Skilled nursing facility · CMS certification number 745054
LEGACY ESTATE LONG TERM CARE
COMANCHE, Texas · Medicare and Medicaid
Certified beds, as filed in Care Compare: 100
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 24 May 2024 to 31 December 2024 — a reporting period of 221 days, not a full year, on form CMS-2540-10, settled, processed by CMS on 28 August 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,268,704 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $2,268,704 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,490,602 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$2,221,898 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $100,007 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$2,121,891 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$2,121,891 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 221 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 55,471 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 1,605 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Medicaid (Title XIX) patient days | 4,087 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 3,150 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 8,842 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 19 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Medicaid discharges | 21 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 22 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 62 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 84.47 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 194.62 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 142.61 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1436109, read from the public cost report file SNF10FY2024.zip.
Nurse staffing
Nurse staffing hours from the Payroll-Based Journal, quarter by quarter, are on this facility’s staffing page, each quarter with the file it came from.
Ownership, as filed with CMS
Care Compare
As filed in the CMS file dated 1 August 2026 (Care Compare ownership).
| Owner or manager | Role | Type | Ownership percentage | Association |
|---|---|---|---|---|
| DONHAM, GUYLE | ADP OF THE SNF | Individual | NOT APPLICABLE | since 11/21/2024 |
| STARK, ELIZABETH | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 04/01/2024 |
| STARK, ELIZABETH | W-2 MANAGING EMPLOYEE | Individual | NOT APPLICABLE | since 04/01/2024 |
Medicare enrollment
As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of COMANCHE COUNTY CONSOLIDATED HOSPITAL DISTRICT (enrollment ID O20240312001092).
| Owner | Individual or organization | Role | Ownership percentage | Association date | Described in the filing as |
|---|---|---|---|---|---|
| GUYLE P DONHAM | 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. | 11/21/2024 | 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. |
| ELIZABETH N STARK | Individual | CORPORATE OFFICER | CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle. | 4/1/2024 | 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. |
| ELIZABETH N STARK | Individual | W-2 MANAGING EMPLOYEE | 0 | 4/1/2024 | 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. |
Changes in ownership
- 1 July 2026: ELIZABETH N STARK no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: ELIZABETH N STARK no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: ELIZABETH N STARK appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: ELIZABETH N STARK appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 January 2025: GUYLE P DONHAM appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 1 January 2025: ELIZABETH N STARK appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 1 January 2025: ELIZABETH N STARK appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
Recent changes on this record
- 1 July 2026: ELIZABETH N STARK no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: ELIZABETH N STARK no longer appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: ELIZABETH N STARK appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-07-01.csv
- 1 July 2026: ELIZABETH N STARK appears as CORPORATE OFFICER 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 January 2025: GUYLE P DONHAM appears as ADP OF THE SNF in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 1 January 2025: ELIZABETH N STARK appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
- 1 January 2025: ELIZABETH N STARK appears as CORPORATE OFFICER in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-01-01.csv
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | 1 July 2025 | 1 July 2025 | 3 | 2 |
| 2 | 24 May 2024 | 24 May 2024 | 0 | 0 |
From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.
Deficiencies cited
3 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| 1 July 2025 | Health | F 0656 | Resident Assessment and Care Planning Deficiencies | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | Yes | Deficient, Provider has date of correction | 6 August 2025 |
| 1 July 2025 | Health | F 0812 | Nutrition and Dietary Deficiencies | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | Yes | Deficient, Provider has date of correction | 6 August 2025 |
| 1 July 2025 | 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 | Yes | Deficient, Provider has date of correction | 6 August 2025 |
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 | Government - Hospital district |
| Legal Business Name | COMANCHE COUNTY CONSOLIDATED HOSPITAL DISTRICT |
| Date First Approved to Provide Medicare and Medicaid Services | 2024-05-24 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | N |
| County/Parish | Comanche |
| Telephone Number | 2548794970 |
| 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 | 100 |
| Average Number of Residents per Day | 76.2 |
| Overall Rating | 4 |
| Health Inspection Rating | 4 |
| QM Rating | 2 |
| Long-Stay QM Rating | 3 |
| Short-Stay QM Rating | 1 |
| Processing Date | 2026-08-01 |
From the Care Compare Provider Information file NH_ProviderInfo_Aug2026.csv, processed on 1 August 2026.
Get an email when this record changes
One email a day naming what moved on LEGACY ESTATE LONG TERM CARE: the field, the value before, the value after, and the date of the file that first showed it.
The facility alert follows this one record: a cost report filed or a figure on one changed, an inspection, a deficiency or a penalty recorded, an owner added or removed. The certification number arrives filled in.
On 1 July 2026: ELIZABETH N STARK no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. That is one line of the alert.
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The citable document for LEGACY ESTATE LONG TERM CARE
This page shows the record as it stands today. The report is the citable document: the same figures with the cell each came from, and beyond this page — five facilities of a similar size in Texas at the same fiscal year, listed by name; every change on the record rather than the recent ones below; the inspection and staffing history in blocks of their own; and a citation block naming every CMS file it was read from.
Every figure on this page is printed as it appears in the CMS file named beside it. A figure that does not match its file? Tell us on the corrections page, quoting certification number 745054.