Skilled nursing facility · CMS certification number 515196

NELLA'S AT AUTUMN LAKE HEALTHCARE

ELKINS, West Virginia · Medicare and Medicaid

Certified beds, as filed in Care Compare: 100

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, as submitted, processed by CMS on 23 June 2025.

Revenue and expenses, fiscal year 2024
Figure	As filed	Where it comes from
Total patient revenue	$10,908,744	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$332,654	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$10,576,090	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$11,243,759	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$667,669	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$1,051,979	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$384,310	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $384,310 (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%).

Beds, days and discharges, fiscal year 2024
Figure	As filed	Where it comes from
Total facility beds, all components	100	CMS-2540-10 worksheet S300001 line 800 column 100
Bed days available, all components	36,600	CMS-2540-10 worksheet S300001 line 800 column 200
Medicare (Title XVIII) patient days	1,756	CMS-2540-10 worksheet S300001 line 800 column 400
Medicaid (Title XIX) patient days	26,820	CMS-2540-10 worksheet S300001 line 800 column 500
Other-payer patient days	3,961	CMS-2540-10 worksheet S300001 line 800 column 600
Total patient days, all components	32,537	CMS-2540-10 worksheet S300001 line 800 column 700
Medicare discharges	29	CMS-2540-10 worksheet S300001 line 800 column 900
Medicaid discharges	91	CMS-2540-10 worksheet S300001 line 800 column 1000
Other-payer discharges	68	CMS-2540-10 worksheet S300001 line 800 column 1100
Total discharges, all components	188	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	60.55	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	294.73	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	173.07	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1432226, 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 28 August 2025.

Revenue and expenses, fiscal year 2023
Figure	As filed	Where it comes from
Total patient revenue	$9,734,022	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$328,349	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$9,405,673	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$10,855,956	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$1,450,283	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$1,725,040	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$274,757	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $274,757 (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%).

Beds, days and discharges, fiscal year 2023
Figure	As filed	Where it comes from
Total facility beds, all components	100	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	27,166	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	115	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	86.59	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	420.23	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	236.23	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1435754, read from the public cost report file SNF10FY2023.zip.

Fiscal year 2022, ended 31 December 2022

Cost report for 23 December 2021 to 31 December 2022 — a reporting period of 373 days, on form CMS-2540-10, settled, processed by CMS on 12 September 2024.

Revenue and expenses, fiscal year 2022
Figure	As filed	Where it comes from
Total patient revenue	$8,483,505	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$340,404	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$8,143,101	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$9,113,492	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$970,391	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$649,004	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$321,387	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$321,387 (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%).

Beds, days and discharges, fiscal year 2022
Figure	As filed	Where it comes from
Total facility beds, all components	100	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	24,135	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	113	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	69.82	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	369.02	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	213.58	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1394658, read from the public cost report file SNF10FY2022.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.

The staffing record →

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
NELLAS OPCO HOLDCO LLC	5% OR GREATER DIRECT OWNERSHIP INTEREST	Organization	100%	since 06/01/2021
A & R STERN FAMILY WV HOLDINGS LLC	5% OR GREATER INDIRECT OWNERSHIP INTEREST	Organization	99%	since 06/01/2021
A & R STERN FAMILY WV HOLDINGS LLC	ADP OF THE SNF	Organization	NOT APPLICABLE	since 06/01/2021
A STERN FAMILY TRUST WV	ADP OF THE SNF	Organization	NOT APPLICABLE	since 06/01/2021
ACCURATE STAFFING LLC	ADP OF THE SNF	Organization	NOT APPLICABLE	since 06/01/2021
BOLYARD, JONTHAN	ADP OF THE SNF	Individual	NOT APPLICABLE	since 12/06/2021
BRAND SONNENSCHINE LLP	ADP OF THE SNF	Organization	NOT APPLICABLE	since 06/01/2021
CHUA, CATHERINE	ADP OF THE SNF	Individual	NOT APPLICABLE	since 02/01/2024
R STERN FAMILY TRUST	ADP OF THE SNF	Organization	NOT APPLICABLE	since 06/01/2021
STERN, ARYEH	ADP OF THE SNF	Individual	NOT APPLICABLE	since 06/01/2021
STERN, ARYEH	INDIRECT OWNERSHIP INTEREST	Individual	NOT APPLICABLE	since 06/01/2021
BOLYARD, JONTHAN	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 12/06/2021
CHUA, CATHERINE	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 02/01/2024
SCHWARTZ, MARK	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 06/01/2021

Medicare enrollment

As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of 499 FERGUSON ROAD OPCO LLC (enrollment ID O20211215000616).

Owner	Individual or organization	Role	Ownership percentage	Association date	Described in the filing as
NELLAS OPCO HOLDCO LLC	Organization	5% OR GREATER DIRECT OWNERSHIP INTEREST	100	6/1/2021	Private equity company: No Real estate investment trust: No Holding company: Yes
A & R STERN FAMILY WV HOLDINGS LLC	Organization	5% OR GREATER INDIRECT OWNERSHIP INTEREST	99	6/1/2021	Private equity company: No Real estate investment trust: No Holding company: Yes
A & R STERN FAMILY WV 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.	6/1/2021	Private equity company: No Real estate investment trust: No Holding company: Yes
A STERN FAMILY TRUST WV	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.	6/1/2021	Private equity company: No Real estate investment trust: No Holding company: No
ACCURATE STAFFING 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.	6/1/2021	Private equity company: No Real estate investment trust: No Holding company: No
ARYEH STERN	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	6/1/2021	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.
BRAND SONNENSCHINE 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.	6/1/2021	Private equity company: No Real estate investment trust: No Holding company: No
CATHERINE M CHUA	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.	2/1/2024	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
JONTHAN PAUL BOLYARD	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	12/6/2021	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.
R STERN FAMILY TRUST	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.	6/1/2021	Private equity company: No Real estate investment trust: No Holding company: No
ARYEH STERN	Individual	INDIRECT OWNERSHIP INTEREST	1	6/1/2021	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.
CATHERINE M CHUA	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.	2/1/2024	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
JONTHAN PAUL BOLYARD	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.	12/6/2021	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.
MARK SCHWARTZ	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.	6/1/2021	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: BRAND SONNENSCHINE LLP no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: CATHERINE M CHUA no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: CATHERINE M CHUA 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: A & R STERN FAMILY WV HOLDINGS LLC no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: A & R STERN FAMILY WV HOLDINGS LLC no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: BRAND SONNENSCHINE 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: CATHERINE M CHUA appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: CATHERINE M CHUA appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: A & R STERN FAMILY WV HOLDINGS 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: A & R STERN FAMILY WV HOLDINGS LLC appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 August 2025: VNB NEW YORK LLC no longer appears as 5% OR GREATER SECURITY INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: VNB NEW YORK LLC no longer appears as 5% OR GREATER MORTGAGE INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: ARYEH STERN no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: A STERN FAMILY TRUST WV no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: SAM STERN no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: R STERN FAMILY TRUST no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: MICHELLE LANE-GAYDOS no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: JONTHAN PAUL BOLYARD appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: JONTHAN PAUL BOLYARD appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: MARK SCHWARTZ appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: ARYEH STERN appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: ARYEH STERN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: A STERN FAMILY TRUST WV appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: ACCURATE STAFFING LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: R STERN FAMILY TRUST appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: BRAND SONNENSCHINE LLP appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: CATHERINE M CHUA appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: CATHERINE M CHUA appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: A & R STERN FAMILY WV HOLDINGS LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv

Recent changes on this record

1 July 2026: BRAND SONNENSCHINE LLP no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: CATHERINE M CHUA no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: CATHERINE M CHUA 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: A & R STERN FAMILY WV HOLDINGS LLC no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: A & R STERN FAMILY WV HOLDINGS LLC no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: BRAND SONNENSCHINE 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: CATHERINE M CHUA appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: CATHERINE M CHUA appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: A & R STERN FAMILY WV HOLDINGS 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: A & R STERN FAMILY WV HOLDINGS LLC appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
28 August 2025: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
1 August 2025: VNB NEW YORK LLC no longer appears as 5% OR GREATER SECURITY INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: VNB NEW YORK LLC no longer appears as 5% OR GREATER MORTGAGE INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: ARYEH STERN no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: A STERN FAMILY TRUST WV no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: SAM STERN no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: R STERN FAMILY TRUST no longer appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: MICHELLE LANE-GAYDOS no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: JONTHAN PAUL BOLYARD appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: JONTHAN PAUL BOLYARD appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: MARK SCHWARTZ appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: ARYEH STERN appears as INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: ARYEH STERN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: A STERN FAMILY TRUST WV appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: ACCURATE STAFFING LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: R STERN FAMILY TRUST appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: BRAND SONNENSCHINE LLP appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: CATHERINE M CHUA appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: CATHERINE M CHUA appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
1 August 2025: A & R STERN FAMILY WV HOLDINGS LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-08-01.csv
23 June 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
12 September 2024: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip

Inspections

Inspection cycle	Health inspection	Fire safety inspection	Health deficiencies	Fire safety deficiencies
1	5 August 2025	5 August 2025	17	6
2	8 November 2023	8 November 2023	13	8
3	2 June 2021	2 June 2021	5	0

From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.

Deficiencies cited

35 deficiencies on file, newest inspection first

Inspection date	Inspection type	Tag	Category	What was cited	Scope and severity	Complaint	Corrected	Correction date
30 December 2025	Health	F 0584	Resident Rights Deficiencies	Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.	E	Yes	Deficient, Provider has date of correction	20 January 2026
30 December 2025	Health	F 0801	Nutrition and Dietary Deficiencies	Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.	F	Yes	Deficient, Provider has date of correction	20 January 2026
30 December 2025	Health	F 0812	Nutrition and Dietary Deficiencies	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.	F	Yes	Deficient, Provider has date of correction	20 January 2026
30 December 2025	Health	F 0880	Infection Control Deficiencies	Provide and implement an infection prevention and control program.	F	Yes	Deficient, Provider has date of correction	20 January 2026
5 August 2025	Health	F 0584	Resident Rights Deficiencies	Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.	D	No	Deficient, Provider has date of correction	2 September 2025
5 August 2025	Health	F 0628	Resident Rights Deficiencies	Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.	D	No	Deficient, Provider has date of correction	2 September 2025
5 August 2025	Health	F 0641	Resident Assessment and Care Planning Deficiencies	Ensure each resident receives an accurate assessment.	D	No	Deficient, Provider has date of correction	2 September 2025
5 August 2025	Health	F 0644	Resident Assessment and Care Planning Deficiencies	Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.	D	No	Deficient, Provider has date of correction	2 September 2025
5 August 2025	Health	F 0656	Resident Assessment and Care Planning Deficiencies	Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.	E	No	Deficient, Provider has date of correction	2 September 2025
5 August 2025	Health	F 0657	Resident Assessment and Care Planning Deficiencies	Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.	E	No	Deficient, Provider has date of correction	2 September 2025
5 August 2025	Health	F 0679	Quality of Life and Care Deficiencies	Provide activities to meet all resident's needs.	E	No	Deficient, Provider has date of correction	2 September 2025
5 August 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.	L	No	Deficient, Provider has date of correction	6 August 2025
5 August 2025	Health	F 0745	Quality of Life and Care Deficiencies	Provide medically-related social services to help each resident achieve the highest possible quality of life.	D	No	Deficient, Provider has date of correction	2 September 2025
5 August 2025	Health	F 0812	Nutrition and Dietary Deficiencies	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.	E	No	Deficient, Provider has date of correction	2 September 2025
5 August 2025	Health	F 0825	Quality of Life and Care Deficiencies	Provide or get specialized rehabilitative services as required for a resident.	D	Yes	Deficient, Provider has date of correction	2 September 2025
5 August 2025	Health	F 0842	Resident Assessment and Care Planning Deficiencies	Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.	E	No	Deficient, Provider has date of correction	2 September 2025
5 August 2025	Health	F 0880	Infection Control Deficiencies	Provide and implement an infection prevention and control program.	D	No	Deficient, Provider has date of correction	2 September 2025
4 July 2024	Health	F 0584	Resident Rights Deficiencies	Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.	E	Yes	Deficient, Provider has date of correction	27 August 2024
4 July 2024	Health	F 0908	Environmental Deficiencies	Keep all essential equipment working safely.	D	Yes	Deficient, Provider has date of correction	27 August 2024
8 November 2023	Health	F 0584	Resident Rights Deficiencies	Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.	D	No	Deficient, Provider has date of correction	8 December 2023
8 November 2023	Health	F 0585	Resident Rights Deficiencies	Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.	E	No	Deficient, Provider has date of correction	8 December 2023
8 November 2023	Health	F 0600	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.	E	No	Deficient, Provider has date of correction	8 December 2023
8 November 2023	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	8 December 2023
8 November 2023	Health	F 0641	Resident Assessment and Care Planning Deficiencies	Ensure each resident receives an accurate assessment.	E	No	Deficient, Provider has date of correction	8 December 2023
8 November 2023	Health	F 0645	Resident Assessment and Care Planning Deficiencies	PASARR screening for Mental disorders or Intellectual Disabilities	D	No	Deficient, Provider has date of correction	8 December 2023
8 November 2023	Health	F 0684	Quality of Life and Care Deficiencies	Provide appropriate treatment and care according to orders, resident’s preferences and goals.	D	No	Deficient, Provider has date of correction	15 December 2023
8 November 2023	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	No	Deficient, Provider has date of correction	8 December 2023
8 November 2023	Health	F 0697	Quality of Life and Care Deficiencies	Provide safe, appropriate pain management for a resident who requires such services.	E	No	Deficient, Provider has date of correction	8 December 2023
8 November 2023	Health	F 0732	Nursing and Physician Services Deficiencies	Post nurse staffing information every day.	C	No	Deficient, Provider has date of correction	8 December 2023
8 November 2023	Health	F 0812	Nutrition and Dietary Deficiencies	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.	E	No	Deficient, Provider has date of correction	8 December 2023
8 November 2023	Health	F 0943	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.	D	No	Deficient, Provider has date of correction	8 December 2023
8 November 2023	Health	F 0947	Nursing and Physician Services Deficiencies	Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.	D	No	Deficient, Provider has date of correction	8 December 2023
2 June 2021	Health	F 0561	Resident Rights Deficiencies	Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.	E	No	Deficient, Provider has date of correction	28 June 2021
2 June 2021	Health	F 0578	Resident Rights Deficiencies	Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.	D	No	Deficient, Provider has date of correction	28 June 2021
2 June 2021	Health	F 0761	Pharmacy Service Deficiencies	Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.	E	No	Deficient, Provider has date of correction	28 June 2021

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
5 August 2025	Fine	$22,474			134826
8 November 2023	Fine	$37,336			8975

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	499 FERGUSON ROAD OPCO LLC
Date First Approved to Provide Medicare and Medicaid Services	2021-12-23
Provider Resides in Hospital	N
Continuing Care Retirement Community	N
Urban	N
County/Parish	Randolph
Telephone Number	3046361008
Chain Name	AUTUMN LAKE HEALTHCARE
Chain ID	56
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	100
Average Number of Residents per Day	94.7
Overall Rating	1
Health Inspection Rating	1
QM Rating	4
Long-Stay QM Rating	5
Short-Stay QM Rating	3
Processing Date	2026-08-01

From the Care Compare Provider Information file NH_ProviderInfo_Aug2026.csv, processed on 1 August 2026.

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