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Facility record report · CMS certification number 676397

PINE SHADOW RETREAT

PORTER, Texas

This certification number is not in CMS’s current Care Compare Provider Information file, processed on 1 August 2026.

Finances, as filed

From this facility’s Medicare cost reports on form CMS-2540, each figure with the worksheet, line and column it was read from.

Cost report for 1 January 2019 to 31 December 2019 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 24 September 2020.

Revenue and expenses, fiscal year 2019
FigureAs filedWhere it comes from
Total patient revenue$5,220,888CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$126,962CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$5,093,926CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$4,956,626CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients$137,300CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$125,637CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$262,937CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $262,937 (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 2019
FigureAs filedWhere it comes from
Total facility beds, all components126CMS-2540-10 worksheet S300001 line 800 column 100
Bed days available, all components45,990CMS-2540-10 worksheet S300001 line 800 column 200
Medicare (Title XVIII) patient days1,811CMS-2540-10 worksheet S300001 line 800 column 400
Medicaid (Title XIX) patient days19,059CMS-2540-10 worksheet S300001 line 800 column 500
Other-payer patient days2,110CMS-2540-10 worksheet S300001 line 800 column 600
Total patient days, all components22,980CMS-2540-10 worksheet S300001 line 800 column 700
Medicare discharges40CMS-2540-10 worksheet S300001 line 800 column 900
Medicaid discharges174CMS-2540-10 worksheet S300001 line 800 column 1000
Other-payer discharges24CMS-2540-10 worksheet S300001 line 800 column 1100
Total discharges, all components238CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days45.28CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days109.53CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days96.55CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1269621, read from the public cost report file SNF10FY2019.zip.

Cost report for 1 January 2018 to 31 December 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 15 July 2019.

Revenue and expenses, fiscal year 2018
FigureAs filedWhere it comes from
Total patient revenue$7,526,935CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$770,075CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$6,756,860CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$6,142,582CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients$614,278CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$19,294CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$633,572CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $633,572 (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 2018
FigureAs filedWhere it comes from
Total facility beds, all components126CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components31,972CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components245CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days50.2CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days184.85CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days130.5CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1236982, read from the public cost report file SNF10FY2018.zip.

Cost report for 1 January 2017 to 31 December 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 21 August 2018.

Revenue and expenses, fiscal year 2017
FigureAs filedWhere it comes from
Total patient revenue$6,990,950CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$928,907CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$6,062,043CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$5,734,817CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients$327,226CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$1,756CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$328,982CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $328,982 (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 2017
FigureAs filedWhere it comes from
Total facility beds, all components126CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components33,166CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components219CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days60.24CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days204.49CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days151.44CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1209283, read from the public cost report file SNF10FY2017.zip.

Cost report for 18 February 2016 to 31 December 2016 — a reporting period of 317 days, on form CMS-2540-10, settled, processed by CMS on 18 August 2017.

Revenue and expenses, fiscal year 2016
FigureAs filedWhere it comes from
Total patient revenue$5,497,425CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts−$124,166CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$5,621,591CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$5,881,822CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients−$260,231CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$8,549CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income−$251,682CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$251,682 (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 2016
FigureAs filedWhere it comes from
Total facility beds, all components126CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components36,297CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components191CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days85.63CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days237.48CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days190.04CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1173923, read from the public cost report file SNF10FY2016.zip.

Five facilities of a similar size in Texas, fiscal year 2019

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.

FacilityTotal facility bedsTotal patient daysNet patient revenueTotal operating expensesNet income from service to patientsPeriod ended
CREEKSIDE TERRACE REHAB12635,477$8,334,294$8,474,911−$140,61731 December 2019
LIFE CARE CENTER OF HALTOM12734,050$8,118,216$9,199,773−$1,081,55731 August 2019
MANSFIELD NURSING & REHABILITATION L12724,009$4,043,275$4,679,277−$636,00231 December 2019
MEDINA CO HOS DIS-TOWN & COUNTRY NRC12633,527$6,247,786$6,477,153−$229,36731 December 2019
PINE SHADOW RETREAT12622,980$5,093,926$4,956,626$137,30031 December 2019
RETAMA MANOR-MCALLEN12629,565$5,685,040$5,897,085−$212,04531 December 2019

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

Not yet extracted for this facility.

Medicare enrollment

Not yet extracted for this facility.

Changes in ownership

Not yet extracted for this facility.

Inspections

Not yet extracted for this facility.

Deficiencies cited

Not yet extracted for this facility.

Penalties

Not yet extracted for this facility.

Care Compare provider information

Not yet extracted for this facility.

Every change on this record

  • 24 September 2020: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
  • 15 July 2019: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2018.zip
  • 21 August 2018: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2017.zip
  • 18 August 2017: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2016.zip

How to read this report

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

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

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

How to cite this report

Velarion Records, PINE SHADOW RETREAT — facility record report, CMS certification number 676397. https://velarionrecords.com/facility/676397/report.

Published by VELARIONAI LLC · Andrew Richardson, founder. Corrections: hello@velarionrecords.com, quoting certification number 676397. 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
QuarterQuarter endedDays reportedResident daysRegistered nurse hoursLicensed practical nurse hoursNurse aide hoursTotal nurse hours
2017Q131 March 2017908,3857475,832.2514,012.7520,592
2017Q230 June 2017918,3447046,017.2514,037.2520,758.5
2017Q330 September 2017928,387757.56,876.2512,93820,571.75
2017Q431 December 2017928,272790.756,58811,67319,051.75
2018Q131 March 2018907,9151,533.756,47013,28521,288.75
2018Q230 June 2018918,2311,5076,370.2513,666.8321,544.08
2018Q330 September 2018928,0431,803.756,05814,019.7521,881.5
2018Q431 December 2018927,8991,725.756,17313,177.3721,076.12
2019Q131 March 2019907,8501,8706,30013,260.521,430.5
2019Q230 June 2019917,9862,120.756,440.2513,052.7521,613.75
2019Q330 September 2019927,1591,494.55,96011,688.7519,143.25
2019Q431 December 201992276469.751,062.251,320.752,852.75
Nurse staffing hours per resident day by quarter
QuarterRegistered nurse hours per resident dayLicensed practical nurse hours per resident dayNurse aide hours per resident dayTotal nurse hours per resident day
2017Q10.0890880.6955581.6711692.455814
2017Q20.0843720.7211471.6823172.487836
2017Q30.0903180.819871.5426252.452814
2017Q40.0955940.7964221.4111462.303161
2018Q10.1937780.8174351.6784592.689672
2018Q20.1830880.7739341.6604092.617432
2018Q30.2242630.7532021.74312.720564
2018Q40.2184770.7814911.6682332.668201
2019Q10.2382170.8025481.6892362.73
2019Q20.2655580.8064431.6344542.706455
2019Q30.2087580.8325191.6327352.674012
2019Q41.7019933.8487324.78532610.336051

How each quarter is derived, and its file

  • 2017Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2017-03-31.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. This file names the totals hrs_rn_donadmin, hrs_lpn_admin, hrs_na_trn; they are read as hrs_rndon, hrs_lpnadmin, hrs_natrn. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2017-03-31.csv
  • 2017Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2017-06-30.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. This file names the totals hrs_lpn_admin; they are read as hrs_lpnadmin. CMS's file labels its last six hours columns hrs_medaide, hrs_medaide_emp, hrs_rn_donadmin, hrs_na_trn, hrs_natrn_emp, hrs_natrn_ctr; they are read by position as Hrs_MedAide_emp, Hrs_MedAide_ctr, Hrs_NAtrn, Hrs_NAtrn_emp, Hrs_NAtrn_ctr, Hrs_MedAide, the order in which each total equals its employee and contract parts on every row. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2017-06-30.csv
  • 2017Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2017-09-30.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. This file names the totals hrs_lpn_admin, hrs_na_trn; they are read as hrs_lpnadmin, hrs_natrn. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2017-09-30.csv
  • 2017Q4: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2017-12-31.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. This file names the totals hrs_lpn_admin, hrs_na_trn; they are read as hrs_lpnadmin, hrs_natrn. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2017-12-31.csv
  • 2018Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2018-03-31.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_:_2018-03-31.csv
  • 2018Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2018-06-30.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_:_2018-06-30.csv
  • 2018Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2018-09-30.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_:_2018-09-30.csv
  • 2018Q4: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2018-12-13.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_:_2018-12-13.csv
  • 2019Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2019-03-13.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_:_2019-03-13.csv
  • 2019Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2019-06-30.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_:_2019-06-30.csv
  • 2019Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2019-09-30.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_:_2019-09-30.csv
  • 2019Q4: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2019-12-31.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_:_2019-12-31.csv

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