Facility record report · CMS certification number 555927

PIH HEALTH GOOD SAMARITAN HOSPITAL D/P SNF

LOS ANGELES, California · Medicare and Medicaid

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 2023 to 30 September 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 28 August 2025.

Revenue and expenses, fiscal year 2024
Figure	As filed	Where it comes from
Total patient revenue	$27,172,130	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$21,737,704	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$5,434,426	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$7,788,305	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$2,353,879	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$66,377	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$2,287,502	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$2,287,512 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2024
Figure	As filed	Where it comes from
Total facility beds, all components	28	CMS-2540-10 worksheet S300001 line 800 column 100
Bed days available, all components	10,248	CMS-2540-10 worksheet S300001 line 800 column 200
Medicare (Title XVIII) patient days	733	CMS-2540-10 worksheet S300001 line 800 column 400
Other-payer patient days	5,403	CMS-2540-10 worksheet S300001 line 800 column 600
Total patient days, all components	6,136	CMS-2540-10 worksheet S300001 line 800 column 700
Medicare discharges	88	CMS-2540-10 worksheet S300001 line 800 column 900
Other-payer discharges	463	CMS-2540-10 worksheet S300001 line 800 column 1100
Total discharges, all components	551	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	8.33	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, all patients, in days	11.14	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1435927, read from the public cost report file SNF10FY2024.zip.

Cost report for 1 December 2022 to 30 September 2023 — a reporting period of 303 days, on form CMS-2540-10, settled, processed by CMS on 20 June 2024.

Revenue and expenses, fiscal year 2023
Figure	As filed	Where it comes from
Total patient revenue	$20,479,674	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$16,932,595	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$3,547,079	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$5,444,617	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$1,897,538	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$26,385	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$1,871,153	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$1,871,153 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2023
Figure	As filed	Where it comes from
Total facility beds, all components	28	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	4,173	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	368	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	9.24	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, all patients, in days	11.34	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1385306, read from the public cost report file SNF10FY2023.zip.

Five facilities of a similar size in California, fiscal year 2024

Chosen for having certified bed counts closest to this facility’s, listed by name. Every one filed for the same fiscal year; the day each year ends differs and is shown. Each figure is that facility’s own filing.

Facility	Total facility beds	Total patient days	Net patient revenue	Total operating expenses	Net income from service to patients	Period ended
CHOWCHILLA MEMORIAL SNF	28	9,663	$2,766,139	$4,350,329	−$1,584,190	30 June 2024
FOREST HILL MANOR HEALTH CENTER	26	7,777	$8,242,573	$5,849,168	$2,393,405	31 December 2024
PIH HEALH GOOD SAMARITAN HOSPITAL	28	6,136	$5,434,426	$7,788,305	−$2,353,879	30 September 2024
ST. ANTHONY CARE CENTER INC.	30	9,369	$4,591,395	$4,422,865	$168,530	31 December 2024
STANLEY HEALTHCARE CENTER	30	9,098	$3,302,113	$3,388,852	−$86,739	31 December 2024
STRATFORD VILLA POST-ACUTE	27	8,962	$5,400,185	$5,273,810	$126,375	31 December 2024

Where each column comes from, on every filing in this table: Total facility beds: CMS-2540-10 worksheet S300001 line 800 column 100 · Total patient days: CMS-2540-10 worksheet S300001 line 800 column 700 · Net patient revenue: CMS-2540-10 worksheet G300000 line 300 column 100 · Total operating expenses: CMS-2540-10 worksheet G300000 line 400 column 100 · Net income from service to patients: CMS-2540-10 worksheet G300000 line 500 column 100.

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
PIH HEALTH GOOD SAMARITAN HOSPITAL	5% OR GREATER DIRECT OWNERSHIP INTEREST	Organization	100%	since 01/01/2020
COPPINGER, NOEL	ADP OF THE SNF	Individual	NOT APPLICABLE	since 01/01/2020
KPMG LLP	ADP OF THE SNF	Organization	NOT APPLICABLE	since 02/18/2025
LEONARD, ANNA	ADP OF THE SNF	Individual	NOT APPLICABLE	since 02/01/2022
MAHALINGAMSHIVARAMAN, VIDHYASHANKARAN	ADP OF THE SNF	Individual	NOT APPLICABLE	since 04/12/2021
NECKE, SHELLY	ADP OF THE SNF	Individual	NOT APPLICABLE	since 12/01/2022
PIH HEALTH GOOD SAMARITAN HOSPITAL	ADP OF THE SNF	Organization	NOT APPLICABLE	since 02/18/2025
PIH HEALTH INC	ADP OF THE SNF	Organization	NOT APPLICABLE	since 01/01/2020
PIH HEALTH WHITTIER HOSPITAL	ADP OF THE SNF	Organization	NOT APPLICABLE	since 02/19/2025
PONCE, SUSANNE	ADP OF THE SNF	Individual	NOT APPLICABLE	since 01/01/2020
PRATT, ANDREW	ADP OF THE SNF	Individual	NOT APPLICABLE	since 11/20/2023
RAHNEMA, GUDARS	ADP OF THE SNF	Individual	NOT APPLICABLE	since 10/02/2022
VAZQUEZ, CINDY	ADP OF THE SNF	Individual	NOT APPLICABLE	since 10/01/2022
WEST, JAMES	ADP OF THE SNF	Individual	NOT APPLICABLE	since 01/01/2020
ALVAREZ, ALEX	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 10/09/2017
ATWOOD, J	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 04/25/2005
BARENDSE, THURSO	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 02/08/2024
BATISTE, MELANIE	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 10/21/2021
GOLDBERG, MARISSA	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 10/01/2021
GREANEY, PETER	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 11/13/2018
HAMAR, HAMILTON	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 10/10/2016
KHORSANDI, MOEZ	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 03/22/2024
KROG, SCOTT	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 12/13/2024
MEDRANO, DEBORAH	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 12/13/2024
MONROE, PATRICK	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 10/10/2016
ROTH, WILLIAM	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 03/01/2023
SARALIEV, TRACEA	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 02/08/2024
SOUTHRON, SCOTT	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 12/13/2024
SYDA-LAWTON, REGINE	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 12/13/2024
TREINEN, PAUL	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 11/12/2019
WEAVER, CHARLOTTE	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 10/10/2016
WOODS, KENTON	CORPORATE DIRECTOR	Individual	NOT APPLICABLE	since 02/28/2005
MAHALINGAMSHIVARAMAN, VIDHYASHANKARAN	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 04/12/2021
WEST, JAMES	CORPORATE OFFICER	Individual	NOT APPLICABLE	since 01/01/2020
ALVAREZ, ALEX	MANAGING CONTROL - GOVERNING BODY	Individual	NOT APPLICABLE	since 10/09/2017
ATWOOD, J	MANAGING CONTROL - GOVERNING BODY	Individual	NOT APPLICABLE	since 04/25/2005
BARENDSE, THURSO	MANAGING CONTROL - GOVERNING BODY	Individual	NOT APPLICABLE	since 02/08/2024
BATISTE, MELANIE	MANAGING CONTROL - GOVERNING BODY	Individual	NOT APPLICABLE	since 11/21/2021
GOLDBERG, MARISSA	MANAGING CONTROL - GOVERNING BODY	Individual	NOT APPLICABLE	since 10/01/2021
GREANEY, PETER	MANAGING CONTROL - GOVERNING BODY	Individual	NOT APPLICABLE	since 11/13/2018
HAMAR, HAMILTON	MANAGING CONTROL - GOVERNING BODY	Individual	NOT APPLICABLE	since 10/10/2016
KHORSANDI, MOEZ	MANAGING CONTROL - GOVERNING BODY	Individual	NOT APPLICABLE	since 03/22/2024
KROG, SCOTT	MANAGING CONTROL - GOVERNING BODY	Individual	NOT APPLICABLE	since 12/13/2024
MEDRANO, DEBORAH	MANAGING CONTROL - GOVERNING BODY	Individual	NOT APPLICABLE	since 12/13/2024
MONROE, PATRICK	MANAGING CONTROL - GOVERNING BODY	Individual	NOT APPLICABLE	since 10/10/2016
ROTH, WILLIAM	MANAGING CONTROL - GOVERNING BODY	Individual	NOT APPLICABLE	since 03/01/2023
SARALIEV, TRACEA	MANAGING CONTROL - GOVERNING BODY	Individual	NOT APPLICABLE	since 02/08/2024
SOUTHRON, SCOTT	MANAGING CONTROL - GOVERNING BODY	Individual	NOT APPLICABLE	since 12/13/2024
SYDA-LAWTON, REGINE	MANAGING CONTROL - GOVERNING BODY	Individual	NOT APPLICABLE	since 12/13/2024
TREINEN, PAUL	MANAGING CONTROL - GOVERNING BODY	Individual	NOT APPLICABLE	since 11/12/2019
WEAVER, CHARLOTTE	MANAGING CONTROL - GOVERNING BODY	Individual	NOT APPLICABLE	since 10/10/2016
WEST, JAMES	MANAGING CONTROL - GOVERNING BODY	Individual	NOT APPLICABLE	since 01/01/2020
WOODS, KENTON	MANAGING CONTROL - GOVERNING BODY	Individual	NOT APPLICABLE	since 02/28/2005
COPPINGER, NOEL	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 01/01/2020
KPMG LLP	OPERATIONAL/MANAGERIAL CONTROL	Organization	NOT APPLICABLE	since 06/01/2023
LEONARD, ANNA	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 02/01/2022
MAHALINGAMSHIVARAMAN, VIDHYASHANKARAN	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 04/12/2021
NECKE, SHELLY	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 12/01/2022
PIH HEALTH GOOD SAMARITAN HOSPITAL	OPERATIONAL/MANAGERIAL CONTROL	Organization	NOT APPLICABLE	since 01/01/2020
PIH HEALTH WHITTIER HOSPITAL	OPERATIONAL/MANAGERIAL CONTROL	Organization	NOT APPLICABLE	since 01/01/2020
PONCE, SUSANNE	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 05/04/1983
PRATT, ANDREW	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 11/20/2023
RAHNEMA, GUDARS	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 10/02/2022
VAZQUEZ, CINDY	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 10/01/2022
WEST, JAMES	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 01/01/2020

Medicare enrollment

As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of PIH HEALTH GOOD SAMARITAN HOSPITAL (enrollment ID O20220217000877).

Owner	Individual or organization	Role	Ownership percentage	Association date	Described in the filing as
PIH HEALTH GOOD SAMARITAN HOSPITAL	Organization	5% OR GREATER DIRECT OWNERSHIP INTEREST	100	1/1/2020	Private equity company: No Real estate investment trust: No Holding company: No
ANDREW MICHAEL PRATT	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.	11/20/2023	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.
ANNA MARIA LEONARD	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	2/1/2022	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.
CINDY VAZQUEZ	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.	10/1/2022	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.
GUDARS M RAHNEMA	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.	10/2/2022	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.
JAMES R WEST	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	1/1/2020	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
KPMG LLP	Organization	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	2/18/2025	Private equity company: No Real estate investment trust: No Holding company: No
NOEL PATRICK COPPINGER	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	1/1/2020	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
PIH HEALTH GOOD SAMARITAN HOSPITAL	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.	2/18/2025	Private equity company: No Real estate investment trust: No Holding company: No
PIH HEALTH 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.	1/1/2020	Private equity company: No Real estate investment trust: No Holding company: No
PIH HEALTH WHITTIER HOSPITAL	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.	2/19/2025	Private equity company: No Real estate investment trust: No Holding company: No
SHELLY L NECKE	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	12/1/2022	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.
SUSANNE R PONCE	Individual	ADP OF THE SNF	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	1/1/2020	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
VIDHYASHANKARAN MAHALINGAMSHIVARAMAN	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.	4/12/2021	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
ALEX F ALVAREZ	Individual	CORPORATE DIRECTOR	0	10/9/2017	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.
CHARLOTTE A WEAVER	Individual	CORPORATE DIRECTOR	0	10/10/2016	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.
DEBORAH MEDRANO	Individual	CORPORATE DIRECTOR	0	12/13/2024	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
HAMILTON J HAMAR	Individual	CORPORATE DIRECTOR	0	10/10/2016	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.
J RICHARD ATWOOD	Individual	CORPORATE DIRECTOR	0	4/25/2005	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.
KENTON C WOODS	Individual	CORPORATE DIRECTOR	0	2/28/2005	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.
MARISSA GOLDBERG	Individual	CORPORATE DIRECTOR	0	10/1/2021	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
MELANIE CATHERINE BATISTE	Individual	CORPORATE DIRECTOR	0	10/21/2021	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
MOEZ D KHORSANDI	Individual	CORPORATE DIRECTOR	0	3/22/2024	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
PATRICK L MONROE	Individual	CORPORATE DIRECTOR	0	10/10/2016	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.
PAUL A TREINEN	Individual	CORPORATE DIRECTOR	0	11/12/2019	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
PETER P GREANEY	Individual	CORPORATE DIRECTOR	0	11/13/2018	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.
REGINE JEANNE SYDA-LAWTON	Individual	CORPORATE DIRECTOR	0	12/13/2024	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
SCOTT KROG	Individual	CORPORATE DIRECTOR	0	12/13/2024	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
SCOTT SOUTHRON	Individual	CORPORATE DIRECTOR	0	12/13/2024	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
THURSO BARENDSE	Individual	CORPORATE DIRECTOR	0	2/8/2024	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
TRACEA R SARALIEV	Individual	CORPORATE DIRECTOR	0	2/8/2024	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
WILLIAM HAROLD ROTH	Individual	CORPORATE DIRECTOR	0	3/1/2023	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.
JAMES R WEST	Individual	CORPORATE OFFICER	0	1/1/2020	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
VIDHYASHANKARAN MAHALINGAMSHIVARAMAN	Individual	CORPORATE OFFICER	0	4/12/2021	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
ALEX F ALVAREZ	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.	10/9/2017	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.
CHARLOTTE A WEAVER	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.	10/10/2016	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.
DEBORAH MEDRANO	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.	12/13/2024	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
HAMILTON J HAMAR	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.	10/10/2016	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.
J RICHARD ATWOOD	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.	4/25/2005	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.
JAMES R WEST	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.	1/1/2020	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
KENTON C WOODS	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.	2/28/2005	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.
MARISSA GOLDBERG	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.	10/1/2021	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
MELANIE CATHERINE BATISTE	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.	11/21/2021	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
MOEZ D KHORSANDI	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.	3/22/2024	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
PATRICK L MONROE	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.	10/10/2016	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.
PAUL A TREINEN	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.	11/12/2019	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
PETER P GREANEY	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.	11/13/2018	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.
REGINE JEANNE SYDA-LAWTON	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.	12/13/2024	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
SCOTT KROG	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.	12/13/2024	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
SCOTT SOUTHRON	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.	12/13/2024	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
THURSO BARENDSE	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.	2/8/2024	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
TRACEA R SARALIEV	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.	2/8/2024	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
WILLIAM HAROLD ROTH	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.	3/1/2023	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.
ANDREW MICHAEL PRATT	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.	11/20/2023	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.
ANNA MARIA LEONARD	Individual	OPERATIONAL/MANAGERIAL CONTROL	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	2/1/2022	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.
CINDY VAZQUEZ	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.	10/1/2022	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.
GUDARS M RAHNEMA	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.	10/2/2022	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.
JAMES R WEST	Individual	OPERATIONAL/MANAGERIAL CONTROL	0	1/1/2020	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
KPMG LLP	Organization	OPERATIONAL/MANAGERIAL CONTROL	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	6/1/2023	Private equity company: No Real estate investment trust: No Holding company: No
NOEL PATRICK COPPINGER	Individual	OPERATIONAL/MANAGERIAL CONTROL	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	1/1/2020	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
PIH HEALTH GOOD SAMARITAN HOSPITAL	Organization	OPERATIONAL/MANAGERIAL CONTROL	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	1/1/2020	Private equity company: No Real estate investment trust: No Holding company: No
PIH HEALTH WHITTIER HOSPITAL	Organization	OPERATIONAL/MANAGERIAL CONTROL	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	1/1/2020	Private equity company: No Real estate investment trust: No Holding company: No
SHELLY L NECKE	Individual	OPERATIONAL/MANAGERIAL CONTROL	CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.	12/1/2022	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.
SUSANNE R PONCE	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.	5/4/1983	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.
VIDHYASHANKARAN MAHALINGAMSHIVARAMAN	Individual	OPERATIONAL/MANAGERIAL CONTROL	0	4/12/2021	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.

Changes in ownership

1 July 2026: VIDHYASHANKARAN MAHALINGAMSHIVARAMAN no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: VIDHYASHANKARAN MAHALINGAMSHIVARAMAN no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: VIDHYASHANKARAN MAHALINGAMSHIVARAMAN no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: MELANIE CATHERINE BATISTE no longer appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: MELANIE CATHERINE BATISTE no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: TRACEA R SARALIEV no longer appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: TRACEA R SARALIEV no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: MARISSA GOLDBERG no longer appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: MARISSA GOLDBERG no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: VIDHYASHANKARAN MAHALINGAMSHIVARAMAN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: VIDHYASHANKARAN MAHALINGAMSHIVARAMAN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: VIDHYASHANKARAN MAHALINGAMSHIVARAMAN appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: MELANIE CATHERINE BATISTE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: MELANIE CATHERINE BATISTE appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: TRACEA R SARALIEV appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: TRACEA R SARALIEV appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: MARISSA GOLDBERG appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: MARISSA GOLDBERG appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 May 2025: PIH HEALTH INC no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: WESLEY R HEARTFIELD no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: JAMES R WEST no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: NOEL PATRICK COPPINGER no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: PAULA K COWAN no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: BLAYNE H CUTLER no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: SUSANNE R PONCE no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: JANE B DICUS no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: ROBERT MALONEY no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: VIDHYASHANKARAN MAHALINGAMSHIVARAMAN no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: ALEX F ALVAREZ appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: THURSO BARENDSE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: THURSO BARENDSE appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: PAUL A TREINEN appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: KENTON C WOODS appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: PIH HEALTH INC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: JAMES R WEST appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: JAMES R WEST appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: SCOTT KROG appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: SCOTT KROG appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: PATRICK L MONROE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: SCOTT SOUTHRON appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: SCOTT SOUTHRON appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: NOEL PATRICK COPPINGER appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: NOEL PATRICK COPPINGER appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: KPMG LLP appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: KPMG LLP appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: PETER P GREANEY appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: WILLIAM HAROLD ROTH appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: WILLIAM HAROLD ROTH appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: PIH HEALTH GOOD SAMARITAN HOSPITAL appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: PIH HEALTH GOOD SAMARITAN HOSPITAL appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: PIH HEALTH GOOD SAMARITAN HOSPITAL appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: HAMILTON J HAMAR appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: MOEZ D KHORSANDI appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: MOEZ D KHORSANDI appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: SHELLY L NECKE appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: SHELLY L NECKE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: SUSANNE R PONCE appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: SUSANNE R PONCE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: PIH HEALTH WHITTIER HOSPITAL appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: PIH HEALTH WHITTIER HOSPITAL appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: REGINE JEANNE SYDA-LAWTON appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: REGINE JEANNE SYDA-LAWTON appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: GUDARS M RAHNEMA appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: GUDARS M RAHNEMA appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: CINDY VAZQUEZ appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: CINDY VAZQUEZ appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: CHARLOTTE A WEAVER appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: DEBORAH MEDRANO appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: DEBORAH MEDRANO appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: ANNA MARIA LEONARD appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: ANNA MARIA LEONARD appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: J RICHARD ATWOOD appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: ANDREW MICHAEL PRATT appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: ANDREW MICHAEL PRATT appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: VIDHYASHANKARAN MAHALINGAMSHIVARAMAN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: MELANIE CATHERINE BATISTE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: TRACEA R SARALIEV appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: TRACEA R SARALIEV appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: MARISSA GOLDBERG appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: MARISSA GOLDBERG appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
15 May 2023: ALEX F ALVAREZ appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: PAUL A TREINEN appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: KENTON C WOODS appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: PIH HEALTH INC appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: WESLEY R HEARTFIELD appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: JAMES R WEST appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: JAMES R WEST appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: JAMES R WEST appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: PATRICK L MONROE appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: NOEL PATRICK COPPINGER appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: PETER P GREANEY appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: PAULA K COWAN appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: BLAYNE H CUTLER appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: HAMILTON J HAMAR appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: SUSANNE R PONCE appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: JANE B DICUS appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: CHARLOTTE A WEAVER appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: ROBERT MALONEY appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: J RICHARD ATWOOD appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: VIDHYASHANKARAN MAHALINGAMSHIVARAMAN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: VIDHYASHANKARAN MAHALINGAMSHIVARAMAN appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: VIDHYASHANKARAN MAHALINGAMSHIVARAMAN appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: MELANIE CATHERINE BATISTE appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv

Inspections

Inspection cycle	Health inspection	Fire safety inspection	Health deficiencies	Fire safety deficiencies
1	4 December 2025	4 December 2025	2	1
2	4 October 2024	4 October 2024	9	6
3	6 October 2023	6 October 2023	11	8

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

Deficiencies cited

22 deficiencies on file, newest inspection first

Inspection date	Inspection type	Tag	Category	What was cited	Scope and severity	Complaint	Corrected	Correction date
4 December 2025	Health	F 0604	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.	D	No	Deficient, Provider has date of correction	22 December 2025
4 December 2025	Health	F 0698	Quality of Life and Care Deficiencies	Provide safe, appropriate dialysis care/services for a resident who requires such services.	D	No	Deficient, Provider has date of correction	22 December 2025
1 July 2025	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.	D	Yes	Deficient, Provider has date of correction	5 August 2025
4 October 2024	Health	F 0640	Resident Assessment and Care Planning Deficiencies	Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.	D	No	Deficient, Provider has date of correction	25 October 2024
4 October 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.	E	No	Deficient, Provider has date of correction	25 October 2024
4 October 2024	Health	F 0661	Resident Assessment and Care Planning Deficiencies	Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.	D	No	Deficient, Provider has date of correction	25 October 2024
4 October 2024	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	25 October 2024
4 October 2024	Health	F 0693	Quality of Life and Care Deficiencies	Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.	D	No	Deficient, Provider has date of correction	25 October 2024
4 October 2024	Health	F 0758	Pharmacy Service Deficiencies	Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.	D	No	Deficient, Provider has date of correction	25 October 2024
4 October 2024	Health	F 0851	Administration Deficiencies	Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.	F	No	Deficient, Provider has date of correction	25 October 2024
4 October 2024	Health	F 0880	Infection Control Deficiencies	Provide and implement an infection prevention and control program.	D	No	Deficient, Provider has date of correction	25 October 2024
6 October 2023	Health	F 0558	Resident Rights Deficiencies	Reasonably accommodate the needs and preferences of each resident.	D	No	Deficient, Provider has date of correction	27 October 2023
6 October 2023	Health	F 0578	Resident Rights Deficiencies	Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.	D	No	Deficient, Provider has date of correction	27 October 2023
6 October 2023	Health	F 0582	Resident Rights Deficiencies	Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.	D	No	Deficient, Provider has date of correction	27 October 2023
6 October 2023	Health	F 0636	Resident Assessment and Care Planning Deficiencies	Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.	F	No	Deficient, Provider has date of correction	27 October 2023
6 October 2023	Health	F 0698	Quality of Life and Care Deficiencies	Provide safe, appropriate dialysis care/services for a resident who requires such services.	D	No	Deficient, Provider has date of correction	27 October 2023
6 October 2023	Health	F 0732	Nursing and Physician Services Deficiencies	Post nurse staffing information every day.	E	No	Deficient, Provider has date of correction	27 October 2023
6 October 2023	Health	F 0760	Pharmacy Service Deficiencies	Ensure that residents are free from significant medication errors.	D	No	Deficient, Provider has date of correction	27 October 2023
6 October 2023	Health	F 0812	Nutrition and Dietary Deficiencies	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.	D	No	Deficient, Provider has date of correction	6 October 2023
6 October 2023	Health	F 0838	Administration Deficiencies	Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.	D	No	Deficient, Provider has date of correction	6 October 2023
6 October 2023	Health	F 0851	Administration Deficiencies	Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.	D	No	Deficient, Provider has date of correction	8 November 2023
6 October 2023	Health	F 0867	Administration Deficiencies	Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.	D	No	Deficient, Provider has date of correction	7 November 2023

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	Non profit - Corporation
Legal Business Name	PIH HEALTH GOOD SAMARITAN HOSPITAL
Date First Approved to Provide Medicare and Medicaid Services	2022-12-01
Provider Resides in Hospital	Y
Continuing Care Retirement Community	N
Urban	Y
County/Parish	Los Angeles
Telephone Number	2132027050
Provider Changed Ownership in Last 12 Months	N
With a Resident and Family Council	None
Automatic Sprinkler Systems in All Required Areas	Yes
Number of Certified Beds	28
Average Number of Residents per Day	23.7
Overall Rating	5
Health Inspection Rating	5
QM Rating	2
Short-Stay QM Rating	2
Processing Date	2026-08-01

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

Every change on this record

1 July 2026: VIDHYASHANKARAN MAHALINGAMSHIVARAMAN no longer appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: VIDHYASHANKARAN MAHALINGAMSHIVARAMAN no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: VIDHYASHANKARAN MAHALINGAMSHIVARAMAN no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: MELANIE CATHERINE BATISTE no longer appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: MELANIE CATHERINE BATISTE no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: TRACEA R SARALIEV no longer appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: TRACEA R SARALIEV no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: MARISSA GOLDBERG no longer appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: MARISSA GOLDBERG no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: VIDHYASHANKARAN MAHALINGAMSHIVARAMAN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: VIDHYASHANKARAN MAHALINGAMSHIVARAMAN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: VIDHYASHANKARAN MAHALINGAMSHIVARAMAN appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: MELANIE CATHERINE BATISTE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: MELANIE CATHERINE BATISTE appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: TRACEA R SARALIEV appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: TRACEA R SARALIEV appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: MARISSA GOLDBERG appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
1 July 2026: MARISSA GOLDBERG appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
28 August 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
1 May 2025: PIH HEALTH INC no longer appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: WESLEY R HEARTFIELD no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: JAMES R WEST no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: NOEL PATRICK COPPINGER no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: PAULA K COWAN no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: BLAYNE H CUTLER no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: SUSANNE R PONCE no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: JANE B DICUS no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: ROBERT MALONEY no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: VIDHYASHANKARAN MAHALINGAMSHIVARAMAN no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: ALEX F ALVAREZ appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: THURSO BARENDSE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: THURSO BARENDSE appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: PAUL A TREINEN appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: KENTON C WOODS appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: PIH HEALTH INC appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: JAMES R WEST appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: JAMES R WEST appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: SCOTT KROG appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: SCOTT KROG appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: PATRICK L MONROE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: SCOTT SOUTHRON appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: SCOTT SOUTHRON appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: NOEL PATRICK COPPINGER appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: NOEL PATRICK COPPINGER appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: KPMG LLP appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: KPMG LLP appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: PETER P GREANEY appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: WILLIAM HAROLD ROTH appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: WILLIAM HAROLD ROTH appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: PIH HEALTH GOOD SAMARITAN HOSPITAL appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: PIH HEALTH GOOD SAMARITAN HOSPITAL appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: PIH HEALTH GOOD SAMARITAN HOSPITAL appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: HAMILTON J HAMAR appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: MOEZ D KHORSANDI appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: MOEZ D KHORSANDI appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: SHELLY L NECKE appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: SHELLY L NECKE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: SUSANNE R PONCE appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: SUSANNE R PONCE appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: PIH HEALTH WHITTIER HOSPITAL appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: PIH HEALTH WHITTIER HOSPITAL appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: REGINE JEANNE SYDA-LAWTON appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: REGINE JEANNE SYDA-LAWTON appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: GUDARS M RAHNEMA appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: GUDARS M RAHNEMA appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: CINDY VAZQUEZ appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: CINDY VAZQUEZ appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: CHARLOTTE A WEAVER appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: DEBORAH MEDRANO appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: DEBORAH MEDRANO appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: ANNA MARIA LEONARD appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: ANNA MARIA LEONARD appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: J RICHARD ATWOOD appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: ANDREW MICHAEL PRATT appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: ANDREW MICHAEL PRATT appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: VIDHYASHANKARAN MAHALINGAMSHIVARAMAN appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: MELANIE CATHERINE BATISTE appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: TRACEA R SARALIEV appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: TRACEA R SARALIEV appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: MARISSA GOLDBERG appears as MANAGING CONTROL - GOVERNING BODY in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
1 May 2025: MARISSA GOLDBERG appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-05-01.csv
20 June 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
15 May 2023: ALEX F ALVAREZ appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: PAUL A TREINEN appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: KENTON C WOODS appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: PIH HEALTH INC appears as 5% OR GREATER DIRECT OWNERSHIP INTEREST in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: WESLEY R HEARTFIELD appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: JAMES R WEST appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: JAMES R WEST appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: JAMES R WEST appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: PATRICK L MONROE appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: NOEL PATRICK COPPINGER appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: PETER P GREANEY appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: PAULA K COWAN appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: BLAYNE H CUTLER appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: HAMILTON J HAMAR appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: SUSANNE R PONCE appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: JANE B DICUS appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: CHARLOTTE A WEAVER appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: ROBERT MALONEY appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: J RICHARD ATWOOD appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: VIDHYASHANKARAN MAHALINGAMSHIVARAMAN appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: VIDHYASHANKARAN MAHALINGAMSHIVARAMAN appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: VIDHYASHANKARAN MAHALINGAMSHIVARAMAN appears as OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv
15 May 2023: MELANIE CATHERINE BATISTE appears as DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2023-05-15.csv

How to read this report

Every figure is printed as the CMS file it came from printed it. Each cost-report figure carries the worksheet, line and column of form CMS-2540 it was read from, so a reader holding the same public file can go to that cell; each Care Compare and Medicare enrollment section names its file and the date CMS stamped on it.

A figure the filing does not carry is left out, and so is a figure whose value the filing’s own arithmetic contradicts. Net income is printed with what the form’s own arithmetic shows about it — plainly where it follows from the lines above it, and, where it does not, beside what the form’s own lines leave unaccounted for. An ownership field left empty carries the dated sentence on CMS’s pause of the expanded Form CMS-855A disclosure. A source that holds nothing for this facility says so in its section.

This report carries no percentile and no score, and it does not place this facility above or below another. The five facilities above are the one comparison it draws: the nearest certified bed counts in the same state at the same fiscal year, listed by name. Nurse staffing is printed in its own section, on its own page, apart from the cost-report figures.

How to cite this report

Velarion Records, PIH HEALTH GOOD SAMARITAN HOSPITAL D/P SNF — facility record report, CMS certification number 555927. https://velarionrecords.com/facility/555927/report.

Cost report figures: CMS Healthcare Cost Report Information System, form CMS-2540-10, publication year 2024, file SNF10FY2024.zip.
Provider information, inspections, deficiencies and penalties: CMS Care Compare, file dated 1 August 2026.
Care Compare ownership: CMS file dated 1 August 2026.
Medicare enrollment ownership: CMS file dated 1 August 2026.
Nurse staffing: CMS Payroll-Based Journal, quarters 2023Q3 to 2026Q1.

Published by VELARIONAI LLC · Andrew Richardson, founder. Corrections: hello@velarionrecords.com, quoting certification number 555927. Velarion Records publishes these records as filed.

Nurse staffing, quarter by quarter

Hours this facility reported to CMS’s Payroll-Based Journal, one row per quarter, oldest first, each with how its figures are derived and the file it came from.

Nurse staffing hours by quarter
Quarter	Quarter ended	Days reported	Resident days	Registered nurse hours	Licensed practical nurse hours	Nurse aide hours	Total nurse hours
2023Q3	30 September 2023	92	3,796	3,598.01	1,301.73	4,178.88	9,078.62
2023Q4	31 December 2023	92	7,937	4,155.81	2,691.67	5,202.35	12,049.83
2024Q1	31 March 2024	91	9,691	3,100.11	1,579.6	6,002.3	10,682.01
2024Q2	30 June 2024	91	5,962	5,443.24	2,480.56	4,978.68	12,902.48
2024Q3	30 September 2024	92	3,397	5,476.84	3,203.15	5,651.83	14,331.82
2024Q4	31 December 2024	92	3,095	5,757.1	4,599.8	5,856.7	16,213.6
2025Q1	31 March 2025	90	2,269	8,947.37	3,965.07	5,796.53	18,708.97
2025Q2	30 June 2025	91	3,001	9,398.78	3,744.19	5,764.35	18,907.32
2025Q3	30 September 2025	92	3,394	10,104.06	4,561.41	6,618.37	21,283.84
2025Q4	31 December 2025	92	2,551	10,036.43	3,983.4	7,174.87	21,194.7
2026Q1	31 March 2026	90	2,137	10,693.24	4,372.17	7,588.04	22,653.45

Nurse staffing hours per resident day by quarter
Quarter	Registered nurse hours per resident day	Licensed practical nurse hours per resident day	Nurse aide hours per resident day	Total nurse hours per resident day
2023Q3	0.947842	0.342921	1.100864	2.391628
2023Q4	0.5236	0.339129	0.655455	1.518184
2024Q1	0.319896	0.162997	0.619368	1.102261
2024Q2	0.912989	0.416062	0.835069	2.164119
2024Q3	1.612258	0.942935	1.663771	4.218964
2024Q4	1.860129	1.486204	1.89231	5.238643
2025Q1	3.94331	1.747497	2.554663	8.245469
2025Q2	3.131883	1.247647	1.92081	6.30034
2025Q3	2.977036	1.343963	1.950021	6.271019
2025Q4	3.934312	1.561505	2.812572	8.308389
2026Q1	5.003856	2.045938	3.550791	10.600585

How each quarter is derived, and its file

2023Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2023-09-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2023-09-01.csv
2023Q4: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2023-12-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2023-12-01.csv
2024Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-01-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-01-01.csv
2024Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-04-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-04-01.csv
2024Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-09-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-09-01.csv
2024Q4: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-12-31.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-12-31.csv
2025Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-01-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-01-01.csv
2025Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-04-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-04-01.csv
2025Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-07-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-07-01.csv
2025Q4: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-10-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-10-01.csv
2026Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2026-01-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2026-01-01.csv

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