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Source: CMS Government Data
Report Card Number |
Provider CCN |
Facility Name |
Street Address |
City |
State Code |
Zip Code |
County |
Medicare CBSA Number |
Rural versus Urban |
Fiscal Year Begin Date |
Fiscal Year End Date |
Type of Control |
Total Days Title V |
Total Days Title XVIII |
Total Days Title XIX |
Total Days Other |
Total Days Total |
Number of Beds |
Total Bed Days Available |
Total Discharges Title V |
Total Discharges Title XVIII |
Total Discharges Title XIX |
Total Discharges Title Other |
Total Discharges Total |
SNF Avg Length Stay Title V |
SNF Avg Length Stay Title Xviii |
SNF Avg Length Stay Title Xix |
SNF Avg Length Stay Total |
SNF Admissions Title V |
SNF Admissions Title Xviii |
SNF Admissions Title Xix |
SNF Admissions Other |
SNF Admissions Total |
SNF Days Title V |
SNF Days Title Xviii |
SNF Days Title Xix |
SNF Days Other |
SNF Days Total |
SNF Number Of Beds |
SNF Bed Days Available |
SNF Discharges Title V |
SNF Discharges Title Xviii |
SNF Discharges Title Xix |
SNF Discharges Title Other |
SNF Discharges Total |
NF Number Of Beds |
NF Bed Days Available |
NF Days Title V |
NF Days Title Xix |
NF Days Other |
NF Days Total |
NF Discharges Title V |
NF Discharges Title Xix |
NF Discharges Title Other |
NF Discharges Total |
NF Avg Length Stay Title V |
NF Avg Length Stay Title Xix |
NF Avg Length Stay Total |
NF Admissions Title V |
NF Admissions Title Xix |
NF Admissions Other |
NF Admissions Total |
Total RUG Days |
Total Salaries From Worksheet A |
Overhead Non Salary Costs |
Total Charges |
Total Costs |
Wage Related Costs Core |
Total Salaries Adjusted |
Contract Labor |
Cash on hand and in banks |
Temporary Investments |
Notes Receivable |
Accounts Receivable |
Allowances For Uncollectible |
Inventory |
Prepaid Expenses |
Other Current Assets |
Total Current Assets |
Land |
Land Improvements |
Buildings |
Leasehold Improvements |
Fixed Equipment |
Major Movable Equipment |
Minor Equipment Depreciable |
Total Fixed Assets |
Investments |
Other Assets |
Total Other Assets |
Total Assets |
Accounts Payable |
Salaries Wages Fees Payable |
Payroll Taxes Payable |
Notes Loans Payable Short Term |
Deferred Income |
Other Current Liabilities |
Total Current Liabilities |
Mortgage Payable |
Notes Payable |
Unsecured Loans |
Other Long Term Liabilities |
Total Long Term Liabilities |
Total Liabilities |
General Fund Balance |
Total Fund Balances |
Total Liabilities And Fund Balances |
Total General Inpatient Care Services Revenue |
Inpatient Revenue |
Outpatient Revenue |
Gross Revenue |
Contractual Allowance Discounts |
Net Patient Revenue |
Total Operating Expense |
Net Income From Service To Patients |
Total Other Income |
Total Income |
Net Income |
Inpatient Pps Amount |
Nursing Allied Health Education |
Allowable Bad Debts |
Owner Name |
Occupancy Percentage |
Medicare Total Days |
Medicaid Total Days |
Free Market Days |
Total Home Revenue |
Total Payroll Costs |
Total Home Costs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1364005 | 155831 | BRIARCLIFF HEALTH & REHABILITATION C | 5024 WESTERN AVENUE | SOUTH BEND | IN | 46619 | ST. JOSEPH | 43780 | U | 2022-01-01 | 2022-12-31 | 9 | 2070 | 24511 | 4568 | 31149 | 111 | 40515 | 26 | 70 | 59 | 155 | 79.62 | 350.16 | 200.96 | 47 | 32 | 74 | 153 | 2070 | 24511 | 4568 | 31149 | 111 | 40515 | 26 | 70 | 59 | 155 | $3,399,635.00 | $6,628,045.00 | $1,444,453.00 | $751,736.00 | $486,428.00 | $3,406,056.00 | $1,763,451.00 | $-344,245.00 | $2,184,372.00 | $168,249.00 | $146,887.00 | $1,795,878.00 | $37,364.00 | $37,364.00 | $2,347.00 | $2,347.00 | $1,835,589.00 | $630,901.00 | $73,667.00 | $55,757.00 | $221,031.00 | $2,592,560.00 | $-49,390.00 | $155,603.00 | $106,213.00 | $2,698,773.00 | $-863,184.00 | $-863,184.00 | $1,835,589.00 | $10,897,094.00 | $12,341,547.00 | $12,341,547.00 | $2,545,616.00 | $9,795,931.00 | $10,027,680.00 | $-231,749.00 | $586,124.00 | $354,375.00 | $354,375.00 | $1,111,184.00 | $109,369.00 | BRIARCLIFF HEALTH CARE – SOUTH BEND LLC | 63.13 | 24511 | 2070 | 4568 | $12,341,547.00 | $3,399,635.00 | $6,628,045.00 | |||||||||||||||||||||||||||||||||||||||||
| 1364580 | 155115 | CARDINAL NURSING & REHABILITATION | 1121 E. LASALLE AVE. | SOUTH BEND | IN | 46617 | ST. JOSEPH | 43780 | U | 2022-01-01 | 2022-12-31 | 13 | 821 | 21342 | 4156 | 26319 | 144 | 52560 | 23 | 129 | 39 | 191 | 35.70 | 165.44 | 137.80 | 21 | 100 | 34 | 155 | 821 | 21342 | 4156 | 26319 | 144 | 52560 | 23 | 129 | 39 | 191 | $3,987,372.00 | $5,887,286.00 | $1,086,137.00 | $766,909.00 | $652,174.00 | $3,987,372.00 | $561,885.00 | $166,968,573.00 | $49,215,717.00 | $4,793,612.00 | $220,977,902.00 | $12,882,231.00 | $179,049,332.00 | $96,521,947.00 | $71,145,744.00 | $400,236,628.00 | $400,236,628.00 | $692,360,274.00 | $6,570,869.00 | $20,000,267.00 | $14,252,408.00 | $40,823,544.00 | $409,332,376.00 | $409,332,376.00 | $450,155,920.00 | $242,204,354.00 | $242,204,354.00 | $692,360,274.00 | $6,874,221.00 | $7,960,358.00 | $7,960,358.00 | $274,361.00 | $7,685,997.00 | $9,874,658.00 | $-2,188,661.00 | $26,238.00 | $-2,162,423.00 | $-2,162,423.00 | $529,950.00 | $74,797.00 | LAPE, KATHRYN | 41.11 | 21342 | 821 | 4156 | $7,960,358.00 | $3,987,372.00 | $5,887,286.00 | ||||||||||||||||||||||||||||||||||||||||||
| 1360206 | 155153 | HEALTHWIN | 20351 DARDEN ROAD | SOUTH BEND | IN | 46637-2915 | ST. JOSEPH | 43780 | U | 2022-01-01 | 2022-12-31 | 2 | 3534 | 25481 | 5179 | 34194 | 153 | 55845 | 143 | 59 | 152 | 354 | 24.71 | 431.88 | 96.59 | 186 | 31 | 92 | 309 | 3534 | 25481 | 5179 | 34194 | 153 | 55845 | 143 | 59 | 152 | 354 | $10,202,675.00 | $7,598,419.00 | $3,657,174.00 | $2,648,484.00 | $1,722,179.00 | $10,202,675.00 | $474,486.00 | $1,785,721.00 | $686,100.00 | $27,304.00 | $60,998.00 | $2,125,257.00 | $1,250,000.00 | $14,112,276.00 | $3,117,034.00 | $8,402,339.00 | $4,940,355.00 | $4,940,355.00 | $15,467,951.00 | $221,943.00 | $965,386.00 | $51,595.00 | $1,238,924.00 | $1,030,796.00 | $2,269,720.00 | $13,198,231.00 | $13,198,231.00 | $15,467,951.00 | $13,658,905.00 | $17,316,079.00 | $17,316,079.00 | $4,065,336.00 | $13,250,743.00 | $17,801,094.00 | $-4,550,351.00 | $-1,444,866.00 | $-5,995,217.00 | $-5,995,217.00 | $2,144,784.00 | $18,663.00 | DAVIS, LAUREN | 82.76 | 25481 | 3534 | 5179 | $17,316,079.00 | $10,202,675.00 | $7,598,419.00 | ||||||||||||||||||||||||||||||||||||||||||
| 1371377 | 155506 | HOLY CROSS REHABILITATION AND WELLNE | 17475 DUGDALE DRIVE | SOUTH BEND | IN | 46635 | ST. JOSEPH | 43780 | U | 2022-07-01 | 2023-06-30 | 9 | 3992 | 13666 | 6358 | 24016 | 168 | 61320 | 168 | 13 | 205 | 386 | 23.76 | 1051.23 | 62.22 | 160 | 226 | 386 | 3992 | 13666 | 6358 | 24016 | 168 | 61320 | 168 | 13 | 205 | 386 | $5,137,149.00 | $5,762,963.00 | $5,332,808.00 | $1,301,771.00 | $1,102,340.00 | $5,137,149.00 | $674,545.00 | $475,801.00 | $564,289.00 | $167,151.00 | $-103,411.00 | $-103,411.00 | $5,800,695.00 | $5,800,695.00 | $5,800,695.00 | $-5,904,106.00 | $-5,904,106.00 | $-103,411.00 | $10,909,390.00 | $16,242,199.00 | $16,242,199.00 | $6,651,922.00 | $9,590,277.00 | $10,900,112.00 | $-1,309,835.00 | $193,207.00 | $-1,116,628.00 | $-1,116,628.00 | $2,497,812.00 | $18,459.00 | 43.99 | 13666 | 3992 | 6358 | $16,242,199.00 | $5,137,149.00 | $5,762,963.00 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
| 1364701 | 155219 | MAJESTIC CARE OF SOUTH BEND | 52654 N IRONWOOD ROAD | SOUTH BEND | IN | 46635 | ST. JOSEPH | 43780 | U | 2022-01-01 | 2022-12-31 | 9 | 1717 | 15907 | 2908 | 20532 | 103 | 37595 | 26 | 78 | 52 | 156 | 66.04 | 203.94 | 131.62 | 58 | 60 | 61 | 179 | 1717 | 15907 | 2908 | 20532 | 103 | 37595 | 26 | 78 | 52 | 156 | $2,313,195.00 | $5,364,043.00 | $618,193.00 | $590,577.00 | $312,815.00 | $2,313,195.00 | $888,421.00 | $140,842.00 | $1,479,840.00 | $135,572.00 | $174,835.00 | $2,185,898.00 | $130,631.00 | $114,193.00 | $220,627.00 | $2,406,525.00 | $470,181.00 | $76,389.00 | $45,917.00 | $547,304.00 | $1,532,183.00 | $1,277,084.00 | $1,277,084.00 | $2,809,267.00 | $-402,742.00 | $-402,742.00 | $2,406,525.00 | $7,755,703.00 | $8,373,896.00 | $8,373,896.00 | $692,222.00 | $7,681,674.00 | $7,677,238.00 | $4,436.00 | $1,183.00 | $5,619.00 | $5,619.00 | $1,103,258.00 | $114,378.00 | MAJESTIC CARE OF SOUTH BEND LLC | 78.54 | 15907 | 1717 | 2908 | $8,373,896.00 | $2,313,195.00 | $5,364,043.00 | |||||||||||||||||||||||||||||||||||||||||||
| 1365058 | 155684 | SOUTHFIELD VILLAGE INC. | 6450 MIAMI CIRCLE | SOUTH BEND | IN | 46614 | ST. JOSEPH | 43780 | U | 2022-01-01 | 2022-12-31 | 2 | 2460 | 10221 | 6768 | 19449 | 60 | 21900 | 59 | 9 | 51 | 119 | 41.69 | 1135.67 | 163.44 | 80 | 1 | 41 | 122 | 2460 | 10221 | 6768 | 19449 | 60 | 21900 | 59 | 9 | 51 | 119 | $3,107,940.00 | $7,397,895.00 | $1,136,346.00 | $821,354.00 | $654,400.00 | $3,107,940.00 | $2,252,907.00 | $3,105,803.00 | $150,982.00 | $1,047,384.00 | $165,735.00 | $46,930.00 | $3,758.00 | $4,760,418.00 | $1,197,353.00 | $675,293.00 | $17,998,370.00 | $2,076,878.00 | $12,604,372.00 | $101,256.00 | $163,237.00 | $17,528,027.00 | $485,044.00 | $757,594.00 | $-556.00 | $1,242,082.00 | $16,127,076.00 | $52,813.00 | $16,322,209.00 | $17,564,291.00 | $-36,264.00 | $-36,264.00 | $17,528,027.00 | $8,274,633.00 | $12,257,722.00 | $12,257,722.00 | $2,086,003.00 | $10,171,719.00 | $10,505,835.00 | $-334,116.00 | $100,789.00 | $-233,327.00 | $-233,327.00 | $1,384,734.00 | $10,784.00 | SOUTHFIELD VILLAGE INC | 82.83 | 10221 | 2460 | 6768 | $12,257,722.00 | $3,107,940.00 | $7,397,895.00 | |||||||||||||||||||||||||||||||||||||
| 1379263 | 155738 | THE MILTON HOME | 206 EAST MARION ST. | SOUTH BEND | IN | 46601 | ST. JOSEPH | 43780 | U | 2022-01-01 | 2022-12-31 | 9 | 1427 | 6182 | 6737 | 14346 | 62 | 22630 | 11 | 32 | 17 | 60 | 129.73 | 193.19 | 157.10 | 27 | 34 | 24 | 85 | 1427 | 6182 | 1817 | 9426 | 34 | 12410 | 11 | 32 | 17 | 60 | $1,814,147.00 | $4,052,999.00 | $785,085.00 | $476,941.00 | $239,214.00 | $1,798,587.00 | $1,170,031.00 | $456,486.00 | $832,174.00 | $6,302.00 | $52,080.00 | $1,051,766.00 | $25,184.00 | $8,588.00 | $1,470.00 | $35,755.00 | $1,087,521.00 | $461,080.00 | $206,681.00 | $95,584.00 | $2,657,370.00 | $104,484.00 | $40,933.00 | $145,417.00 | $2,802,787.00 | $-1,715,266.00 | $-1,715,266.00 | $1,087,521.00 | $4,109,020.00 | $4,894,105.00 | $4,894,105.00 | $552,295.00 | $4,341,810.00 | $5,867,146.00 | $-1,525,336.00 | $98,203.00 | $-1,427,133.00 | $-1,427,133.00 | $804,471.00 | $54,144.00 | MILTON HOME NURSING HOME AND REHABILITATION | 79.71 | 6182 | 1427 | 6737 | $4,894,105.00 | $1,814,147.00 | $4,052,999.00 | ||||||||||||||||||||||||||||||||||||||||||
| 1368822 | 155103 | TRAILPOINT VILLAGE | 1950 RIDGEDALE RD. | SOUTH BEND | IN | 46614 | ST. JOSEPH | 43780 | U | 2022-01-01 | 2022-12-31 | 13 | 2088 | 29272 | 6158 | 37518 | 183 | 66795 | 48 | 244 | 52 | 344 | 43.50 | 119.97 | 109.06 | 59 | 193 | 46 | 298 | 2088 | 29272 | 6158 | 37518 | 183 | 66795 | 48 | 244 | 52 | 344 | $7,915,791.00 | $7,223,426.00 | $2,964,165.00 | $2,147,447.00 | $1,221,644.00 | $7,870,611.00 | $497,906.00 | $166,968,573.00 | $49,215,717.00 | $4,793,612.00 | $220,977,902.00 | $12,882,231.00 | $179,049,332.00 | $96,521,947.00 | $71,145,744.00 | $400,236,628.00 | $400,236,628.00 | $692,360,274.00 | $6,570,869.00 | $20,000,267.00 | $14,252,408.00 | $40,823,544.00 | $409,332,376.00 | $409,332,376.00 | $450,155,920.00 | $242,204,354.00 | $242,204,354.00 | $692,360,274.00 | $10,688,332.00 | $13,652,497.00 | $13,652,497.00 | $1,073,396.00 | $12,579,101.00 | $15,139,217.00 | $-2,560,116.00 | $33,324.00 | $-2,526,792.00 | $-2,526,792.00 | $1,312,732.00 | $142,151.00 | BRADFORD, KATRINA | 49.78 | 29272 | 2088 | 6158 | $13,652,497.00 | $7,915,791.00 | $7,223,426.00 | ||||||||||||||||||||||||||||||||||||||||||
| 1358921 | 155824 | WELLBROOKE OF SOUTH BEND | 52565 STATE ROAD 933 | SOUTH BEND | IN | 46637-3257 | ST. JOSEPH | 43780 | U | 2022-01-01 | 2022-12-31 | 4 | 4979 | 4317 | 19474 | 28770 | 119 | 43435 | 142 | 14 | 200 | 356 | 35.06 | 308.36 | 62.69 | 175 | 10 | 82 | 267 | 4979 | 4317 | 8194 | 17490 | 70 | 25550 | 142 | 14 | 123 | 279 | $4,457,389.00 | $6,043,346.00 | $1,528,421.00 | $1,149,913.00 | $963,995.00 | $4,457,389.00 | $642,052.00 | $1,202.00 | $866,524.00 | $122,405.00 | $15,474.00 | $3,693.00 | $803,516.00 | $358,433.00 | $42,529.00 | $192,609.00 | $611,940.00 | $5,357,406.00 | $5,357,406.00 | $6,772,862.00 | $106,086.00 | $275,181.00 | $6,906.00 | $1,253,969.00 | $1,642,142.00 | $10,838,602.00 | $10,838,602.00 | $12,480,744.00 | $-5,707,882.00 | $-5,707,882.00 | $6,772,862.00 | $9,889,448.00 | $11,417,870.00 | $11,417,870.00 | $1,185,907.00 | $10,231,963.00 | $10,500,735.00 | $-268,772.00 | $-2,526,998.00 | $-2,795,770.00 | $-2,795,770.00 | $3,241,618.00 | $63,894.00 | WISE, RAYNE | 68.43 | 4317 | 4979 | 19474 | $11,417,870.00 | $4,457,389.00 | $6,043,346.00 | |||||||||||||||||||||||||||||||||||||||
| 1364945 | 155355 | WEST BEND NURSING & REHABILITATION | 4600 W. WASHINGTON AVE. | SOUTH BEND | IN | 46619 | ST. JOSEPH | 43780 | U | 2022-01-01 | 2022-12-31 | 13 | 924 | 15083 | 4493 | 20500 | 157 | 57305 | 35 | 87 | 36 | 158 | 26.40 | 173.37 | 129.75 | 33 | 65 | 29 | 127 | 924 | 15083 | 4493 | 20500 | 157 | 57305 | 35 | 87 | 36 | 158 | $3,546,057.00 | $4,157,676.00 | $702,208.00 | $543,525.00 | $591,217.00 | $3,546,057.00 | $54,193.00 | $166,968,573.00 | $49,215,717.00 | $4,793,612.00 | $220,977,902.00 | $12,882,231.00 | $179,049,332.00 | $96,521,947.00 | $71,145,744.00 | $400,236,628.00 | $400,236,628.00 | $692,360,274.00 | $6,570,869.00 | $20,000,267.00 | $14,252,408.00 | $40,823,544.00 | $409,332,376.00 | $409,332,376.00 | $450,155,920.00 | $242,204,354.00 | $242,204,354.00 | $692,360,274.00 | $6,124,812.00 | $6,827,020.00 | $6,827,020.00 | $731,536.00 | $6,095,484.00 | $7,703,733.00 | $-1,608,249.00 | $15,005.00 | $-1,593,244.00 | $-1,593,244.00 | $528,699.00 | $112,931.00 | BAILEY, EMILY | 34.01 | 15083 | 924 | 4493 | $6,827,020.00 | $3,546,057.00 | $4,157,676.00 |
