Skilled nursing facility · CMS certification number 525326
PINE CREST HEALTH AND MEMORY CARE
MERRILL, Wisconsin · Medicare and Medicaid
Certified beds, as filed in Care Compare: 120
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 2025 to 12 August 2025 — a reporting period of 223 days, not a full year, on form CMS-2540-10, settled, processed by CMS on 1 June 2026.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,094,394 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$232,162 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,326,556 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,465,206 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,138,650 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $720,492 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$418,158 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$418,158 (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 | 120 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 26,880 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 636 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 11,931 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 3,419 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 15,986 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 28 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 7 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 8 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 43 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 22.71 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,704.43 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 371.77 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1450114, read from the public cost report file SNF10FY2025.zip.
Fiscal year 2024, ended 31 December 2024
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 29 August 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,901,968 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$968,931 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $12,870,899 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $14,414,467 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,543,568 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $950,679 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$592,889 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$592,889 (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 | 120 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 29,375 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 110.81 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 2,549.22 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 587.5 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1438165, 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 10 September 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,167,701 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | −$447,720 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $11,615,421 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $13,687,491 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$2,072,070 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $2,576,157 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $504,087 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $504,087 (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 | 120 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 30,067 | 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 | 58.14 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 4,833.4 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 400.89 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1394431, 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 24 August 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $91,680,958 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $34,244,285 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $57,436,673 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $91,581,081 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$34,144,408 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $37,659,166 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $3,514,758 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $3,514,758 (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 | 120 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 31,153 | 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 | 65.06 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 4,313.67 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 415.37 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1363161, 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 19 September 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $83,078,384 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $28,124,250 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $54,954,134 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $86,806,175 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$31,852,041 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $27,667,645 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$4,184,396 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$4,184,396 (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 | 160 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 33,297 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 140 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 39.72 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,940.14 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 237.84 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1332852, 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 28 October 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $85,892,983 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $29,978,269 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $55,914,714 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $89,256,280 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$33,341,566 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $29,388,633 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$3,952,933 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$3,952,933 (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 | 160 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 44,182 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 213 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 56.7 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 461.69 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 207.43 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1303378, read from the public cost report file SNF10FY2020.zip.
Fiscal year 2019, ended 31 December 2019
Cost report for 1 January 2019 to 31 December 2019 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 20 July 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,837,742 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $275,256 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $11,562,486 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $16,200,144 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$4,637,658 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $2,921,169 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$1,716,489 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,720,742 (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 | 180 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 55,188 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 282 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 35.23 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,560.82 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 195.7 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1260735, 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 22 August 2019.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,999,919 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $374,911 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,625,008 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $14,962,615 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$4,337,607 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $2,944,334 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$1,393,273 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,406,612 (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 | 180 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 56,973 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 251 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 38.04 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,446.06 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 226.98 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1241820, 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 17 September 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,315,201 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $390,074 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,925,127 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $13,710,812 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$3,785,685 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,830,708 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$1,954,977 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$2,004,971 (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 | 180 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 57,248 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 178 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 45.94 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,448.29 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 321.62 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1211328, 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 11 August 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,335,553 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $262,837 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,072,716 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $13,241,871 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$3,169,155 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,638,089 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$1,531,066 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,538,694 (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 | 180 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 59,262 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 163 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 45.33 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,463.85 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 363.57 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1172800, 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 16 August 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,664,087 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $378,522 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,285,565 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $12,886,794 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$2,601,229 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,961,194 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$640,035 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$651,416 (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 | 180 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 59,412 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 184 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 78.1 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,431.36 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 322.89 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1141405, 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 25 July 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,580,713 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $305,598 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,275,115 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $12,460,499 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$2,185,384 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,699,530 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$485,854 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$494,070 (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 | 180 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 60,591 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 158 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 79.43 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 775.98 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 383.49 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1105324, 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 13 August 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,439,565 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $338,609 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,100,956 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $12,193,014 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$2,092,058 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,665,749 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$426,309 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$426,547 (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 | 180 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 61,242 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 158 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 94.32 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 613.15 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 387.61 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1075813, 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 15 August 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,179,420 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $264,774 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,914,646 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $12,042,496 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$2,127,850 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,974,735 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$153,115 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$154,653 (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 | 180 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 62,459 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 130 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 81.52 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,169.09 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 480.45 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1046464, 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 6 November 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,269,441 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $91,841 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,177,600 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $12,231,562 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$2,053,962 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,545,698 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$508,264 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$508,264 (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 | 180 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 61,397 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 150 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 98.64 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 699.84 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 409.31 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1018774, 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 27 September 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $10,001,910 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $11,898,051 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$1,896,141 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $1,585,229 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$310,912 (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 | 180 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 61,818 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 146 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 109.68 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 481.97 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 423.41 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 418440, 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 27 August 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $9,580,350 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $11,254,111 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$1,673,761 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $1,636,668 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $4,433 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: −$41,526 (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 | 180 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 62,864 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 89 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 94.91 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 885.89 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 706.34 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 386631, 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 21 August 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $9,326,341 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,953,206 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$1,626,865 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $1,311,546 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $10,833 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: −$326,152 (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 | 180 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 63,271 | 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 | 61.29 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 2,591.4 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 680.33 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 355178, 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 12 June 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $8,780,582 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,376,859 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$1,596,277 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $1,161,375 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$434,902 (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 | 180 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 63,287 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 94 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 70.16 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,351.41 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 673.27 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 344099, read from the public cost report file SNFFY2007.zip.
Fiscal year 2006, ended 31 December 2006
Cost report for 1 January 2006 to 31 December 2006 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 28 December 2007.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $8,748,664 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,876,943 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$1,128,279 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $1,087,103 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $4,406 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: −$45,582 (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 | 180 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 63,069 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 87 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 83.59 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 2,537.43 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 724.93 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 299634, 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 March 2007.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $8,599,622 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,546,137 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$946,515 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $987,593 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $4,190 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: $36,888 (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 | 180 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 62,168 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 146 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 53.68 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,148.69 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 425.81 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 274370, 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 24 March 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $8,211,842 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,076,829 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$864,987 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $1,103,134 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $238,147 (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 | 180 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 61,560 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 166 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 64.59 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,480.86 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 370.84 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 245905, 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 19 January 2005.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $7,907,931 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,932,874 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$1,024,943 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $1,074,394 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $4,467 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: $44,984 (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 | 180 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 61,583 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 452 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 42.29 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 136.25 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 204222, 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 12 December 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $8,107,097 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,490,258 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$383,161 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $23,213 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $107 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: −$360,055 (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 | 180 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 60,995 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 132 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 29.19 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 462.08 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 165258, 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, as submitted, processed by CMS on 13 February 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $7,536,256 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,892,142 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$355,886 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $125,109 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | $10,507 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: −$241,284 (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 | 180 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 61,225 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 74 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 73.5 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 827.36 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 125734, 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, settled, processed by CMS on 12 February 2003.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $6,895,263 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,240,344 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$345,081 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $61,505 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$283,576 (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 | 180 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 59,544 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 102 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 35.5 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 583.76 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 122282, 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, settled, processed by CMS on 18 June 2001.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $6,868,071 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,773,909 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | $94,162 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $21,522 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $115,684 (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 | 180 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 61,682 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 87 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 56.14 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 708.99 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 71342, 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, settled, processed by CMS on 21 November 2000.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $7,072,642 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,011,145 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | $61,497 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $13,512 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $75,009 (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 | 180 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 63,322 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 98 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 96.38 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 646.14 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 71340, 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, settled, processed by CMS on 12 November 1999.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $6,585,063 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,760,562 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$175,499 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $15,913 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$159,586 (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 | 180 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 63,698 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 61 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 261.18 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 1,044.23 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 71338, read from the public cost report file SNFFY1997.zip.
Fiscal year 1996, ended 31 December 1996
Cost report for 1 January 1996 to 31 December 1996 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 31 August 1998.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $6,322,880 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $6,637,114 | CMS-2540-96 worksheet G200002 line 1500 column 100 |
| Net income from service to patients | −$314,234 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $13,484 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
| Total other expenses | −$15 | CMS-2540-96 worksheet G300000 line 3100 column 100 |
Net income, stated at moderate confidence: −$300,735 (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 | 180 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 62,842 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 63 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 68.53 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, all patients, in days | 997.49 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 71337, read from the public cost report file SNFFY1996.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 |
|---|---|---|---|---|
| ENSIGN SERVICES INC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 04/29/2025 |
| HANSON, RYAN | ADP OF THE SNF | Individual | NOT APPLICABLE | since 08/13/2025 |
| MERRILL HEALTH HOLDINGS LLC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 08/13/2025 |
| SMITH, DANIEL | ADP OF THE SNF | Individual | NOT APPLICABLE | since 08/13/2025 |
| STANDARD BEARER HEALTHCARE OP, LP | ADP OF THE SNF | Organization | NOT APPLICABLE | since 12/12/2025 |
| THE ENSIGN GROUP INC | ADP OF THE SNF | Organization | NOT APPLICABLE | since 12/12/2025 |
| BURNAM, SOON | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 04/29/2025 |
| KEETCH, CHAD | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 03/01/2011 |
| PORT, BARRY | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | Individual | NOT APPLICABLE | since 08/18/2025 |
| BURNAM, SOON | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 04/29/2025 |
| JORGENSEN, DAVID | MANAGING CONTROL - GOVERNING BODY | Individual | NOT APPLICABLE | since 04/29/2025 |
| HANSON, RYAN | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 08/13/2025 |
| SMITH, DANIEL | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 08/13/2025 |
Medicare enrollment
As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of JACK PINES HEALTHCARE LLC (enrollment ID O20260203002866).
| Owner | Individual or organization | Role | Ownership percentage | Association date | Described in the filing as |
|---|---|---|---|---|---|
| GATEWAY HEALTHCARE LLC | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100 | 4/29/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| THE ENSIGN GROUP INC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 100 | 4/29/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| DANIEL JOSEPH SMITH | 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. | 8/13/2025 | 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. |
| ENSIGN SERVICES INC | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 4/29/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| MERRILL HEALTH 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. | 8/13/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| RYAN A HANSON | 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. | 8/13/2025 | 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. |
| STANDARD BEARER HEALTHCARE OP, LP | 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. | 12/12/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| THE ENSIGN GROUP INC | Organization | ADP OF THE SNF | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 12/12/2025 | 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. | 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. | 12/12/2025 | Private equity company: No Real estate investment trust: No Holding company: No |
| SOON BURNAM | Individual | CORPORATE DIRECTOR | 0 | 4/29/2025 | 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. |
| CHAD KEETCH | Individual | CORPORATE OFFICER | 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. | 3/1/2011 | 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. |
| DAVID JORGENSEN | 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. | 4/29/2025 | 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. |
| SOON BURNAM | 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. | 4/29/2025 | 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. |
| DANIEL JOSEPH SMITH | 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. | 8/13/2025 | 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. |
| RYAN A HANSON | 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. | 8/13/2025 | 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. |
Changes in ownership
- 1 May 2026: COUNTY OF LINCOLN no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: RYAN A HANSON no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: RYAN A HANSON no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: SOON BURNAM appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: SOON BURNAM appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: MERRILL HEALTH HOLDINGS LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: STANDARD BEARER HEALTHCARE OP, LP appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: CHAD KEETCH appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: DANIEL JOSEPH SMITH appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: DANIEL JOSEPH SMITH appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: GATEWAY HEALTHCARE LLC appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: DAVID JORGENSEN appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: RYAN A HANSON appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: RYAN A HANSON appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: ENSIGN SERVICES INC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: THE ENSIGN GROUP INC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: THE ENSIGN GROUP INC appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
Recent changes on this record
- 1 June 2026: A cost report was filed for fiscal year 2025, on form CMS-2540-10. SNF10FY2025.zip
- 1 May 2026: COUNTY OF LINCOLN no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: RYAN A HANSON no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: RYAN A HANSON no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: A listing under ADP OF THE SNF appears in the Medicare enrollment ownership file, with no owner named. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: SOON BURNAM appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: SOON BURNAM appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: MERRILL HEALTH HOLDINGS LLC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: STANDARD BEARER HEALTHCARE OP, LP appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: CHAD KEETCH appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: DANIEL JOSEPH SMITH appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: DANIEL JOSEPH SMITH appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: GATEWAY HEALTHCARE LLC appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: DAVID JORGENSEN appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: RYAN A HANSON appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: RYAN A HANSON appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: ENSIGN SERVICES INC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: THE ENSIGN GROUP INC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: THE ENSIGN GROUP INC appears as 5% OR GREATER INDIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-05-01.csv
- 1 May 2026: enrollment_id changed from O20111108000367 to O20260203002866. Skilled_Nursing_Facility_Enrollments_:_2026-05-01.csv
- 29 August 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- 10 September 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
- 24 August 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
- 19 September 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
- 28 October 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
- 20 July 2020: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
- 22 August 2019: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2018.zip
- 17 September 2018: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2017.zip
- 11 August 2017: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2016.zip
- 16 August 2016: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2015.zip
- 25 July 2015: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2014.zip
- 13 August 2014: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2013.zip
- 15 August 2013: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2012.zip
- 6 November 2012: A cost report was filed for fiscal year 2011, on form CMS-2540-10. SNF10FY2011.zip
- 27 September 2011: A cost report was filed for fiscal year 2010, on form CMS-2540-96. SNFFY2010.zip
- 27 August 2010: A cost report was filed for fiscal year 2009, on form CMS-2540-96. SNFFY2009.zip
- 21 August 2009: A cost report was filed for fiscal year 2008, on form CMS-2540-96. SNFFY2008.zip
- 12 June 2009: A cost report was filed for fiscal year 2007, on form CMS-2540-96. SNFFY2007.zip
- 28 December 2007: A cost report was filed for fiscal year 2006, on form CMS-2540-96. SNFFY2006.zip
- 12 March 2007: A cost report was filed for fiscal year 2005, on form CMS-2540-96. SNFFY2005.zip
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | 4 June 2026 | 4 June 2026 | 9 | 3 |
| 2 | 1 May 2025 | 1 May 2025 | 9 | 5 |
| 3 | 6 March 2024 | 6 March 2024 | 2 | 3 |
From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.
Deficiencies cited
20 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| 4 June 2026 | Health | F 0627 | Resident Rights Deficiencies | Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge. | F | No | Deficient, Provider has date of correction | 1 July 2026 |
| 4 June 2026 | Health | F 0628 | Resident Rights Deficiencies | Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. | F | No | Deficient, Provider has date of correction | 1 July 2026 |
| 4 June 2026 | 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 | 1 July 2026 |
| 4 June 2026 | Health | F 0687 | Quality of Life and Care Deficiencies | Provide appropriate foot care. | E | No | Deficient, Provider has date of correction | 1 July 2026 |
| 4 June 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. | D | No | Deficient, Provider has date of correction | 1 July 2026 |
| 4 June 2026 | Health | F 0694 | Quality of Life and Care Deficiencies | Provide for the safe, appropriate administration of IV fluids for a resident when needed. | D | No | Deficient, Provider has date of correction | 1 July 2026 |
| 4 June 2026 | Health | F 0812 | Nutrition and Dietary Deficiencies | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | No | Deficient, Provider has date of correction | 1 July 2026 |
| 4 June 2026 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | F | No | Deficient, Provider has date of correction | 1 July 2026 |
| 27 August 2025 | Health | F 0755 | Pharmacy Service Deficiencies | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | Yes | Deficient, Provider has date of correction | 25 September 2025 |
| 18 June 2025 | 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. | D | Yes | Deficient, Provider has date of correction | 9 July 2025 |
| 1 May 2025 | Health | F 0580 | Resident Rights Deficiencies | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | D | No | Deficient, Provider has date of correction | 27 May 2025 |
| 1 May 2025 | Health | F 0677 | Quality of Life and Care Deficiencies | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | No | Deficient, Provider has date of correction | 27 May 2025 |
| 1 May 2025 | Health | F 0697 | Quality of Life and Care Deficiencies | Provide safe, appropriate pain management for a resident who requires such services. | D | No | Deficient, Provider has date of correction | 27 May 2025 |
| 1 May 2025 | Health | F 0732 | Nursing and Physician Services Deficiencies | Post nurse staffing information every day. | C | No | Deficient, Provider has date of correction | 27 May 2025 |
| 1 May 2025 | 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 | 27 May 2025 |
| 1 May 2025 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | No | Deficient, Provider has date of correction | 27 May 2025 |
| 14 October 2024 | Health | F 0806 | Nutrition and Dietary Deficiencies | Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | D | Yes | Deficient, Provider has date of correction | 16 November 2024 |
| 20 August 2024 | Health | F 0656 | Resident Assessment and Care Planning Deficiencies | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | Yes | Deficient, Provider has date of correction | 10 September 2024 |
| 6 March 2024 | Health | F 0755 | Pharmacy Service Deficiencies | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | D | No | Deficient, Provider has date of correction | 29 March 2024 |
| 6 March 2024 | Health | F 0882 | Infection Control Deficiencies | Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. | C | No | Deficient, Provider has date of correction | 29 March 2024 |
From the Care Compare health citations file NH_HealthCitations_Aug2026.csv, processed on 1 August 2026.
Penalties
Not yet extracted for this facility.
Care Compare provider information
| Field | As filed |
|---|---|
| Provider Type | Medicare and Medicaid |
| Ownership Type | For profit - Corporation |
| Legal Business Name | JACK PINES HEALTHCARE LLC |
| Date First Approved to Provide Medicare and Medicaid Services | 1983-01-19 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | N |
| County/Parish | Lincoln |
| Telephone Number | 7155360355 |
| Chain Name | THE ENSIGN GROUP |
| Chain ID | 507 |
| Provider Changed Ownership in Last 12 Months | Y |
| With a Resident and Family Council | Resident |
| Automatic Sprinkler Systems in All Required Areas | Yes |
| Number of Certified Beds | 120 |
| Average Number of Residents per Day | 90.2 |
| Overall Rating | 3 |
| Health Inspection Rating | 3 |
| QM Rating | 3 |
| Long-Stay QM Rating | 3 |
| 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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On 1 June 2026: A cost report was filed for fiscal year 2025, on form CMS-2540-10. That is one line of the alert.
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The citable document for PINE CREST HEALTH AND MEMORY CARE
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 Wisconsin 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 525326.