Facility record report · CMS certification number 415115
NANCY ANN CONVALESCENT HOME
FOSTER, Rhode Island
This certification number is not in CMS’s current Care Compare Provider Information file, processed on 1 August 2026.
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 2017 to 14 November 2017 — a reporting period of 317 days, on form CMS-2540-10, settled, processed by CMS on 29 May 2018.
None of these figures is carried on this report.
CMS report record 1190347, read from the public cost report file SNF10FY2017.zip.
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 15 August 2017.
None of these figures is carried on this report.
CMS report record 1173364, read from the public cost report file SNF10FY2016.zip.
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 11 August 2016.
None of these figures is carried on this report.
CMS report record 1140776, read from the public cost report file SNF10FY2015.zip.
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 10 August 2015.
None of these figures is carried on this report.
CMS report record 1107269, read from the public cost report file SNF10FY2014.zip.
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 8 August 2014.
None of these figures is carried on this report.
CMS report record 1075329, read from the public cost report file SNF10FY2013.zip.
Cost report for 1 January 2012 to 31 December 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 23 July 2013.
None of these figures is carried on this report.
CMS report record 1042475, read from the public cost report file SNF10FY2012.zip.
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 26 September 2012.
None of these figures is carried on this report.
CMS report record 1012270, read from the public cost report file SNF10FY2011.zip.
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 29 August 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,358,782 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,293,288 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $65,494 | CMS-2540-96 worksheet G300000 line 500 column 100 |
Net income, stated at moderate confidence: $65,494 (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 | 20 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 7,124 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 4 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 20.5 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 3,709 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 1,781 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 416406, read from the public cost report file SNFFY2010.zip.
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 31 August 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,263,057 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,265,056 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$1,999 | CMS-2540-96 worksheet G300000 line 500 column 100 |
Net income, stated at moderate confidence: −$1,999 (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 | 20 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 6,865 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 16 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 42 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 427.73 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 429.06 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 387090, read from the public cost report file SNFFY2009.zip.
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 25 July 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,257,805 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,216,873 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $40,932 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $800 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $41,732 (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 | 20 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 7,090 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 9 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 57 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 815.33 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 787.78 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 352672, read from the public cost report file SNFFY2008.zip.
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 20 August 2008.
None of these figures is carried on this report.
CMS report record 324636, read from the public cost report file SNFFY2007.zip.
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 20 September 2005.
None of these figures is carried on this report.
CMS report record 233251, read from the public cost report file SNFFY2004.zip.
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 22 January 2004.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $903,219 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $928,421 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$25,202 | CMS-2540-96 worksheet G300000 line 500 column 100 |
Net income, stated at moderate confidence: −$25,202 (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 | 20 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 7,229 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 5 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 18 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,564.5 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 1,445.8 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 167283, read from the public cost report file SNFFY2002.zip.
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 18 August 2003.
None of these figures is carried on this report.
CMS report record 157076, read from the public cost report file SNFFY2001.zip.
Cost report for 1 January 2000 to 31 December 2000 — a reporting period of 365 days, on form CMS-2540-96, as submitted, processed by CMS on 12 February 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $834,728 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $843,262 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$8,534 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $5,840 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$2,694 (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 | 20 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 7,197 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 6 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 25.5 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 2,220.5 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 1,199.5 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 117972, read from the public cost report file SNFFY2000.zip.
Cost report for 1 January 1997 to 31 December 1997 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 1 February 1999.
None of these figures is carried on this report.
CMS report record 58020, read from the public cost report file SNFFY1997.zip.
Five facilities of a similar size in Rhode Island, fiscal year 2017
No other facility in Rhode Island has a cost report on file for fiscal year 2017 with a bed count to set beside this one.
Ownership, as filed with CMS
Care Compare
Not yet extracted for this facility.
Medicare enrollment
Not yet extracted for this facility.
Changes in ownership
Not yet extracted for this facility.
Inspections
Not yet extracted for this facility.
Deficiencies cited
Not yet extracted for this facility.
Penalties
Not yet extracted for this facility.
Care Compare provider information
Not yet extracted for this facility.
Every change on this record
- 29 May 2018: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2017.zip
- 15 August 2017: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2016.zip
- 11 August 2016: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2015.zip
- 10 August 2015: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2014.zip
- 8 August 2014: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2013.zip
- 23 July 2013: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2012.zip
- 26 September 2012: A cost report was filed for fiscal year 2011, on form CMS-2540-10. SNF10FY2011.zip
- 29 August 2011: A cost report was filed for fiscal year 2010, on form CMS-2540-96. SNFFY2010.zip
- 31 August 2010: A cost report was filed for fiscal year 2009, on form CMS-2540-96. SNFFY2009.zip
- 25 July 2009: A cost report was filed for fiscal year 2008, on form CMS-2540-96. SNFFY2008.zip
- 20 August 2008: A cost report was filed for fiscal year 2007, on form CMS-2540-96. SNFFY2007.zip
- 20 September 2005: A cost report was filed for fiscal year 2004, on form CMS-2540-96. SNFFY2004.zip
- 22 January 2004: A cost report was filed for fiscal year 2002, on form CMS-2540-96. SNFFY2002.zip
- 18 August 2003: A cost report was filed for fiscal year 2001, on form CMS-2540-96. SNFFY2001.zip
- 12 February 2003: A cost report was filed for fiscal year 2000, on form CMS-2540-96. SNFFY2000.zip
- 1 February 1999: A cost report was filed for fiscal year 1997, on form CMS-2540-96. SNFFY1997.zip
How to read this report
Every figure is printed as the CMS file it came from printed it. Each cost-report figure carries the worksheet, line and column of form CMS-2540 it was read from, so a reader holding the same public file can go to that cell; each Care Compare and Medicare enrollment section names its file and the date CMS stamped on it.
A figure the filing does not carry is left out, and so is a figure whose value the filing’s own arithmetic contradicts. Net income is printed with what the form’s own arithmetic shows about it — plainly where it follows from the lines above it, and, where it does not, beside what the form’s own lines leave unaccounted for. An ownership field left empty carries the dated sentence on CMS’s pause of the expanded Form CMS-855A disclosure. A source that holds nothing for this facility says so in its section.
This report carries no percentile and no score, and it does not place this facility above or below another. The five facilities above are the one comparison it draws: the nearest certified bed counts in the same state at the same fiscal year, listed by name. Nurse staffing is printed in its own section, on its own page, apart from the cost-report figures.
How to cite this report
Velarion Records, NANCY ANN CONVALESCENT HOME — facility record report, CMS certification number 415115. https://velarionrecords.com/facility/415115/report.
- Cost report figures: CMS Healthcare Cost Report Information System, form CMS-2540-10, publication year 2017, file
SNF10FY2017.zip. - Provider information, inspections, deficiencies and penalties: CMS Care Compare, file dated 1 August 2026.
- Care Compare ownership: CMS file dated 1 August 2026.
- Medicare enrollment ownership: CMS file dated 1 August 2026.
- Nurse staffing: CMS Payroll-Based Journal, quarters 2017Q1 to 2017Q3.
Published by VELARIONAI LLC · Andrew Richardson, founder. Corrections: hello@velarionrecords.com, quoting certification number 415115. Velarion Records publishes these records as filed.
Nurse staffing, quarter by quarter
Hours this facility reported to CMS’s Payroll-Based Journal, one row per quarter, oldest first, each with how its figures are derived and the file it came from.
| Quarter | Quarter ended | Days reported | Resident days | Registered nurse hours | Licensed practical nurse hours | Nurse aide hours | Total nurse hours |
|---|---|---|---|---|---|---|---|
| 2017Q1 | 31 March 2017 | 90 | 1,725 | 2,363 | 0 | 4,166.25 | 6,529.25 |
| 2017Q2 | 30 June 2017 | 91 | 1,669 | 2,466.75 | 0 | 4,178.75 | 6,645.5 |
| 2017Q3 | 30 September 2017 | 92 | 683 | 1,141.75 | 0 | 1,768.5 | 2,910.25 |
| Quarter | Registered nurse hours per resident day | Licensed practical nurse hours per resident day | Nurse aide hours per resident day | Total nurse hours per resident day |
|---|---|---|---|---|
| 2017Q1 | 1.369855 | 0 | 2.415217 | 3.785072 |
| 2017Q2 | 1.477981 | 0 | 2.503745 | 3.981726 |
| 2017Q3 | 1.671669 | 0 | 2.589312 | 4.260981 |
How each quarter is derived, and its file
- 2017Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2017-03-31.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. This file names the totals hrs_rn_donadmin, hrs_lpn_admin, hrs_na_trn; they are read as hrs_rndon, hrs_lpnadmin, hrs_natrn.
Payroll_Based_Journal_Daily_Nurse_Staffing_:_2017-03-31.csv - 2017Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2017-06-30.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. This file names the totals hrs_lpn_admin; they are read as hrs_lpnadmin. CMS's file labels its last six hours columns hrs_medaide, hrs_medaide_emp, hrs_rn_donadmin, hrs_na_trn, hrs_natrn_emp, hrs_natrn_ctr; they are read by position as Hrs_MedAide_emp, Hrs_MedAide_ctr, Hrs_NAtrn, Hrs_NAtrn_emp, Hrs_NAtrn_ctr, Hrs_MedAide, the order in which each total equals its employee and contract parts on every row.
Payroll_Based_Journal_Daily_Nurse_Staffing_:_2017-06-30.csv - 2017Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2017-09-30.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. This file names the totals hrs_lpn_admin, hrs_na_trn; they are read as hrs_lpnadmin, hrs_natrn.
Payroll_Based_Journal_Daily_Nurse_Staffing_:_2017-09-30.csv