Facility record report · CMS certification number 445332
MITCHELL MANOR INC.
LEBANON, Tennessee
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 2005 to 31 December 2005 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 4 June 2007.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,172,055 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,937,161 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | $234,894 | CMS-2540-96 worksheet G300000 line 500 column 100 |
Net income, stated at moderate confidence: $234,894 (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 |
| Bed days available, all components | 15,330 | CMS-2540-96 worksheet S300001 line 900 column 200 |
| Medicare (Title XVIII) patient days | 637 | CMS-2540-96 worksheet S300001 line 900 column 400 |
| Medicaid (Title XIX) patient days | 11,801 | CMS-2540-96 worksheet S300001 line 900 column 500 |
| Other-payer patient days | 1,216 | CMS-2540-96 worksheet S300001 line 900 column 600 |
| Total patient days, all components | 13,654 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Medicare discharges | 16 | CMS-2540-96 worksheet S300001 line 900 column 900 |
| Total discharges, all components | 16 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 39.81 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 853.38 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 280709, read from the public cost report file SNFFY2005.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 30 August 2005.
None of these figures is carried on this report.
CMS report record 231963, read from the public cost report file SNFFY2004.zip.
Cost report for 1 January 2003 to 31 December 2003 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 16 December 2004.
None of these figures is carried on this report.
CMS report record 202665, read from the public cost report file SNFFY2003.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 28 October 2003.
None of these figures is carried on this report.
CMS report record 162173, read from the public cost report file SNFFY2002.zip.
Cost report for 1 February 2000 to 31 December 2000 — a reporting period of 334 days, on form CMS-2540-96, settled, processed by CMS on 1 October 2001.
None of these figures is carried on this report.
CMS report record 62476, read from the public cost report file SNFFY2000.zip.
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 6 January 2000.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,164,827 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,335,642 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$170,815 | CMS-2540-96 worksheet G300000 line 500 column 100 |
Net income, stated at moderate confidence: −$170,815 (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 | 14,871 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 49 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 53.42 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,936 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 303.49 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 62473, read from the public cost report file SNFFY1998.zip.
Cost report for 1 July 1996 to 30 June 1997 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 18 May 1999.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,287,429 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,150,384 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | $137,045 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $8,703 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $145,748 (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 | 15,167 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 13 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 51.2 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 1,166.69 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 62470, read from the public cost report file SNFFY1996.zip.
Cost report for 1 July 1995 to 30 June 1996 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 7 October 1998.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,186,936 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,091,850 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | $95,086 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $7,396 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $102,482 (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 | 16,495 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 37 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 23.32 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 445.81 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 62468, read from the public cost report file SNFFY1995.zip.
Five facilities of a similar size in Tennessee, fiscal year 2005
Chosen for having certified bed counts closest to this facility’s, listed by name. Every one filed for the same fiscal year; the day each year ends differs and is shown. Each figure is that facility’s own filing.
| Facility | Total facility beds | Total patient days | Net patient revenue | Total operating expenses | Net income from service to patients | Period ended |
|---|---|---|---|---|---|---|
| AHF CENTRAL STATES BELCOURT TERRACE | 49 | 15,459 | $2,647,724 | $2,664,376 | −$16,652 | 31 December 2005 |
| ARBOR PLACE OF PURYEAR | 25 | 8,214 | $1,057,888 | $984,065 | $73,823 | 31 December 2005 |
| MITCHELL MANOR INC. | 42 | 13,654 | $2,172,055 | $1,937,161 | $234,894 | 31 December 2005 |
| OAKWOOD COMMUNITY LIVING CENTER | 50 | 11,341 | $1,786,906 | $1,823,929 | −$37,023 | 31 December 2005 |
| PRESBYTERIAN HOMES OF TN | 44 | 11,688 | $2,608,431 | $2,640,673 | −$32,242 | 31 December 2005 |
| WOODCREST AT THE BLAKEFORD | 40 | 13,747 | $8,980,265 | $9,955,599 | −$975,334 | 31 December 2005 |
Where each column comes from, on every filing in this table: Total facility beds: CMS-2540-96 worksheet S300001 line 900 column 100 · Total patient days: CMS-2540-96 worksheet S300001 line 900 column 700 · Net patient revenue: CMS-2540-96 worksheet G300000 line 300 column 100 · Total operating expenses: CMS-2540-96 worksheet G200002 line 1500 column 100 · Net income from service to patients: CMS-2540-96 worksheet G300000 line 500 column 100.
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
- 4 June 2007: A cost report was filed for fiscal year 2005, on form CMS-2540-96. SNFFY2005.zip
- 30 August 2005: A cost report was filed for fiscal year 2004, on form CMS-2540-96. SNFFY2004.zip
- 16 December 2004: A cost report was filed for fiscal year 2003, on form CMS-2540-96. SNFFY2003.zip
- 28 October 2003: A cost report was filed for fiscal year 2002, on form CMS-2540-96. SNFFY2002.zip
- 1 October 2001: A cost report was filed for fiscal year 2000, on form CMS-2540-96. SNFFY2000.zip
- 21 November 2000: A cost report was filed for fiscal year 2000, on form CMS-2540-96. SNFFY1999.zip
- 6 January 2000: A cost report was filed for fiscal year 1998, on form CMS-2540-96. SNFFY1998.zip
- 18 May 1999: A cost report was filed for fiscal year 1997, on form CMS-2540-96. SNFFY1996.zip
- 7 October 1998: A cost report was filed for fiscal year 1996, on form CMS-2540-96. SNFFY1995.zip
- 31 August 1998: 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, MITCHELL MANOR INC. — facility record report, CMS certification number 445332. https://velarionrecords.com/facility/445332/report.
- Cost report figures: CMS Healthcare Cost Report Information System, form CMS-2540-96, publication year 2005, file
SNFFY2005.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.
Published by VELARIONAI LLC · Andrew Richardson, founder. Corrections: hello@velarionrecords.com, quoting certification number 445332. 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.
Not yet extracted for this facility.