Facility record report · CMS certification number 676491

Mission Ridge Rehab & Nursing Center

Refugio, Texas · 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 January 2024 to 31 December 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	$4,899,296	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$376,435	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$4,522,861	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$4,593,835	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$70,974	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$420,122	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$349,148	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $349,148 (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	90	CMS-2540-10 worksheet S300001 line 800 column 100
Bed days available, all components	32,940	CMS-2540-10 worksheet S300001 line 800 column 200
Medicare (Title XVIII) patient days	1,772	CMS-2540-10 worksheet S300001 line 800 column 400
Medicaid (Title XIX) patient days	20,891	CMS-2540-10 worksheet S300001 line 800 column 500
Other-payer patient days	6,532	CMS-2540-10 worksheet S300001 line 800 column 600
Total patient days, all components	29,195	CMS-2540-10 worksheet S300001 line 800 column 700
Medicare discharges	41	CMS-2540-10 worksheet S300001 line 800 column 900
Medicaid discharges	94	CMS-2540-10 worksheet S300001 line 800 column 1000
Other-payer discharges	90	CMS-2540-10 worksheet S300001 line 800 column 1100
Total discharges, all components	225	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	43.22	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	222.24	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	129.76	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1436100, read from the public cost report file SNF10FY2024.zip.

Cost report for 1 January 2023 to 31 December 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 8 August 2024.

Revenue and expenses, fiscal year 2023
Figure	As filed	Where it comes from
Total patient revenue	$4,414,768	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$568,013	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$3,846,755	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$4,361,965	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$515,210	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$432,849	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$82,361	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$82,361 (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	90	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	15,958	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	87	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	42.53	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	381.68	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	183.43	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1391659, read from the public cost report file SNF10FY2023.zip.

Cost report for 1 January 2022 to 31 December 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 16 October 2024.

Revenue and expenses, fiscal year 2022
Figure	As filed	Where it comes from
Total patient revenue	$4,927,459	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$722,247	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$4,205,212	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$4,552,685	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$347,473	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$502,595	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	$155,122	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $155,122 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2022
Figure	As filed	Where it comes from
Total facility beds, all components	90	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	18,942	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	103	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	69.29	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	472.48	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	183.9	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1397299, read from the public cost report file SNF10FY2022.zip.

Cost report for 1 March 2021 to 31 December 2021 — a reporting period of 305 days, on form CMS-2540-10, settled, processed by CMS on 2 August 2022.

Revenue and expenses, fiscal year 2021
Figure	As filed	Where it comes from
Total patient revenue	$3,845,302	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	$464,009	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$3,381,293	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$3,851,341	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$470,048	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	$234,115	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$235,933	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$235,933 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2021
Figure	As filed	Where it comes from
Total facility beds, all components	90	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	15,425	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	82	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	63	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	326.61	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	188.11	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1328685, read from the public cost report file SNF10FY2021.zip.

Cost report for 13 July 2020 to 31 December 2020 — a reporting period of 171 days, not a full year, on form CMS-2540-10, settled, processed by CMS on 10 August 2021.

Revenue and expenses, fiscal year 2020
Figure	As filed	Where it comes from
Total patient revenue	$644,183	CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts	−$517,202	CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue	$1,161,385	CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses	$2,549,908	CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients	−$1,388,523	CMS-2540-10 worksheet G300000 line 500 column 100
Total other income	−$22,306	CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income	−$1,410,829	CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$1,022,342 (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 2020
Figure	As filed	Where it comes from
Total facility beds, all components	90	CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components	5,377	CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components	6	CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days	330.67	CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days	3,879	CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days	896.17	CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1292762, read from the public cost report file SNF10FY2020.zip.

Five facilities of a similar size in Texas, 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
CITY OF ENNIS DBA PARKS HEALTH CTR	90	23,545	$9,340,210	$9,083,217	$256,993	31 December 2024
MISSION RIDGE REHAB & NURSING CENTER	90	29,195	$4,522,861	$4,593,835	−$70,974	31 December 2024
PLEASANT SPRINGS HEALTHCARE CENTER	90	35,352	$5,728,886	$5,741,933	−$13,047	31 December 2024
RENAISSANCE CARE CENTER	91	21,829	$5,816,495	$5,690,809	$125,686	30 September 2024
RIDGECREST RETIREMENT & HEALTHCARE	90	23,481	$5,593,528	$6,810,739	−$1,217,211	31 December 2024
SOUTH DALLAS NURSING AND REHAB	91	21,671	$5,490,612	$5,393,079	$97,533	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
BLAKE, GARY	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 03/01/2021
BLAKE, MALISA	OPERATIONAL/MANAGERIAL CONTROL	Individual	NOT APPLICABLE	since 03/01/2021
CREATIVE SOLUTIONS IN HEALTHCARE INC	OPERATIONAL/MANAGERIAL CONTROL	Organization	NOT APPLICABLE	since 02/01/2022
HUGGINS, LINDA	W-2 MANAGING EMPLOYEE	Individual	NOT APPLICABLE	since 03/01/2021

Medicare enrollment

As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of REFUGIO II ENTERPRISES, LLC (enrollment ID O20210308002399).

Owner	Individual or organization	Role	Ownership percentage	Association date	Described in the filing as
HONOR X ENTERPRISES, LLC	Organization	5% OR GREATER DIRECT OWNERSHIP INTEREST	100	3/1/2021	Private equity company: No Real estate investment trust: No Holding company: No
GARY R BLAKE	Individual	5% OR GREATER INDIRECT OWNERSHIP INTEREST	50	3/1/2021	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.
MALISA A BLAKE	Individual	5% OR GREATER INDIRECT OWNERSHIP INTEREST	50	3/1/2021	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.
CREATIVE SOLUTIONS IN HEALTHCARE INC	Organization	OPERATIONAL/MANAGERIAL CONTROL	100	2/1/2022	Private equity company: No Real estate investment trust: No Holding company: No
GARY R BLAKE	Individual	OPERATIONAL/MANAGERIAL CONTROL	50	3/1/2021	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.
MALISA A BLAKE	Individual	OPERATIONAL/MANAGERIAL CONTROL	50	3/1/2021	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.
LINDA F HUGGINS	Individual	W-2 MANAGING EMPLOYEE	0	3/1/2021	Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.

Changes in ownership

No change in ownership appears in the CMS files on record since 20 September 2022.

Inspections

Inspection cycle	Health inspection	Fire safety inspection	Health deficiencies
1	26 February 2026	26 February 2026	9
2	23 November 2024	23 November 2024	12
3	3 August 2023	3 August 2023	4

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

Deficiencies cited

25 deficiencies on file, newest inspection first

Inspection date	Inspection type	Tag	Category	What was cited	Scope and severity	Complaint	Corrected	Correction date
14 May 2026	Health	F 0761	Pharmacy Service Deficiencies	Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.	D	Yes	Deficient, Provider has date of correction	5 June 2026
26 February 2026	Health	F 0550	Resident Rights Deficiencies	Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.	D	No	Deficient, Provider has date of correction	6 March 2026
26 February 2026	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	6 March 2026
26 February 2026	Health	F 0760	Pharmacy Service Deficiencies	Ensure that residents are free from significant medication errors.	E	No	Deficient, Provider has date of correction	6 March 2026
26 February 2026	Health	F 0812	Nutrition and Dietary Deficiencies	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.	E	No	Deficient, Provider has date of correction	6 March 2026
26 February 2026	Health	F 0880	Infection Control Deficiencies	Provide and implement an infection prevention and control program.	D	No	Deficient, Provider has date of correction	6 March 2026
5 February 2026	Health	F 0583	Resident Rights Deficiencies	Keep residents' personal and medical records private and confidential.	D	Yes	Deficient, Provider has date of correction	6 February 2026
11 September 2025	Health	F 0684	Quality of Life and Care Deficiencies	Provide appropriate treatment and care according to orders, resident’s preferences and goals.	D	Yes	Deficient, Provider has date of correction	12 September 2025
11 September 2025	Health	F 0689	Quality of Life and Care Deficiencies	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.	J	Yes	Past Non-Compliance	30 June 2025
23 November 2024	Health	F 0609	Freedom from Abuse, Neglect, and Exploitation Deficiencies	Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.	D	Yes	Deficient, Provider has date of correction	24 November 2024
23 November 2024	Health	F 0645	Resident Assessment and Care Planning Deficiencies	PASARR screening for Mental disorders or Intellectual Disabilities	D	No	Deficient, Provider has date of correction	24 November 2024
23 November 2024	Health	F 0657	Resident Assessment and Care Planning Deficiencies	Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.	D	No	Deficient, Provider has date of correction	24 November 2024
23 November 2024	Health	F 0684	Quality of Life and Care Deficiencies	Provide appropriate treatment and care according to orders, resident’s preferences and goals.	G	Yes	Deficient, Provider has date of correction	24 November 2024
23 November 2024	Health	F 0761	Pharmacy Service Deficiencies	Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.	D	No	Deficient, Provider has date of correction	24 November 2024
23 November 2024	Health	F 0842	Resident Assessment and Care Planning Deficiencies	Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.	D	Yes	Deficient, Provider has date of correction	24 November 2024
23 November 2024	Health	F 0880	Infection Control Deficiencies	Provide and implement an infection prevention and control program.	E	No	Deficient, Provider has date of correction	24 November 2024
10 October 2024	Health	F 0623	Resident Rights Deficiencies	Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.	D	Yes	Deficient, Provider has date of correction	11 October 2024
10 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	Yes	Deficient, Provider has date of correction	11 October 2024
10 October 2024	Health	F 0657	Resident Assessment and Care Planning Deficiencies	Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.	D	Yes	Deficient, Provider has date of correction	11 October 2024
10 October 2024	Health	F 0689	Quality of Life and Care Deficiencies	Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.	J	Yes	Deficient, Provider has date of correction	11 October 2024
10 October 2024	Health	F 0921	Environmental Deficiencies	Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.	D	Yes	Deficient, Provider has date of correction	11 October 2024
3 August 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	Yes	Deficient, Provider has date of correction	4 August 2023
3 August 2023	Health	F 0692	Quality of Life and Care Deficiencies	Provide enough food/fluids to maintain a resident's health.	D	Yes	Deficient, Provider has date of correction	4 August 2023
3 August 2023	Health	F 0812	Nutrition and Dietary Deficiencies	Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.	E	Yes	Deficient, Provider has date of correction	4 August 2023
3 August 2023	Health	F 0880	Infection Control Deficiencies	Provide and implement an infection prevention and control program.	E	No	Deficient, Provider has date of correction	4 August 2023

From the Care Compare health citations file NH_HealthCitations_Aug2026.csv, processed on 1 August 2026.

Penalties

Penalty date	Type	Fine amount	Fine ID
11 September 2025	Fine	$14,325	135673
23 November 2024	Fine	$15,216	113389
10 October 2024	Fine	$8,157	113300

From the Care Compare penalties file NH_Penalties_Aug2026.csv, processed on 1 August 2026.

Care Compare provider information

Field	As filed
Provider Type	Medicare and Medicaid
Ownership Type	For profit - Limited Liability company
Legal Business Name	REFUGIO II ENTERPRISES, LLC
Date First Approved to Provide Medicare and Medicaid Services	2020-08-14
Provider Resides in Hospital	N
Continuing Care Retirement Community	N
Urban	N
County/Parish	Refugio
Telephone Number	3615269223
Chain Name	CREATIVE SOLUTIONS IN HEALTHCARE
Chain ID	169
Provider Changed Ownership in Last 12 Months	N
With a Resident and Family Council	Resident
Automatic Sprinkler Systems in All Required Areas	Yes
Number of Certified Beds	90
Average Number of Residents per Day	41.4
Overall Rating	2
Health Inspection Rating	3
QM Rating	3
Long-Stay QM Rating	3
Short-Stay QM Rating	3
Processing Date	2026-08-01

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

Every change on this record

28 August 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
16 October 2024: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
8 August 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
2 August 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
25 January 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
10 August 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.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, Mission Ridge Rehab & Nursing Center — facility record report, CMS certification number 676491. https://velarionrecords.com/facility/676491/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 2021Q2 to 2026Q1.

Published by VELARIONAI LLC · Andrew Richardson, founder. Corrections: hello@velarionrecords.com, quoting certification number 676491. 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
2021Q2	30 June 2021	91	3,585	844.94	7,081	8,034.13	15,960.07
2021Q3	30 September 2021	92	4,377	863.73	5,119.16	7,882.89	13,865.78
2021Q4	31 December 2021	92	4,768	1,028.03	6,213.49	9,455.09	16,696.61
2022Q1	31 March 2022	90	4,735	925.99	6,012.59	8,106.01	15,044.59
2022Q2	30 June 2022	91	4,781	1,059.53	4,875.36	6,397.16	12,332.05
2022Q3	30 September 2022	92	4,920	1,683.04	5,109.55	6,551.54	13,344.13
2022Q4	31 December 2022	92	4,477	1,492.02	4,305.17	7,588.27	13,385.46
2023Q1	31 March 2023	90	4,051	1,135.78	4,213.1	6,886.02	12,234.9
2023Q2	30 June 2023	91	4,116	1,149.11	4,148.28	8,449.47	13,746.86
2023Q3	30 September 2023	92	3,812	1,448.5	4,218.46	8,093.44	13,760.4
2023Q4	31 December 2023	92	3,959	1,653.38	4,197.74	7,727.91	13,579.03
2024Q1	31 March 2024	91	4,078	1,466.4	4,602.23	6,843.01	12,911.64
2024Q2	30 June 2024	91	4,512	1,667.06	4,481.68	7,056.36	13,205.1
2024Q3	30 September 2024	92	4,284	2,432.64	3,566.69	6,788.97	12,788.3
2024Q4	31 December 2024	92	4,026	2,454.93	3,811.75	6,120	12,386.68
2025Q1	31 March 2025	90	3,596	2,263.69	3,496.46	6,394.11	12,154.26
2025Q2	30 June 2025	91	3,813	2,523.7	3,506.7	6,778.62	12,809.02
2025Q3	30 September 2025	92	3,849	2,575.99	3,344.77	5,321.63	11,242.39
2025Q4	31 December 2025	92	3,831	1,904.1	4,084.29	5,636.71	11,625.1
2026Q1	31 March 2026	90	3,725	2,669.02	4,007.31	5,191.97	11,868.3

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
2021Q2	0.235688	1.975174	2.24104	4.451902
2021Q3	0.197334	1.169559	1.80098	3.167873
2021Q4	0.21561	1.303165	1.983031	3.501806
2022Q1	0.195563	1.269818	1.711935	3.177316
2022Q2	0.221613	1.019736	1.338038	2.579387
2022Q3	0.342081	1.038526	1.331614	2.712222
2022Q4	0.333263	0.961619	1.694945	2.989828
2023Q1	0.28037	1.040015	1.699832	3.020217
2023Q2	0.279181	1.007843	2.052835	3.339859
2023Q3	0.379984	1.106626	2.123148	3.609759
2023Q4	0.417626	1.060303	1.951985	3.429914
2024Q1	0.359588	1.128551	1.678031	3.16617
2024Q2	0.369473	0.99328	1.56391	2.926662
2024Q3	0.567843	0.832561	1.584727	2.985131
2024Q4	0.609769	0.946783	1.520119	3.076672
2025Q1	0.629502	0.972319	1.778117	3.379939
2025Q2	0.661867	0.91967	1.777766	3.359302
2025Q3	0.669262	0.868997	1.382601	2.92086
2025Q4	0.497024	1.066116	1.471342	3.034482
2026Q1	0.716515	1.075788	1.393817	3.186121

How each quarter is derived, and its file

2021Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2021-06-30.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_:_2021-06-30.csv
2021Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2021-09-30.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_:_2021-09-30.csv
2021Q4: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2021-12-31.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. The file's `incomplete` column flags 0 of this facility's days as 1; those days are included as filed. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2021-12-31.csv
2022Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2022-01-01.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_:_2022-01-01.csv
2022Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2022-06-30.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_:_2022-06-30.csv
2022Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2022-09-30.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_:_2022-09-30.csv
2022Q4: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2022-12-31.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_:_2022-12-31.csv
2023Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2023-01-01.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_:_2023-01-01.csv
2023Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2023-06-01.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_:_2023-06-01.csv
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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