Skilled nursing facility · CMS certification number 555618
COUNTRY CARE CONV HOSPITAL
ATASCADERO, California
This certification number is not in CMS’s current Care Compare Provider Information file, processed on 1 August 2026.
Finances, as filed
From this facility’s Medicare cost reports on form CMS-2540, each figure with the worksheet, line and column it was read from.
Cost report for 1 October 2018 to 30 September 2019 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 9 September 2020.
None of these figures is carried on this report.
CMS report record 1265887, read from the public cost report file SNF10FY2019.zip.
Fiscal year 2018, ended 30 September 2018
Cost report for 1 October 2017 to 30 September 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 22 March 2019.
None of these figures is carried on this report.
CMS report record 1221706, read from the public cost report file SNF10FY2018.zip.
Fiscal year 2017, ended 30 September 2017
Cost report for 1 October 2016 to 30 September 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 2 May 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,030,684 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $767,981 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $3,262,703 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,607,334 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,344,631 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $5,547 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$1,339,084 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$1,339,084 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 13,446 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 99 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 31.13 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 208.22 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 135.82 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1188281, read from the public cost report file SNF10FY2017.zip.
Fiscal year 2016, ended 30 September 2016
Cost report for 1 October 2015 to 30 September 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 18 April 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,424,223 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $699,175 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,725,048 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,270,869 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$545,821 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $30,810 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$515,011 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$515,011 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 18,631 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 92 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 31.1 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 1,060.75 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 202.51 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1155766, read from the public cost report file SNF10FY2016.zip.
Fiscal year 2015, ended 30 September 2015
Cost report for 1 October 2014 to 30 September 2015 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 20 April 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $6,110,775 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $806,024 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,304,751 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,970,745 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $334,006 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $20,599 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $354,605 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $354,605 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,380 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 90 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 43.13 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 127.5 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 226.44 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1121686, read from the public cost report file SNF10FY2015.zip.
Fiscal year 2014, ended 30 September 2014
Cost report for 1 October 2013 to 30 September 2014 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 20 March 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $5,829,550 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $528,397 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $5,301,153 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $5,106,970 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $194,183 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $22,629 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $216,812 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $216,812 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 20,339 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 86 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 45.95 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 876.56 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 236.5 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1087516, read from the public cost report file SNF10FY2014.zip.
Fiscal year 2013, ended 30 September 2013
Cost report for 1 October 2012 to 30 September 2013 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 16 May 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,980,477 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $401,453 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,579,024 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,855,302 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$276,278 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $12,210 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$264,068 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$681,038 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 19,760 | 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 | 39.63 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 609.4 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 174.87 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1060059, read from the public cost report file SNF10FY2013.zip.
Fiscal year 2012, ended 30 September 2012
Cost report for 1 October 2011 to 30 September 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 15 March 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,396,784 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $105,557 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,291,227 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,477,280 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$186,053 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $18,167 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$167,886 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$167,886 (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 | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 18,822 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 104 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 26.74 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 584.26 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 180.98 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1025951, read from the public cost report file SNF10FY2012.zip.
Fiscal year 2011, ended 30 September 2011
Cost report for 1 October 2010 to 30 September 2011 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 30 March 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,366,133 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,609,499 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$243,366 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $25,182 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$218,184 (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 | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 18,770 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 248 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 26.41 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 480.1 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 75.69 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 426984, read from the public cost report file SNFFY2011.zip.
Fiscal year 2010, ended 30 September 2010
Cost report for 1 October 2009 to 30 September 2010 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 20 April 2011.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,429,451 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,433,736 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$4,285 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $37,066 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $32,781 (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 | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,815 | 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 | 31.73 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 740.81 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 223.82 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 397668, read from the public cost report file SNFFY2010.zip.
Fiscal year 2009, ended 30 September 2009
Cost report for 1 October 2008 to 30 September 2009 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 12 March 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,438,098 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,559,495 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$121,397 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $31,719 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$89,678 (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 | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,624 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 109 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 41.29 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 523.88 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 189.21 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 365593, read from the public cost report file SNFFY2009.zip.
Fiscal year 2008, ended 30 September 2008
Cost report for 1 October 2007 to 30 September 2008 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 1 May 2009.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $4,213,418 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,299,600 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$86,182 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $44,754 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$41,428 (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 | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,823 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 116 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 35.44 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 482.27 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 179.51 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 338301, read from the public cost report file SNFFY2008.zip.
Fiscal year 2007, ended 30 September 2007
Cost report for 1 October 2006 to 30 September 2007 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 12 May 2008.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,963,103 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,734,999 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $228,104 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $37,880 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $265,984 (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 | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,734 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 121 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 28.86 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 608.43 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 171.36 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 308726, read from the public cost report file SNFFY2007.zip.
Fiscal year 2006, ended 30 September 2006
Cost report for 1 October 2005 to 30 September 2006 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 1 May 2007.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,668,073 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,602,164 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $65,909 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $87,867 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $153,776 (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 | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 21,358 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 112 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 55.33 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 748.84 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 190.7 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 277619, read from the public cost report file SNFFY2006.zip.
Fiscal year 2005, ended 30 September 2005
Cost report for 1 October 2004 to 30 September 2005 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 8 May 2006.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,456,070 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,453,827 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $2,243 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $93,159 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $95,402 (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 | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,887 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 111 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 38.45 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 436.88 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 188.17 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 248754, read from the public cost report file SNFFY2005.zip.
Fiscal year 2004, ended 30 September 2004
Cost report for 1 October 2003 to 30 September 2004 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 18 April 2005.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $3,035,921 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $3,188,124 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$152,203 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $92,558 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$59,645 (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 | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 21,174 | 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 | 22.89 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 587.3 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 237.91 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 213991, read from the public cost report file SNFFY2004.zip.
Fiscal year 2003, ended 30 September 2003
Cost report for 1 October 2002 to 30 September 2003 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 10 March 2005.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $2,922,718 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,868,566 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $54,152 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $142,165 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $196,317 (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 | 60 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,856 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 65 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 30.82 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 697.8 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 320.86 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 210596, read from the public cost report file SNFFY2003.zip.
Fiscal year 2002, ended 30 September 2002
Cost report for 1 October 2001 to 30 September 2002 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 1 September 2004.
None of these figures is carried on this report.
CMS report record 192569, read from the public cost report file SNFFY2002.zip.
Fiscal year 2001, ended 30 September 2001
Cost report for 1 October 2000 to 30 September 2001 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 5 September 2003.
None of these figures is carried on this report.
CMS report record 158687, read from the public cost report file SNFFY2001.zip.
Fiscal year 2000, ended 30 September 2000
Cost report for 1 October 1999 to 30 September 2000 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 9 January 2002.
Net income, stated at moderate confidence: $117,421 (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.
CMS report record 98628, read from the public cost report file SNFFY2000.zip.
Fiscal year 1999, ended 30 September 1999
Cost report for 1 October 1998 to 30 September 1999 — a reporting period of 364 days, on form CMS-2540-96, as submitted, processed by CMS on 24 April 2000.
Net income, stated at moderate confidence: $168,657 (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.
CMS report record 98627, read from the public cost report file SNFFY1999.zip.
Fiscal year 1998, ended 30 September 1998
Cost report for 1 October 1997 to 30 September 1998 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 14 April 2000.
Net income, stated at moderate confidence: $30,035 (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.
CMS report record 98625, read from the public cost report file SNFFY1998.zip.
Fiscal year 1997, ended 30 September 1997
Cost report for 1 October 1996 to 30 September 1997 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 19 October 1998.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,945,254 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,916,569 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | $28,685 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $55,325 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: $84,010 (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 | 59 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 21,254 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 39 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 50 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 1,457.6 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 544.97 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 98623, read from the public cost report file SNFFY1997.zip.
Fiscal year 1996, ended 30 September 1996
Cost report for 1 October 1995 to 30 September 1996 — a reporting period of 365 days, on form CMS-2540-96, as submitted, processed by CMS on 8 May 1997.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $1,671,863 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,008,701 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$336,838 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $52,916 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$283,922 (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 | 59 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 20,608 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 50 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 33.71 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 724.35 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 412.16 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 98622, 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
Not yet extracted for this facility.
Medicare enrollment
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Changes in ownership
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Recent changes on this record
- 9 September 2020: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
- 22 March 2019: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2018.zip
- 2 May 2018: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2017.zip
- 18 April 2017: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2016.zip
- 20 April 2016: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2015.zip
- 20 March 2015: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2014.zip
- 16 May 2014: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2013.zip
- 15 March 2013: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2012.zip
- 30 March 2012: A cost report was filed for fiscal year 2011, on form CMS-2540-96. SNFFY2011.zip
- 20 April 2011: A cost report was filed for fiscal year 2010, on form CMS-2540-96. SNFFY2010.zip
- 12 March 2010: A cost report was filed for fiscal year 2009, on form CMS-2540-96. SNFFY2009.zip
- 1 May 2009: A cost report was filed for fiscal year 2008, on form CMS-2540-96. SNFFY2008.zip
- 12 May 2008: A cost report was filed for fiscal year 2007, on form CMS-2540-96. SNFFY2007.zip
- 1 May 2007: A cost report was filed for fiscal year 2006, on form CMS-2540-96. SNFFY2006.zip
- 8 May 2006: A cost report was filed for fiscal year 2005, on form CMS-2540-96. SNFFY2005.zip
- 18 April 2005: A cost report was filed for fiscal year 2004, on form CMS-2540-96. SNFFY2004.zip
- 10 March 2005: A cost report was filed for fiscal year 2003, on form CMS-2540-96. SNFFY2003.zip
- 1 September 2004: A cost report was filed for fiscal year 2002, on form CMS-2540-96. SNFFY2002.zip
- 5 September 2003: A cost report was filed for fiscal year 2001, on form CMS-2540-96. SNFFY2001.zip
- 9 January 2002: A cost report was filed for fiscal year 2000, on form CMS-2540-96. SNFFY2000.zip
- 24 April 2000: A cost report was filed for fiscal year 1999, on form CMS-2540-96. SNFFY1999.zip
- 14 April 2000: A cost report was filed for fiscal year 1998, on form CMS-2540-96. SNFFY1998.zip
- 19 October 1998: A cost report was filed for fiscal year 1997, on form CMS-2540-96. SNFFY1997.zip
- 8 May 1997: A cost report was filed for fiscal year 1996, on form CMS-2540-96. SNFFY1996.zip
Inspections
Not yet extracted for this facility.
Deficiencies cited
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Penalties
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Care Compare provider information
Not yet extracted for this facility.
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