Skilled nursing facility · CMS certification number 366174
CMS certification number 366174
This certification number is not in CMS’s current Care Compare Provider Information file, processed on 1 August 2026.
For this facility: the citable document with full history — $795 · an email when this record changes — $99/month
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 2008 to 20 May 2008 — a reporting period of 140 days, not a full year, on form CMS-2540-96, settled, processed by CMS on 30 September 2009.
None of these figures is carried on this report.
CMS report record 357336, 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 2 March 2009.
None of these figures is carried on this report.
CMS report record 334496, 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 22 February 2008.
None of these figures is carried on this report.
CMS report record 302841, 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.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,050,744 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,191,057 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$140,313 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $2,977 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: −$137,336 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 13,532 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 14 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 128.25 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,399 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 966.57 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 277564, 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 30 March 2006.
None of these figures is carried on this report.
CMS report record 246373, 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 213258, read from the public cost report file SNFFY2003.zip.
Fiscal year 2002, ended 31 December 2002
Cost report for 1 January 2002 to 31 December 2002 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 19 May 2004.
None of these figures is carried on this report.
CMS report record 176917, read from the public cost report file SNFFY2002.zip.
Fiscal year 2001, ended 31 December 2001
Cost report for 1 January 2001 to 31 December 2001 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 7 May 2003.
None of these figures is carried on this report.
CMS report record 143507, 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 23 January 2002.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,653,504 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,590,000 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $63,504 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $39,874 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income: $103,378 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 14,950 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 29 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 82 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 886.33 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 515.52 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 50465, read from the public cost report file SNFFY2000.zip.
Fiscal year 1999, ended 31 December 1999
Cost report for 1 January 1999 to 31 December 1999 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 23 March 2001.
Net income: $1,161,147 (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 50463, read from the public cost report file SNFFY1999.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
Not listed in CMS’s Care Compare data.
Medicare enrollment
No owner listed for this facility in CMS’s Medicare enrollment ownership data.
Changes in ownership
No change in ownership appears in CMS’s ownership data for this facility.
Recent changes on this record
- 30 September 2009: A cost report was filed for fiscal year 2008, on form CMS-2540-96. SNFFY2008.zip
- 2 March 2009: A cost report was filed for fiscal year 2007, on form CMS-2540-96. SNFFY2007.zip
- 22 February 2008: A cost report was filed for fiscal year 2006, on form CMS-2540-96. SNFFY2006.zip
- 1 May 2007: A cost report was filed for fiscal year 2005, on form CMS-2540-96. SNFFY2005.zip
- 30 March 2006: A cost report was filed for fiscal year 2004, on form CMS-2540-96. SNFFY2004.zip
- 16 April 2005: A cost report was filed for fiscal year 2003, on form CMS-2540-96. SNFFY2003.zip
- 19 May 2004: A cost report was filed for fiscal year 2002, on form CMS-2540-96. SNFFY2002.zip
- 7 May 2003: A cost report was filed for fiscal year 2001, on form CMS-2540-96. SNFFY2001.zip
- 23 January 2002: A cost report was filed for fiscal year 2000, on form CMS-2540-96. SNFFY2000.zip
- 23 March 2001: A cost report was filed for fiscal year 1999, on form CMS-2540-96. SNFFY1999.zip
Inspections
Not listed in CMS’s Care Compare data.
Deficiencies cited
Not listed in CMS’s Care Compare data.
Penalties
Not listed in CMS’s Care Compare data.
Care Compare provider information
Not listed in CMS’s Care Compare data.
Get an email when this record changes
One email a day naming what moved on CMS certification number 366174: the field, the value before, the value after, and the date of the file that first showed it.
The facility alert follows this one record: a cost report filed or a figure on one changed, an inspection, a deficiency or a penalty recorded, an owner added or removed. The certification number arrives filled in.
On 30 September 2009: A cost report was filed for fiscal year 2008, on form CMS-2540-96. That is one line of the alert.
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The citable document for CMS certification number 366174
This page shows the record as it stands today. The report is the citable document: the same figures with the cell each came from, and beyond this page — five facilities of a similar size in the same state at the same fiscal year, listed by name; every change on the record rather than the recent ones below; the inspection and staffing history in blocks of their own; and a citation block naming every CMS file it was read from.
Every figure on this page is printed as it appears in the CMS file named beside it. A figure that does not match its file? Tell us on the corrections page, quoting certification number 366174.