILLAGE HEALTH CARE CENTER INC (enrollment ID O20120718000940).

Owner	Individual or organization	Role	Ownership percentage	Association date	Described in the filing as
ROBERT J. O'DONNELL IRREVOCABLE BUSINESS TRUST	Organization	5% OR GREATER DIRECT OWNERSHIP INTEREST	26.45	12/31/2016	Private equity company: No Real estate investment trust: No Holding company: No
ROBERT ODONNELL	Individual	5% OR GREATER DIRECT OWNERSHIP INTEREST	49.4	3/1/1993	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.
THOMAS ODONNELL	Individual	5% OR GREATER DIRECT OWNERSHIP INTEREST	20.74	1/1/1997	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.
BRIAN MCCLAIN	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	5/31/2019	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
JEFFREY TUCKER	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	1/1/2015	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.
MARCINA SHUTT	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	12/18/2000	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.
MICHAEL HOHMAN	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.	11/18/2018	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.
ROBERT J. O'DONNELL IRREVOCABLE BUSINESS TRUST	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	12/16/2016	Private equity company: No Real estate investment trust: No Holding company: No
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	5/31/2019	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	1/1/2020	Private equity company: No Real estate investment trust: No Holding company: No
JEFFREY TUCKER	Individual	CORPORATE DIRECTOR	0	1/1/2015	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 ODONNELL	Individual	CORPORATE DIRECTOR	49.4	3/1/1993	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
JEFFREY TUCKER	Individual	CORPORATE OFFICER	0	1/1/2015	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 ODONNELL	Individual	CORPORATE OFFICER	49.4	3/1/1993	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.
THOMAS ODONNELL	Individual	CORPORATE OFFICER	20.74	1/1/1997	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
JEFFREY TUCKER	Individual	OPERATIONAL/MANAGERIAL CONTROL	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	1/1/2015	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.
MARCINA SHUTT	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.	12/18/2000	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.
MICHAEL HOHMAN	Individual	OPERATIONAL/MANAGERIAL CONTROL	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	11/18/2018	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.
ROBERT ODONNELL	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.	12/17/1992	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.
THOMAS ODONNELL	Individual	OPERATIONAL/MANAGERIAL CONTROL	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	1/1/1997	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: JEFFREY TUCKER 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: JEFFREY TUCKER no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: JEFFREY TUCKER no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: JEFFREY TUCKER no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: JEFFREY TUCKER appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: JEFFREY TUCKER appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: JEFFREY TUCKER appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: JEFFREY TUCKER appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 March 2026: MARY ANN ODONNELL no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
1 March 2026: ROBERT ODONNELL no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
1 March 2026: MARCINA SHUTT appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
1 March 2026: MARCINA SHUTT appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
1 March 2026: THOMAS ODONNELL appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
1 March 2026: BRIAN MCCLAIN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
1 March 2026: ROBERT J. O'DONNELL IRREVOCABLE BUSINESS TRUST appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
1 March 2026: ROBERT ODONNELL appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
1 March 2026: ROBERT ODONNELL appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
1 March 2026: MICHAEL HOHMAN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
1 March 2026: MICHAEL HOHMAN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
1 March 2026: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
1 March 2026: JEFFREY TUCKER appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
1 March 2026: JEFFREY TUCKER appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv

Recent changes on this record

1 July 2026: JEFFREY TUCKER 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: JEFFREY TUCKER no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: JEFFREY TUCKER no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: JEFFREY TUCKER no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: JEFFREY TUCKER appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: JEFFREY TUCKER appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: JEFFREY TUCKER appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: JEFFREY TUCKER appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 March 2026: MARY ANN ODONNELL no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
1 March 2026: ROBERT ODONNELL no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
1 March 2026: MARCINA SHUTT appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
1 March 2026: MARCINA SHUTT appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
1 March 2026: THOMAS ODONNELL appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
1 March 2026: BRIAN MCCLAIN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
1 March 2026: ROBERT J. O'DONNELL IRREVOCABLE BUSINESS TRUST appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
1 March 2026: ROBERT ODONNELL appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
1 March 2026: ROBERT ODONNELL appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
1 March 2026: MICHAEL HOHMAN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
1 March 2026: MICHAEL HOHMAN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
1 March 2026: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
1 March 2026: JEFFREY TUCKER appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
1 March 2026: JEFFREY TUCKER appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-03-01.csv
27 February 2026: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
6 February 2025: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
14 July 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
22 July 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
2 August 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
30 July 2020: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
19 September 2019: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2018.zip
27 June 2018: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2017.zip
28 February 2018: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2016.zip
23 March 2017: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2015.zip
26 May 2016: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2014.zip
6 August 2015: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2013.zip
28 October 2014: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2012.zip
27 June 2013: A cost report was filed for fiscal year 2011, on form CMS-2540-10. SNF10FY2011.zip
28 September 2012: A cost report was filed for fiscal year 2010, on form CMS-2540-96. SNFFY2010.zip
24 February 2011: A cost report was filed for fiscal year 2009, on form CMS-2540-96. SNFFY2009.zip
27 April 2010: A cost report was filed for fiscal year 2008, on form CMS-2540-96. SNFFY2008.zip
13 August 2008: A cost report was filed for fiscal year 2007, on form CMS-2540-96. SNFFY2007.zip

Inspections

Inspection cycle	Health inspection	Fire safety inspection	Health deficiencies	Fire safety deficiencies
1	22 April 2026	22 April 2026	4	5
2	4 April 2024	4 April 2024	4	5
3	7 April 2022	7 April 2022	7	5

From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.

Deficiencies cited

15 deficiencies on file, newest inspection first

Inspection date	Inspection type	Tag	Category	What was cited	Scope and severity	Complaint	Corrected	Correction date
22 April 2026	Health	F 0644	Resident Assessment and Care Planning Deficiencies	Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.	D	No	Deficient, Provider has date of correction	9 June 2026
22 April 2026	Health	F 0812	Nutrition and Dietary Deficiencies	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.	F	No	Deficient, Provider has date of correction	9 June 2026
22 April 2026	Health	F 0849	Administration Deficiencies	Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.	D	Yes	Deficient, Provider has date of correction	9 June 2026
22 April 2026	Health	F 0880	Infection Control Deficiencies	Provide and implement an infection prevention and control program.	D	No	Deficient, Provider has date of correction	9 June 2026
4 April 2024	Health	F 0625	Resident Rights Deficiencies	Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.	B	No	Deficient, Provider has plan of correction	10 May 2024
4 April 2024	Health	F 0645	Resident Assessment and Care Planning Deficiencies	PASARR screening for Mental disorders or Intellectual Disabilities	D	No	Deficient, Provider has date of correction	10 May 2024
4 April 2024	Health	F 0812	Nutrition and Dietary Deficiencies	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.	E	No	Deficient, Provider has date of correction	10 May 2024
4 April 2024	Health	F 0881	Infection Control Deficiencies	Implement a program that monitors antibiotic use.	D	No	Deficient, Provider has date of correction	10 May 2024
28 February 2024	Health	F 0880	Infection Control Deficiencies	Provide and implement an infection prevention and control program.	F	Yes	Deficient, Provider has date of correction	19 March 2024
27 December 2023	Health	F 0580	Resident Rights Deficiencies	Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.	D	Yes	Deficient, Provider has date of correction	19 March 2024
27 December 2023	Health	F 0684	Quality of Life and Care Deficiencies	Provide appropriate treatment and care according to orders, resident’s preferences and goals.	J	Yes	Deficient, Provider has date of correction	19 March 2024
27 December 2023	Health	F 0695	Quality of Life and Care Deficiencies	Provide safe and appropriate respiratory care for a resident when needed.	D	Yes	Deficient, Provider has date of correction	1 February 2024
27 December 2023	Health	F 0697	Quality of Life and Care Deficiencies	Provide safe, appropriate pain management for a resident who requires such services.	D	Yes	Deficient, Provider has date of correction	19 March 2024
27 December 2023	Health	F 0842	Resident Assessment and Care Planning Deficiencies	Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.	D	Yes	Deficient, Provider has date of correction	19 March 2024
27 December 2023	Health	F 0867	Administration Deficiencies	Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.	F	Yes	Deficient, Provider has date of correction	19 March 2024

From the Care Compare health citations file NH_HealthCitations_Aug2026.csv, processed on 1 August 2026.

Penalties

Penalty date	Type	Fine amount	Payment denial began	Payment denial, days	Fine ID
27 December 2023	Fine	$77,552			77780
27 December 2023	Payment Denial		24 January 2024	55

From the Care Compare penalties file NH_Penalties_Aug2026.csv, processed on 1 August 2026.

Care Compare provider information

Field	As filed
Provider Type	Medicare and Medicaid
Ownership Type	For profit - Individual
Legal Business Name	PARK VILLAGE HEALTH CARE CENTER INC
Date First Approved to Provide Medicare and Medicaid Services	1996-11-14
Provider Resides in Hospital	N
Continuing Care Retirement Community	Y
Urban	N
County/Parish	Tuscarawas
Telephone Number	3303644436
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	90
Average Number of Residents per Day	73.0
Overall Rating	4
Health Inspection Rating	3
QM Rating	4
Long-Stay QM Rating	5
Short-Stay QM Rating	3
Processing Date	2026-08-01

From the Care Compare Provider Information file NH_ProviderInfo_Aug2026.csv, processed on 1 August 2026.

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On 1 July 2026: JEFFREY TUCKER 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 PARK VILLAGE HEALTH CARE CENTER INC

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