Skilled nursing facility · CMS certification number 435058
AVANTARA CLARK CITY
CLARK, South Dakota · Medicare and Medicaid
Certified beds, as filed in Care Compare: 35
Finances, as filed
From this facility’s Medicare cost reports on form CMS-2540, each figure with the worksheet, line and column it was read from.
Cost report for 1 January 2024 to 31 December 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 11 September 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,066,028 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,091,055 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,974,973 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,644,837 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $330,136 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $15,227 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $345,363 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $345,363 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 38 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 13,908 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 1,800 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 5,881 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 3,549 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 11,230 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 32 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 25 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 28 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 85 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 56.25 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 235.24 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 132.12 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1439151, read from the public cost report file SNF10FY2024.zip.
Fiscal year 2023, ended 31 December 2023
Cost report for 1 January 2023 to 31 December 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 17 September 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,951,228 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,417,653 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,533,575 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,180,175 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $353,400 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $5,310 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $358,710 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $358,710 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 38 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 11,018 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 96 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 53.1 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 171.22 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 114.77 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1395031, read from the public cost report file SNF10FY2023.zip.
Fiscal year 2022, ended 31 December 2022
Cost report for 1 January 2022 to 31 December 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 28 August 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,795,941 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,511,786 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,284,155 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,864,898 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $419,257 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $7,309 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $426,566 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $426,566 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 38 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 10,778 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 80 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 82.71 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 161.18 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 134.73 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1363356, read from the public cost report file SNF10FY2022.zip.
Fiscal year 2021, ended 31 December 2021
Cost report for 1 January 2021 to 31 December 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 20 September 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,225,255 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,644,861 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,580,394 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,635,200 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$54,806 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $463,661 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $408,855 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $408,855 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 38 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 10,808 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 75 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 77.84 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 226.59 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 144.11 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1333184, read from the public cost report file SNF10FY2021.zip.
Fiscal year 2020, ended 31 December 2020
Cost report for 1 January 2020 to 31 December 2020 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 24 November 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,710,728 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $2,281,195 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,429,533 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,528,535 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$99,002 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $604,531 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $505,529 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $505,529 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 38 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 10,489 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 75 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 79.75 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 213.31 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 139.85 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1305413, read from the public cost report file SNF10FY2020.zip.
Fiscal year 2019, ended 31 December 2019
Cost report for 1 July 2019 to 31 December 2019 — a reporting period of 183 days, not a full year, on form CMS-2540-10, settled, processed by CMS on 15 January 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,252,952 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,139,113 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $1,113,839 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,227,465 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$113,626 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | −$113,626 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$113,626 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 38 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 5,987 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 35 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 48 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 343.64 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 171.06 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1278193, read from the public cost report file SNF10FY2019.zip.
Fiscal year 2018, ended 31 December 2018
Cost report for 1 January 2018 to 31 December 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 21 August 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,347,254 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $633,293 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $1,713,961 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,161,445 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$447,484 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $170,803 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$276,681 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$276,681 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 38 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 9,573 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 55 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 59.75 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 174.05 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1241633, read from the public cost report file SNF10FY2018.zip.
Fiscal year 2017, ended 31 December 2017
Cost report for 1 January 2017 to 31 December 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 21 August 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,940,031 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $763,687 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,176,344 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,604,907 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$428,563 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,969 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$426,594 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$426,594 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 38 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 12,457 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 57 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 39.65 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 800.89 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 218.54 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1208786, read from the public cost report file SNF10FY2017.zip.
Fiscal year 2016, ended 31 December 2016
Cost report for 1 January 2016 to 31 December 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 7 August 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,066,162 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $871,439 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,194,723 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,775,795 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$581,072 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $14,546 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$566,526 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$566,526 (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 | 43 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 12,101 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 78 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 61.72 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 155.14 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1172175, read from the public cost report file SNF10FY2016.zip.
Fiscal year 2015, ended 31 December 2015
Cost report for 1 January 2015 to 31 December 2015 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 17 August 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,326,747 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $975,860 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,350,887 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,796,598 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$445,711 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $7,337 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$438,374 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$438,374 (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 | 43 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 12,523 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 80 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 49.34 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 156.54 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1141626, read from the public cost report file SNF10FY2015.zip.
Fiscal year 2014, ended 31 December 2014
Cost report for 1 January 2014 to 31 December 2014 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 19 May 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,374,923 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,033,799 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,341,124 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,633,252 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$292,128 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $12,340 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$279,788 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$279,788 (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 | 43 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 12,859 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 87 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 42.28 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 147.8 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1124076, read from the public cost report file SNF10FY2014.zip.
Fiscal year 2013, ended 31 December 2013
Cost report for 1 January 2013 to 31 December 2013 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 10 June 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,464,772 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,086,167 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,378,605 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,544,740 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$166,135 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $18,448 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$147,687 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$147,687 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 43 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 12,969 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 104 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 48.36 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 124.7 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1095163, read from the public cost report file SNF10FY2013.zip.
Fiscal year 2012, ended 31 December 2012
Cost report for 1 January 2012 to 31 December 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 1 August 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,491,928 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,000,198 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,491,730 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,474,089 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $17,641 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $4,543 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $22,184 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $22,184 (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 | 45 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 13,705 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 80 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 47.56 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 171.31 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1044870, read from the public cost report file SNF10FY2012.zip.
Fiscal year 2011, ended 31 December 2011
Cost report for 1 January 2011 to 31 December 2011 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 30 April 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $3,619,821 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $955,336 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,664,485 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,432,114 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $232,371 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $30,842 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $263,213 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $263,213 (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 | 45 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 14,135 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 64 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 87.3 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 220.86 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1028278, read from the public cost report file SNF10FY2011.zip.
Fiscal year 2010, ended 31 December 2010
Cost report for 1 January 2010 to 31 December 2010 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 18 January 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,353,639 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,250,629 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $103,010 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $13,008 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $116,018 (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 | 45 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 12,771 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 93 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 47.65 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 137.32 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 422908, read from the public cost report file SNFFY2010.zip.
Fiscal year 2009, ended 31 December 2009
Cost report for 1 January 2009 to 31 December 2009 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 20 April 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,365,219 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,328,049 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $37,170 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $26,646 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $63,816 (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 | 45 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 13,990 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 78 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 49.16 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 179.36 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 397649, read from the public cost report file SNFFY2009.zip.
Fiscal year 2008, ended 31 December 2008
Cost report for 1 January 2008 to 31 December 2008 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 27 May 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,352,088 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,203,729 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $148,359 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $3,926 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $152,285 (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 | 42 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 14,350 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 69 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 28.75 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 207.97 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 371020, read from the public cost report file SNFFY2008.zip.
Fiscal year 2007, ended 31 December 2007
Cost report for 1 January 2007 to 31 December 2007 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 29 May 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,183,507 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,960,405 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $223,102 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $20,791 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $243,893 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 42 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 14,155 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 75 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 50.21 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 188.73 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 341091, read from the public cost report file SNFFY2007.zip.
Fiscal year 2006, ended 31 December 2006
Cost report for 1 April 2006 to 31 December 2006 — a reporting period of 274 days, not a full year, on form CMS-2540-96, settled, processed by CMS on 28 May 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,484,057 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,433,948 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $50,109 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $821 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $50,930 (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 | 43 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 10,695 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 55 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 34.34 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 194.45 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 310141, read from the public cost report file SNFFY2006.zip.
Fiscal year 2005, ended 31 December 2005
Cost report for 1 January 2005 to 31 December 2005 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 12 December 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,000,726 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,714,569 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | $286,157 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | −$2,296 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $283,861 (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 | 43 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 14,534 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 78 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 38.65 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 186.33 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 268529, read from the public cost report file SNFFY2005.zip.
Fiscal year 2004, ended 31 December 2004
Cost report for 1 January 2004 to 31 December 2004 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 20 March 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,884,664 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,635,158 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | $249,506 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | −$1,578 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $247,928 (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 | 43 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 14,775 | 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 | 41.87 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 289.71 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 245560, read from the public cost report file SNFFY2004.zip.
Fiscal year 2003, ended 31 December 2003
Cost report for 1 January 2003 to 31 December 2003 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 18 March 2005.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,763,764 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,500,537 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | $263,227 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $6,104 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $269,331 (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 | 43 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 14,609 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 64 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 31.13 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 228.27 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 211668, read from the public cost report file SNFFY2003.zip.
Fiscal year 2002, ended 31 December 2002
Cost report for 1 January 2002 to 31 December 2002 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 17 March 2005.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,630,533 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,390,353 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | $240,180 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | −$6,185 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $233,995 (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 | 43 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 12,872 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 69 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 42.31 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 186.55 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 211496, read from the public cost report file SNFFY2002.zip.
Fiscal year 2001, ended 31 December 2001
Cost report for 1 January 2001 to 31 December 2001 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 9 September 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,536,662 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,348,532 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | $188,130 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $6,987 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $195,117 (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 | 45 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 12,748 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 72 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 37.84 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 177.06 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 158988, read from the public cost report file SNFFY2001.zip.
Fiscal year 2000, ended 31 December 2000
Cost report for 1 January 2000 to 31 December 2000 — a reporting period of 365 days, on form CMS-2540-96, as submitted, processed by CMS on 30 July 2001.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,399,325 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,342,730 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | $56,595 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $3,678 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $60,273 (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 | 45 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 12,262 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 60 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 45.91 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 204.37 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 74643, read from the public cost report file SNFFY2000.zip.
Fiscal year 1999, ended 31 December 1999
Cost report for 1 January 1999 to 31 December 1999 — a reporting period of 364 days, on form CMS-2540-96, as submitted, processed by CMS on 3 August 2000.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,339,571 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,343,704 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$4,133 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $2,175 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$1,958 (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 | 45 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 13,650 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 54 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 37.39 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 252.78 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 6937, read from the public cost report file SNFFY1999.zip.
Fiscal year 1998, ended 31 December 1998
Cost report for 1 January 1998 to 31 December 1998 — a reporting period of 364 days, on form CMS-2540-96, as submitted, processed by CMS on 15 February 2000.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,524,542 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,413,697 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | $110,845 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $1,156 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $112,001 (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 | 45 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 15,943 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 45 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 58.28 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 354.29 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 6936, read from the public cost report file SNFFY1998.zip.
Fiscal year 1997, ended 31 December 1997
Cost report for 1 January 1997 to 31 December 1997 — a reporting period of 364 days, on form CMS-2540-96, as submitted, processed by CMS on 16 December 1998.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,349,760 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,331,043 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | $18,717 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $99,199 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $117,916 (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 | 45 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 14,795 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 44 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 90.8 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 336.25 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 6935, read from the public cost report file SNFFY1997.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 |
|---|---|---|---|---|
| DOROS GENERATION TRUST U/A/D 1/3/12 | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | 43% | since 07/01/2019 |
| GPN FAMILY TRUST U/A/D 4/28/08 | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | 43% | since 07/01/2019 |
| OAKWAY OPERATIONS LLC | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | 15% | since 07/01/2015 |
| BOKF,NA | 5% OR GREATER SECURITY INTEREST | Organization | NOT APPLICABLE | since 03/04/2024 |
| CLARK CITY SD PROPERTY HOLDINGS, LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 07/01/2019 |
| DICKES, EDWARD | ADP OF THE SNF | Individual | NOT APPLICABLE | since 01/01/2025 |
| DOROS GENERATION TRUST U/A/D 1/3/12 | ADP OF THE SNF | Organization | NOT APPLICABLE | since 07/01/2019 |
| GPN FAMILY TRUST U/A/D 4/28/08 | ADP OF THE SNF | Organization | NOT APPLICABLE | since 07/01/2019 |
| LEGACY HEALTHCARE FINANCIAL SERVICES LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 07/01/2019 |
| MOREHOUSE, RACHEL | ADP OF THE SNF | Individual | NOT APPLICABLE | since 01/06/2020 |
| RAJCHENBACH, CHAIM | ADP OF THE SNF | Individual | NOT APPLICABLE | since 07/01/2019 |
| ROTH & CO, LLP | ADP OF THE SNF | Organization | NOT APPLICABLE | since 01/01/2024 |
| SHABAT, MENACHEM | ADP OF THE SNF | Individual | NOT APPLICABLE | since 07/01/2019 |
| RAJCHENBACH, CHAIM | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 07/01/2019 |
| SHABAT, MENACHEM | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 07/01/2019 |
| BOKF,NA | OPERATIONAL/MANAGERIAL CONTROL | Organization | NOT APPLICABLE | since 03/04/2024 |
| DICKES, EDWARD | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 01/01/2025 |
| MOREHOUSE, RACHEL | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 01/06/2020 |
| RAJCHENBACH, CHAIM | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 07/01/2019 |
| SHABAT, MENACHEM | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 07/01/2019 |
Medicare enrollment
As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of CLARK CITY SD SKILLED NURSING FACILITY LLC (enrollment ID O20190826001446).
| Owner | Individual or organization | Role | Ownership percentage | Association date | Described in the filing as |
|---|---|---|---|---|---|
| DOROS GENERATION TRUST U/A/D 1/3/12 | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 42.5 | 7/1/2019 | Private equity company: No Real estate investment trust: No Holding company: No |
| GPN FAMILY TRUST U/A/D 4/28/08 | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 42.5 | 7/1/2019 | Private equity company: No Real estate investment trust: No Holding company: No |
| OAKWAY OPERATIONS LLC | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 15 | 7/1/2015 | Private equity company: No Real estate investment trust: No Holding company: No |
| BOKF,NA | Organization | 5% OR GREATER SECURITY INTEREST | 100 | 3/4/2024 | Private equity company: No Real estate investment trust: No Holding company: No |
| CHAIM RAJCHENBACH | 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. | 7/1/2019 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| CLARK CITY SD PROPERTY HOLDINGS, 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. | 7/1/2019 | Private equity company: No Real estate investment trust: No Holding company: No |
| DOROS GENERATION TRUST U/A/D 1/3/12 | 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. | 7/1/2019 | Private equity company: No Real estate investment trust: No Holding company: No |
| EDWARD A DICKES | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2025 | 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. |
| GPN FAMILY TRUST U/A/D 4/28/08 | 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. | 7/1/2019 | Private equity company: No Real estate investment trust: No Holding company: No |
| LEGACY HEALTHCARE FINANCIAL 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. | 7/1/2019 | Private equity company: No Real estate investment trust: No Holding company: No |
| MENACHEM SHABAT | 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. | 7/1/2019 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| RACHEL MOREHOUSE | Individual | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/6/2020 | 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. |
| ROTH & CO, LLP | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2024 | Private equity company: No Real estate investment trust: No Holding company: No |
| CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | Individual | INDIRECT OWNERSHIP INTEREST | 4.9 | 7/1/2019 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | Individual | INDIRECT OWNERSHIP INTEREST | 2.6 | 7/1/2019 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | Individual | INDIRECT OWNERSHIP INTEREST | 4.9 | 7/1/2019 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | Individual | INDIRECT OWNERSHIP INTEREST | 2.6 | 7/1/2019 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| CHAIM RAJCHENBACH | Individual | MANAGING CONTROL - GOVERNING BODY | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 7/1/2019 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| MENACHEM SHABAT | Individual | MANAGING CONTROL - GOVERNING BODY | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 7/1/2019 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| BOKF,NA | Organization | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 3/4/2024 | Private equity company: No Real estate investment trust: No Holding company: No |
| CHAIM RAJCHENBACH | 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. | 7/1/2019 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| EDWARD A DICKES | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/1/2025 | 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. |
| MENACHEM SHABAT | 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. | 7/1/2019 | Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. |
| RACHEL MOREHOUSE | Individual | OPERATIONAL/MANAGERIAL CONTROL | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 1/6/2020 | 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: CIBC BANK USA no longer appears as 5% OR GREATER SECURITY INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: LEGACY HEALTHCARE FINANCIAL SERVICES LLC no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: CHAIM Z RAJCHENBACH no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: MENACHEM SHABAT no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: TIFFANY SCHLOMER no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: EDWARD A DICKES appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: EDWARD A DICKES appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: RACHEL MOREHOUSE appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: RACHEL MOREHOUSE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: DOROS GENERATION TRUST U/A/D 1/3/12 appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: BOKF,NA appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: BOKF,NA appears as 5% OR GREATER SECURITY INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: OAKWAY OPERATIONS 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 July 2026: LEGACY HEALTHCARE FINANCIAL 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: GPN FAMILY TRUST U/A/D 4/28/08 appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: CHAIM RAJCHENBACH appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: CHAIM RAJCHENBACH appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: CHAIM RAJCHENBACH appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: ROTH & CO, LLP appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: MENACHEM SHABAT appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: MENACHEM SHABAT appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: MENACHEM SHABAT appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: A listing under INDIRECT OWNERSHIP INTEREST appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: CLARK CITY SD PROPERTY HOLDINGS, LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
Recent changes on this record
- 1 July 2026: CIBC BANK USA no longer appears as 5% OR GREATER SECURITY INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: LEGACY HEALTHCARE FINANCIAL SERVICES LLC no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: CHAIM Z RAJCHENBACH no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: MENACHEM SHABAT no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: TIFFANY SCHLOMER no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: EDWARD A DICKES appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: EDWARD A DICKES appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: RACHEL MOREHOUSE appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: RACHEL MOREHOUSE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: DOROS GENERATION TRUST U/A/D 1/3/12 appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: BOKF,NA appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: BOKF,NA appears as 5% OR GREATER SECURITY INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: OAKWAY OPERATIONS 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 July 2026: LEGACY HEALTHCARE FINANCIAL 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: GPN FAMILY TRUST U/A/D 4/28/08 appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: CHAIM RAJCHENBACH appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: CHAIM RAJCHENBACH appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: CHAIM RAJCHENBACH appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: ROTH & CO, LLP appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: MENACHEM SHABAT appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: MENACHEM SHABAT appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: MENACHEM SHABAT appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: A listing under INDIRECT OWNERSHIP INTEREST appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: CLARK CITY SD PROPERTY HOLDINGS, LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 11 September 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- 17 September 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
- 28 August 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
- 20 September 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
- 24 November 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
- 15 January 2021: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
- 13 February 2020: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
- 21 August 2019: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2018.zip
- 21 August 2018: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2017.zip
- 7 August 2017: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2016.zip
- 17 August 2016: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2015.zip
- 19 May 2016: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2014.zip
- 10 June 2015: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2013.zip
- 1 August 2013: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2012.zip
- 30 April 2013: A cost report was filed for fiscal year 2011, on form CMS-2540-10. SNF10FY2011.zip
- 18 January 2012: A cost report was filed for fiscal year 2010, on form CMS-2540-96. SNFFY2010.zip
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | 8 January 2026 | 8 January 2026 | 3 | 4 |
| 2 | 12 September 2024 | 12 September 2024 | 2 | 0 |
| 3 | 15 June 2023 | 15 June 2023 | 2 | 7 |
From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.
Deficiencies cited
7 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| 8 January 2026 | Health | F 0609 | Freedom from Abuse, Neglect, and Exploitation Deficiencies | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | No | Deficient, Provider has date of correction | 22 February 2026 |
| 8 January 2026 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | E | Yes | Deficient, Provider has date of correction | 22 February 2026 |
| 8 January 2026 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | E | No | Deficient, Provider has date of correction | 22 February 2026 |
| 17 July 2025 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Yes | Past Non-Compliance | |
| 12 September 2024 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | No | Deficient, Provider has date of correction | 6 October 2024 |
| 15 June 2023 | 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. | E | No | Deficient, Provider has date of correction | 30 July 2023 |
| 15 June 2023 | Health | F 0700 | Quality of Life and Care Deficiencies | Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail. | E | No | Deficient, Provider has date of correction | 30 July 2023 |
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 |
|---|---|---|---|---|---|
| 12 September 2024 | Fine | $11,057 | 100235 |
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 | CLARK CITY SD SKILLED NURSING FACILITY LLC |
| Date First Approved to Provide Medicare and Medicaid Services | 1991-05-01 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | N |
| County/Parish | Clark |
| Telephone Number | 6055323431 |
| Chain Name | LEGACY HEALTHCARE |
| Chain ID | 306 |
| Provider Changed Ownership in Last 12 Months | N |
| With a Resident and Family Council | Both |
| Automatic Sprinkler Systems in All Required Areas | Yes |
| Number of Certified Beds | 35 |
| Average Number of Residents per Day | 29.3 |
| Overall Rating | 4 |
| Health Inspection Rating | 4 |
| QM Rating | 2 |
| Long-Stay QM Rating | 2 |
| Short-Stay QM Rating | 2 |
| 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 AVANTARA CLARK CITY: 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: CIBC BANK USA no longer appears as 5% OR GREATER SECURITY INTEREST in the Medicare enrollment ownership file. That is one line of the alert.
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The citable document for AVANTARA CLARK CITY
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 South Dakota 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 435058.