Why this was flagged
Medicare paid this provider far more than its peers
In 2023 Medicare paid this provider $11,289,105, against a typical payment of $1,140,282 for the same kind of provider that year. High volume can be legitimate, but extreme outliers are where billing fraud shows up.
Source Medicare Skilled Nursing Payments by Provider · record as of 11 Aug 2026 · pulled 9 Nov 2026 · version 2026-11-09 · 0c26d5
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An owner name may match the federal exclusion list
The owner name matches an exclusion-list name, but no second identifier confirms identity. Treat this as low-confidence context until a person verifies it.
Source HHS OIG Exclusion List (LEIE) · record as of 9 Nov 2026 · pulled 9 Nov 2026 · version 2026-11-09 · 9e9c16
View the records behind this flag →
Owner is tied to 44 providers
An owner or managing party of this provider (BMO BANK, N.A.) is listed on 44 separate Medicare enrollments. Chains are legal, and most are ordinary business — this is background context, not a fraud indicator on its own.
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
View the records behind this flag →
Owners and managing parties of record
THOMAS OLDS
5% OR GREATER INDIRECT OWNERSHIP INTEREST · I · 78.13% ownership · since Jul 20, 2017
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
THOMAS OLDS
INDIRECT OWNERSHIP INTEREST · I · 78.13% ownership · since Jul 20, 2017
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
FRED SMITH
5% OR GREATER INDIRECT OWNERSHIP INTEREST · I · 12.69% ownership · since Jul 20, 2017
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
FRED SMITH
INDIRECT OWNERSHIP INTEREST · I · 12.69% ownership · since Jul 20, 2017
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
LOIS A MASTROCOLA
5% OR GREATER INDIRECT OWNERSHIP INTEREST · I · 9.18% ownership · since Jul 20, 2017
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
LOIS A MASTROCOLA
INDIRECT OWNERSHIP INTEREST · I · 9.18% ownership · since Jul 20, 2017
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
LOIS A MASTROCOLA
OPERATIONAL/MANAGERIAL CONTROL · I · since Jul 20, 2017
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
LOIS A MASTROCOLA
ADP OF THE SNF · I · since Jul 20, 2017
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
ANGELO CLYDE ARGUEL
OPERATIONAL/MANAGERIAL CONTROL · I · since Mar 17, 2025
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
ANGELO CLYDE ARGUEL
ADP OF THE SNF · I · since Mar 17, 2025
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
THOMAS OLDS
OPERATIONAL/MANAGERIAL CONTROL · I · since Jul 20, 2017
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
THOMAS OLDS
ADP OF THE SNF · I · since Jul 20, 2017
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
KELSEY COLEMAN
OPERATIONAL/MANAGERIAL CONTROL · I · since May 13, 2016
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
KELSEY COLEMAN
ADP OF THE SNF · I · since May 13, 2016
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
KABIR NAIN
OPERATIONAL/MANAGERIAL CONTROL · I · since Jan 8, 2024
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
KABIR NAIN
ADP OF THE SNF · I · since Jan 8, 2024
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
JESUS GUTIERREZ
OPERATIONAL/MANAGERIAL CONTROL · I · since Oct 31, 2023
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
JESUS GUTIERREZ
ADP OF THE SNF · I · since Oct 31, 2023
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
ALBERTA AMILCAR
OPERATIONAL/MANAGERIAL CONTROL · I · since Jul 11, 2023
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
ALBERTA AMILCAR
ADP OF THE SNF · I · since Jul 11, 2023
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
FRED SMITH
ADP OF THE SNF · I · since Jul 20, 2017
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
MEGAN DALY
OPERATIONAL/MANAGERIAL CONTROL · I · since Jun 30, 2003
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
MEGAN DALY
ADP OF THE SNF · I · since Jun 30, 2003
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
DINA DEGUZMAN
OPERATIONAL/MANAGERIAL CONTROL · I · since Jan 21, 2020
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
DINA DEGUZMAN
ADP OF THE SNF · I · since Jan 21, 2020
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
MICHAEL ANTHONY NIAKI
OPERATIONAL/MANAGERIAL CONTROL · I · since Jul 20, 2017
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
MICHAEL ANTHONY NIAKI
ADP OF THE SNF · I · since Jul 20, 2017
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
SAN RAFAEL RE, LLC
ADP OF THE SNF · O · since Jan 30, 2026
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
THERAGEN, LLC
OPERATIONAL/MANAGERIAL CONTROL · O · since Jul 20, 2017
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
THERAGEN, LLC
ADP OF THE SNF · O · since Jul 20, 2017
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
LIFE GENERATIONS HEALTHCARE, LLC
OPERATIONAL/MANAGERIAL CONTROL · O · since Jul 20, 2017
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
LIFE GENERATIONS HEALTHCARE, LLC
ADP OF THE SNF · O · since Jul 20, 2017
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
BMO BANK, N.A.
5% OR GREATER SECURITY INTEREST · O · since Oct 6, 2021
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
BMO BANK, N.A.
OPERATIONAL/MANAGERIAL CONTROL · O · since Oct 6, 2021
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
BMO BANK, N.A.
ADP OF THE SNF · O · since Oct 6, 2021
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
Source timeline
Corrections and disputes
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Source records
Each value includes its published file, download date, and weekly version. Open a link to check the source record. Verify this lead yourself.
| Detail | Value | Published file | Record as of | Pulled | Version |
|---|---|---|---|---|---|
| Legal name | GHC OF SAN RAFAEL, LLC | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
| Trading name | SMITH RANCH SKILLED NURSING & REHABILITATION CENTER | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
| NPI | 1023534443 | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
| Medicare certification number | 555595 | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
| CMS associate ID | 1658632229 | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
| Provider type | PART A PROVIDER - SKILLED NURSING FACILITY | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
| Organisation type | LLC | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
| Street address | 1550 SILVEIRA PKWY | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
| City | SAN RAFAEL | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
| State | CA | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
| ZIP | 94903-4879 | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
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Public research history
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