Why this was flagged
Medicare paid far more per patient than peers
In 2023 this provider was paid $34,200 per patient, against a typical $14,717 for the same kind of provider in VA. A genuinely high-need patient mix can explain some of this, but extreme per-patient billing is a classic upcoding and phantom-patient pattern.
Source Medicare Skilled Nursing Payments by Provider · record as of 11 Aug 2026 · pulled 9 Nov 2026 · version 2026-11-09 · 0c26d5
View the records behind this flag →
Owner is tied to 18 providers
An owner or managing party of this provider (AKIVA SHAPIRO) is listed on 18 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
YDI IRREVOCABLE TRUST
5% OR GREATER INDIRECT OWNERSHIP INTEREST · O · 100% ownership · since Feb 1, 2024
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
VA SNF OPERATIONS HOLDINGS 2 LLC
5% OR GREATER DIRECT OWNERSHIP INTEREST · O · 100% ownership · since Feb 1, 2024
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
YDI EASTERN HOLDCO LLC
5% OR GREATER INDIRECT OWNERSHIP INTEREST · O · 50% ownership · since Feb 1, 2024
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
JJ UNITED TR
5% OR GREATER INDIRECT OWNERSHIP INTEREST · O · 50% ownership · since Feb 1, 2024
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
AKIVA SHAPIRO
CORPORATE OFFICER · I · 0% ownership · since Feb 1, 2024
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
ANDREW SHULER
W-2 MANAGING EMPLOYEE · I · 0% ownership · since Feb 1, 2024
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
AKIVA SHAPIRO
OTHER · I · since Feb 1, 2024
Source CMS Skilled Nursing Facility All Owners · record as of 19 Oct 2026 · pulled 21 Oct 2026 · version 2026-10-21 · 859da0
Source timeline
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Source records
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| Detail | Value | Published file | Record as of | Pulled | Version |
|---|---|---|---|---|---|
| Legal name | OLD SOUTHWEST HEALTH AND REHABILITATION LLC | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
| Trading name | OLD SOUTHWEST HEALTH AND REHABILITATION | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
| NPI | 1750094033 | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
| Medicare certification number | 495156 | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
| CMS associate ID | 7012355878 | 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 |
| Incorporation date | 2022-11-30 | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
| State of incorporation | VA | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
| Street address | 324 KING GEORGE AVE SW | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
| City | ROANOKE | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
| State | VA | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
| ZIP | 24016-5213 | CMS Skilled Nursing Facility Enrollments | Oct 19, 2026 | Nov 9, 2026 | 2026-11-09 · e83b3d |
What changed
Public research history
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