Skilled nursing facility · CMS certification number 375341
COUNTRYSIDE ESTATES
WARNER, Oklahoma · Medicare and Medicaid
Certified beds, as filed in Care Compare: 111
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 July 2024 to 30 June 2025 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 6 May 2026.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,931,480 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $10,931,480 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,477,635 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $1,453,845 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | $1,453,845 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,453,845 (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 | 111 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 40,515 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 1,497 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 20,133 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 2,148 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 23,778 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 29 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 23 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 8 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 60 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 51.62 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 875.35 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 396.3 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1448951, read from the public cost report file SNF10FY2024.zip.
Fiscal year 2024, ended 30 June 2024
Cost report for 1 July 2023 to 30 June 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 8 January 2026.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $14,541,074 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $14,541,074 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $12,756,350 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $1,784,724 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | $1,784,724 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,784,724 (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 patient days, all components | 26,995 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 256 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 40.89 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 122.78 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 105.45 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1446217, read from the public cost report file SNF10FY2023.zip.
Fiscal year 2023, ended 30 June 2023
Cost report for 1 July 2022 to 30 June 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 7 January 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,734,735 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $8,734,735 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,713,363 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $1,021,372 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | $1,021,372 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,021,372 (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 patient days, all components | 25,955 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 318 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 33.45 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 95.86 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 81.62 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1401930, read from the public cost report file SNF10FY2022.zip.
Fiscal year 2022, ended 30 June 2022
Cost report for 1 July 2021 to 30 June 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 14 July 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $8,315,612 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $8,315,612 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,437,351 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $878,261 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $419,015 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,297,276 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,297,276 (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 patient days, all components | 24,535 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 262 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 107.71 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 97.82 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 93.65 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1358331, read from the public cost report file SNF10FY2021.zip.
Fiscal year 2021, ended 30 June 2021
Cost report for 1 July 2020 to 30 June 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 28 February 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,607,545 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $7,607,545 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,988,928 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $618,617 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,502,615 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $2,121,232 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $2,121,232 (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 patient days, all components | 25,490 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 248 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 57.71 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 108.39 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 102.78 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1343397, read from the public cost report file SNF10FY2020.zip.
Fiscal year 2020, ended 30 June 2020
Cost report for 1 July 2019 to 30 June 2020 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 20 October 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,646,933 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $7,646,933 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,294,035 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $1,352,898 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | $1,352,898 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,352,898 (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 patient days, all components | 28,634 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 273 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 42.18 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 121.64 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 104.89 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1302164, read from the public cost report file SNF10FY2019.zip.
Fiscal year 2019, ended 30 June 2019
Cost report for 1 July 2018 to 30 June 2019 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 5 February 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,199,870 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $6,199,870 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,223,493 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$23,623 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | −$23,623 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$23,623 (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 patient days, all components | 27,981 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 340 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 52.83 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 91.5 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 82.3 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1279796, read from the public cost report file SNF10FY2018.zip.
Fiscal year 2018, ended 30 June 2018
Cost report for 1 July 2017 to 30 June 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 18 October 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,002,305 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $6,002,305 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,464,116 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $538,189 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | $538,189 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $538,189 (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 patient days, all components | 27,556 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 316 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 34.2 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 103.21 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 87.2 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1244697, read from the public cost report file SNF10FY2017.zip.
Fiscal year 2017, ended 30 June 2017
Cost report for 1 July 2016 to 30 June 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 10 June 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $1,095,985 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $1,095,985 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,780,680 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$4,684,695 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | −$4,684,695 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$4,684,695 (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 patient days, all components | 29,859 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 273 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 38.91 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 135.23 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 109.37 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1227409, read from the public cost report file SNF10FY2016.zip.
Fiscal year 2016, ended 30 June 2016
Cost report for 1 July 2015 to 30 June 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 17 October 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,464,854 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $933,626 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,531,228 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,550,149 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $981,079 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $771 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $981,850 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $981,850 (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 | 111 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 30,165 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 124 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 42.07 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 436.15 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 243.27 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1176693, read from the public cost report file SNF10FY2015.zip.
Fiscal year 2015, ended 30 June 2015
Cost report for 1 July 2014 to 30 June 2015 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 25 January 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,233,184 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $67,445 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,165,739 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,852,566 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $1,313,173 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | −$3,398 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $1,309,775 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $1,309,775 (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 | 111 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 31,107 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 271 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 59.92 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 132.18 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 114.79 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1117932, read from the public cost report file SNF10FY2014.zip.
Fiscal year 2014, ended 30 June 2014
Cost report for 1 July 2013 to 30 June 2014 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 30 March 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,259,471 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $86,580 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $6,172,891 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,322,409 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $850,482 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $53,628 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $904,110 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $904,110 (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 | 111 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 29,645 | 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 | 39.59 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 107.86 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 96.56 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1121454, read from the public cost report file SNF10FY2013.zip.
Fiscal year 2013, ended 30 June 2013
Cost report for 1 July 2012 to 30 June 2013 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 15 June 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,280,260 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $720,528 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,559,732 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,866,019 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $693,713 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $5,406 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $699,119 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $699,119 (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 | 111 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 28,608 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 309 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 46.47 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 120.1 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 92.58 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1096884, read from the public cost report file SNF10FY2012.zip.
Fiscal year 2012, ended 30 June 2012
Cost report for 1 July 2011 to 30 June 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 1 May 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,600,935 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $42,911 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,558,024 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,532,193 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $25,831 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $30,230 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $56,061 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $56,061 (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 | 111 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 26,399 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 182 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 51.5 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 145.05 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1059091, read from the public cost report file SNF10FY2011.zip.
Fiscal year 2011, ended 30 June 2011
Cost report for 1 July 2010 to 30 June 2011 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 11 June 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $5,277,955 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,200,975 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $1,076,980 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $3,183 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $1,080,163 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 111 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 26,361 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 50 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 51.46 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,267.95 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 527.22 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 434819, read from the public cost report file SNFFY2010.zip.
Fiscal year 2010, ended 30 June 2010
Cost report for 1 July 2009 to 30 June 2010 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 21 October 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,950,167 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,547,256 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $402,911 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $883 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $403,794 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 111 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 21,489 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 39 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 43.33 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,182.81 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 551 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 418778, read from the public cost report file SNFFY2009.zip.
Fiscal year 2009, ended 30 June 2009
Cost report for 1 July 2008 to 30 June 2009 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 22 July 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,780,818 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,810,775 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$29,957 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $854 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$29,103 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 111 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,464 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 51 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 38.41 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 842 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 401.25 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 383153, read from the public cost report file SNFFY2008.zip.
Fiscal year 2008, ended 30 June 2008
Cost report for 1 July 2007 to 30 June 2008 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 30 December 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,925,149 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,491,424 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $433,725 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $9,901 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $443,626 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 111 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 22,599 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 63 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 124.5 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 407.07 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 358.71 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 331186, read from the public cost report file SNFFY2007.zip.
Fiscal year 2007, ended 30 June 2007
Cost report for 1 July 2006 to 30 June 2007 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 24 January 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,217,089 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,150,213 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $66,876 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $17,230 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $84,106 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 111 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 21,106 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 23 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 85.38 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,205.29 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 917.65 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 299815, read from the public cost report file SNFFY2006.zip.
Fiscal year 2006, ended 30 June 2006
Cost report for 1 July 2005 to 30 June 2006 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 21 December 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,066,558 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,941,670 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $124,888 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $2,845 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $127,733 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 111 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 22,436 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 26 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 37.5 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,651.08 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 862.92 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 269408, read from the public cost report file SNFFY2005.zip.
Fiscal year 2005, ended 30 June 2005
Cost report for 1 July 2004 to 30 June 2005 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 30 January 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,877,286 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,657,959 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $219,327 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $11,196 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $230,523 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 111 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 22,585 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 73 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 24.3 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 489.22 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 309.38 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 241742, read from the public cost report file SNFFY2004.zip.
Fiscal year 2004, ended 30 June 2004
Cost report for 1 July 2003 to 30 June 2004 — a reporting period of 365 days, on form CMS-2540-96, as submitted, processed by CMS on 16 December 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,558,608 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,329,895 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $228,713 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $10,523 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $239,236 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 111 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 21,756 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 71 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 46.95 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 444.41 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 306.42 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 202782, read from the public cost report file SNFFY2003.zip.
Fiscal year 2003, ended 30 June 2003
Cost report for 1 July 2002 to 30 June 2003 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 25 May 2005.
None of these figures is carried on this report.
CMS report record 217993, read from the public cost report file SNFFY2002.zip.
Fiscal year 2002, ended 30 June 2002
Cost report for 1 July 2001 to 30 June 2002 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 30 January 2004.
None of these figures is carried on this report.
CMS report record 168028, read from the public cost report file SNFFY2001.zip.
Fiscal year 2001, ended 30 June 2001
Cost report for 1 July 2000 to 30 June 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 138914, read from the public cost report file SNFFY2000.zip.
Fiscal year 2000, ended 30 June 2000
Cost report for 1 July 1999 to 30 June 2000 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 15 March 2002.
Net income, stated at moderate confidence: $131,978 (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 93881, read from the public cost report file SNFFY1999.zip.
Fiscal year 1999, ended 30 June 1999
Cost report for 1 July 1998 to 30 June 1999 — a reporting period of 364 days, on form CMS-2540-96, as submitted, processed by CMS on 14 April 2000.
Net income, stated at moderate confidence: $112,264 (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 93880, read from the public cost report file SNFFY1998.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 |
|---|---|---|---|---|
| COUNTRYSIDE ESTATES INC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | NO PERCENTAGE PROVIDED | since 07/18/2013 |
| COUNTRYSIDE HEALTH SERVICES LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | NO PERCENTAGE PROVIDED | since 07/01/1998 |
| COUNTRYSIDE ESTATES INC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 09/15/2025 |
| COUNTRYSIDE HEALTH SERVICES LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 09/15/2025 |
| REYNOLDS, RYAN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 12/03/2025 |
| ROGERS, JACE | ADP OF THE SNF | Individual | NOT APPLICABLE | since 06/15/2025 |
| ROGERS, JOHN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 09/01/2024 |
| ROGERS, JUSTIN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 09/01/2024 |
| ROGERS, JOHN | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 09/01/2024 |
| ROGERS, JUSTIN | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 11/27/2000 |
| ROGERS, JOHN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 09/01/2024 |
Medicare enrollment
As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of COUNTRYSIDE HEALTH SERVICES LLC (enrollment ID O20050802000619).
| Owner | Individual or organization | Role | Ownership percentage | Association date | Described in the filing as |
|---|---|---|---|---|---|
| COUNTRYSIDE ESTATES INC | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100 | 7/18/2013 | Private equity company: No Real estate investment trust: No Holding company: No |
| COUNTRYSIDE HEALTH SERVICES LLC | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100 | 7/1/1998 | Private equity company: No Real estate investment trust: No Holding company: No |
| JOHN E ROGERS | Individual | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 50 | 9/1/2024 | 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. |
| JUSTIN TODD ROGERS | Individual | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 50 | 9/1/2024 | 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. |
| COUNTRYSIDE ESTATES INC | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 9/15/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| COUNTRYSIDE HEALTH SERVICES 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. | 9/15/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| JACE CLARK ROGERS | 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. | 6/15/2025 | 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. |
| JOHN E ROGERS | 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. | 9/1/2024 | 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. |
| JUSTIN TODD ROGERS | 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. | 9/1/2024 | 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. |
| RYAN REYNOLDS | 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. | 12/3/2025 | 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. |
| JOHN E ROGERS | Individual | CORPORATE OFFICER | 50 | 9/1/2024 | 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. |
| JUSTIN TODD ROGERS | Individual | CORPORATE OFFICER | 25 | 11/27/2000 | 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. |
| JOHN E ROGERS | 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. | 9/1/2024 | 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: COUNTRYSIDE HEALTH SERVICES 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: COUNTRYSIDE HEALTH SERVICES LLC no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: COUNTRYSIDE HEALTH SERVICES 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: COUNTRYSIDE HEALTH SERVICES LLC appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 February 2026: JACK S ROGERS no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- 1 February 2026: JACK S ROGERS no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- 1 February 2026: JACK S ROGERS no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- 1 February 2026: RYAN REYNOLDS appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- 1 February 2026: JOHN E ROGERS appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- 1 February 2026: JOHN E ROGERS appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- 1 February 2026: COUNTRYSIDE ESTATES INC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- 1 February 2026: JUSTIN TODD ROGERS appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- 1 February 2026: JACE CLARK ROGERS appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- 1 February 2026: COUNTRYSIDE HEALTH SERVICES LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- 1 February 2026: COUNTRYSIDE HEALTH SERVICES LLC appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
Recent changes on this record
- 1 July 2026: COUNTRYSIDE HEALTH SERVICES 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: COUNTRYSIDE HEALTH SERVICES LLC no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: COUNTRYSIDE HEALTH SERVICES 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: COUNTRYSIDE HEALTH SERVICES LLC appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 6 May 2026: A cost report was filed for fiscal year 2025, on form CMS-2540-10. SNF10FY2024.zip
- 1 February 2026: JACK S ROGERS no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- 1 February 2026: JACK S ROGERS no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- 1 February 2026: JACK S ROGERS no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- 1 February 2026: RYAN REYNOLDS appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- 1 February 2026: JOHN E ROGERS appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- 1 February 2026: JOHN E ROGERS appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- 1 February 2026: COUNTRYSIDE ESTATES INC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- 1 February 2026: JUSTIN TODD ROGERS appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- 1 February 2026: JACE CLARK ROGERS appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- 1 February 2026: COUNTRYSIDE HEALTH SERVICES LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- 1 February 2026: COUNTRYSIDE HEALTH SERVICES LLC appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-02-01.csv
- 8 January 2026: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2023.zip
- 7 January 2025: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2022.zip
- 14 July 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2021.zip
- 28 February 2023: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2020.zip
- 20 October 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2019.zip
- 5 February 2021: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2018.zip
- 18 October 2019: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2017.zip
- 10 June 2019: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2016.zip
- 17 October 2017: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2015.zip
- 30 March 2016: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2013.zip
- 25 January 2016: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2014.zip
- 15 June 2015: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2012.zip
- 1 May 2014: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2011.zip
- 11 June 2013: A cost report was filed for fiscal year 2011, on form CMS-2540-96. SNFFY2010.zip
- 21 October 2011: A cost report was filed for fiscal year 2010, on form CMS-2540-96. SNFFY2009.zip
- 22 July 2010: A cost report was filed for fiscal year 2009, on form CMS-2540-96. SNFFY2008.zip
- 30 December 2008: A cost report was filed for fiscal year 2008, on form CMS-2540-96. SNFFY2007.zip
- 24 January 2008: A cost report was filed for fiscal year 2007, on form CMS-2540-96. SNFFY2006.zip
- 21 December 2006: A cost report was filed for fiscal year 2006, on form CMS-2540-96. SNFFY2005.zip
- 30 January 2006: A cost report was filed for fiscal year 2005, on form CMS-2540-96. SNFFY2004.zip
- 25 May 2005: A cost report was filed for fiscal year 2003, on form CMS-2540-96. SNFFY2002.zip
- 16 December 2004: A cost report was filed for fiscal year 2004, on form CMS-2540-96. SNFFY2003.zip
- 30 January 2004: A cost report was filed for fiscal year 2002, on form CMS-2540-96. SNFFY2001.zip
- 7 April 2003: A cost report was filed for fiscal year 2001, on form CMS-2540-96. SNFFY2000.zip
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | 9 January 2025 | 9 January 2025 | 4 | 0 |
| 2 | 27 October 2023 | 27 October 2023 | 7 | 2 |
| 3 | 7 February 2022 | 7 February 2022 | 3 | 3 |
From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.
Deficiencies cited
14 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| 9 January 2025 | Health | F 0578 | Resident Rights Deficiencies | Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | E | No | Deficient, Provider has date of correction | 11 February 2025 |
| 9 January 2025 | Health | F 0604 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment. | E | No | Deficient, Provider has date of correction | 11 February 2025 |
| 9 January 2025 | 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 | 11 February 2025 |
| 9 January 2025 | Health | F 0657 | Resident Assessment and Care Planning Deficiencies | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | No | Deficient, Provider has date of correction | 11 February 2025 |
| 27 October 2023 | Health | F 0626 | Resident Rights Deficiencies | Permit a resident to return to the nursing home after hospitalization or therapeutic leave that exceeds bed-hold policy. | D | Yes | Deficient, Provider has date of correction | 20 December 2023 |
| 27 October 2023 | 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 | 20 December 2023 |
| 27 October 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. | E | Yes | Deficient, Provider has date of correction | 20 December 2023 |
| 27 October 2023 | Health | F 0699 | Quality of Life and Care Deficiencies | Provide care or services that was trauma informed and/or culturally competent. | D | No | Deficient, Provider has date of correction | 20 December 2023 |
| 27 October 2023 | 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 | 20 December 2023 |
| 27 October 2023 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | E | No | Deficient, Provider has date of correction | 20 December 2023 |
| 27 October 2023 | Health | F 0909 | Environmental Deficiencies | Regularly inspect all bed frames, mattresses, and bed rails (if any) for safety; and all bed rails and mattresses must attach safely to the bed frame. | E | No | Deficient, Provider has date of correction | 20 December 2023 |
| 7 February 2022 | Health | F 0578 | Resident Rights Deficiencies | Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | E | No | Deficient, Provider has date of correction | 6 April 2022 |
| 7 February 2022 | 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 | 6 April 2022 |
| 7 February 2022 | Health | F 0677 | Quality of Life and Care Deficiencies | Provide care and assistance to perform activities of daily living for any resident who is unable. | E | No | Deficient, Provider has date of correction | 6 April 2022 |
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 |
|---|---|---|---|---|---|
| 23 October 2023 | Fine | $3,145 | 97894 |
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 - Limited Liability company |
| Legal Business Name | COUNTRYSIDE HEALTH SERVICES LLC |
| Date First Approved to Provide Medicare and Medicaid Services | 1998-07-01 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | N |
| County/Parish | Muskogee |
| Telephone Number | 9184635143 |
| 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 | 111 |
| Average Number of Residents per Day | 78.0 |
| Overall Rating | 3 |
| Health Inspection Rating | 4 |
| QM Rating | 2 |
| Long-Stay QM Rating | 1 |
| Short-Stay QM Rating | 3 |
| Processing Date | 2026-08-01 |
From the Care Compare Provider Information file NH_ProviderInfo_Aug2026.csv, processed on 1 August 2026.
Get an email when this record changes
One email a day naming what moved on COUNTRYSIDE ESTATES: the field, the value before, the value after, and the date of the file that first showed it.
The facility alert follows this one record: a cost report filed or a figure on one changed, an inspection, a deficiency or a penalty recorded, an owner added or removed. The certification number arrives filled in.
On 1 July 2026: COUNTRYSIDE HEALTH SERVICES LLC no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. That is one line of the alert.
What the alerts are, and what a day of them looks like, is on the alerts page.
Following a list of facilities? The portfolio watch follows up to 100 certification numbers you name, on one subscription — on the alerts page.
The citable document for COUNTRYSIDE ESTATES
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 Oklahoma 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 375341.