Public record

CMS Skilled Nursing Facility All Owners

Associate id - owner: 7012283047 · 37 matching records

Enrollment id
O20171019000111
Associate id
6103192125
Organization name
PAVILION AT KENTON FOR NURSING AND REHABILITATION LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2017-05-09
First name - owner
RAFAEL
Last name - owner
MOERMAN
Percentage ownership
26
Enrollment id
O20171019000111
Associate id
6103192125
Organization name
PAVILION AT KENTON FOR NURSING AND REHABILITATION LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2017-05-09
First name - owner
RAFAEL
Last name - owner
MOERMAN
Title - owner
COO
Enrollment id
O20171019000111
Associate id
6103192125
Organization name
PAVILION AT KENTON FOR NURSING AND REHABILITATION LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2017-05-09
First name - owner
RAFAEL
Last name - owner
MOERMAN
Enrollment id
O20171019000111
Associate id
6103192125
Organization name
PAVILION AT KENTON FOR NURSING AND REHABILITATION LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2017-05-09
First name - owner
RAFAEL
Last name - owner
MOERMAN
Enrollment id
O20180705000414
Associate id
9436405404
Organization name
CT OHIO BELLBROOK, LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2022-09-29
First name - owner
RAFAEL
Last name - owner
MOERMAN
Title - owner
CEO
Percentage ownership
100
Enrollment id
O20180705000414
Associate id
9436405404
Organization name
CT OHIO BELLBROOK, LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2022-09-29
First name - owner
RAFAEL
Last name - owner
MOERMAN
Enrollment id
O20180711003358
Associate id
8820344468
Organization name
CT OHIO BEAVERCREEK, LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2022-09-29
First name - owner
RAFAEL
Last name - owner
MOERMAN
Title - owner
CEO
Enrollment id
O20180712002510
Associate id
3072869585
Organization name
CT OHIO ENGLEWOOD LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2022-09-29
First name - owner
RAFAEL
Last name - owner
MOERMAN
Title - owner
LLC MANAGER
Percentage ownership
50
Enrollment id
O20180712002510
Associate id
3072869585
Organization name
CT OHIO ENGLEWOOD LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2022-09-29
First name - owner
RAFAEL
Last name - owner
MOERMAN
Title - owner
CEO
Enrollment id
O20180712002510
Associate id
3072869585
Organization name
CT OHIO ENGLEWOOD LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2022-09-29
First name - owner
RAFAEL
Last name - owner
MOERMAN
Enrollment id
O20180712002951
Associate id
3870849391
Organization name
CT OHIO JAMESTOWN LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2022-09-29
First name - owner
RAFAEL
Last name - owner
MOERMAN
Title - owner
CEO
Enrollment id
O20180712002951
Associate id
3870849391
Organization name
CT OHIO JAMESTOWN LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
86
Role text - owner
INDIRECT OWNERSHIP INTEREST
Association date - owner
2022-09-29
First name - owner
RAFAEL
Last name - owner
MOERMAN
Percentage ownership
50
Enrollment id
O20180712003219
Associate id
4385990803
Organization name
CT OHIO PORTSMOUTH LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
40
Role text - owner
CORPORATE OFFICER
Association date - owner
2022-09-29
First name - owner
RAFAEL
Last name - owner
MOERMAN
Title - owner
CEO
Enrollment id
O20180712003219
Associate id
4385990803
Organization name
CT OHIO PORTSMOUTH LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
41
Role text - owner
CORPORATE DIRECTOR
Association date - owner
2022-09-29
First name - owner
RAFAEL
Last name - owner
MOERMAN
Title - owner
CEO
Enrollment id
O20180712003219
Associate id
4385990803
Organization name
CT OHIO PORTSMOUTH LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2022-09-29
First name - owner
RAFAEL
Last name - owner
MOERMAN
Title - owner
CEO
Enrollment id
O20180712003462
Associate id
1951657485
Organization name
CT OHIO XENIA LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2022-09-29
First name - owner
RAFAEL
Last name - owner
MOERMAN
Title - owner
CEO
Enrollment id
O20180712003462
Associate id
1951657485
Organization name
CT OHIO XENIA LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
86
Role text - owner
INDIRECT OWNERSHIP INTEREST
Association date - owner
2022-09-29
First name - owner
RAFAEL
Last name - owner
MOERMAN
Percentage ownership
50
Enrollment id
O20180713001339
Associate id
7517213093
Organization name
CT OHIO DAYTON-CENTERVILLE LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2022-09-29
First name - owner
RAFAEL
Last name - owner
MOERMAN
Percentage ownership
50
Enrollment id
O20180713001339
Associate id
7517213093
Organization name
CT OHIO DAYTON-CENTERVILLE LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2022-09-29
First name - owner
RAFAEL
Last name - owner
MOERMAN
Title - owner
CEO
Enrollment id
O20180713001339
Associate id
7517213093
Organization name
CT OHIO DAYTON-CENTERVILLE LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2022-09-29
First name - owner
RAFAEL
Last name - owner
MOERMAN
Enrollment id
O20181017002071
Associate id
2668724774
Organization name
PAVILION AT PIKETON FOR NURSING AND REHABILITATION LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2018-06-01
First name - owner
RAFAEL
Last name - owner
MOERMAN
Percentage ownership
17.5
Enrollment id
O20210513003005
Associate id
3375952781
Organization name
THE PAVILION AT CRESCENT LAKE FOR NURSING AND REHABILITATION LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2021-05-01
First name - owner
RAFAEL
Last name - owner
MOERMAN
Percentage ownership
55
Enrollment id
O20210513003005
Associate id
3375952781
Organization name
THE PAVILION AT CRESCENT LAKE FOR NURSING AND REHABILITATION LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2021-05-01
First name - owner
RAFAEL
Last name - owner
MOERMAN
Enrollment id
O20210513003005
Associate id
3375952781
Organization name
THE PAVILION AT CRESCENT LAKE FOR NURSING AND REHABILITATION LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
86
Role text - owner
INDIRECT OWNERSHIP INTEREST
Association date - owner
2021-05-01
First name - owner
RAFAEL
Last name - owner
MOERMAN
Percentage ownership
55
Enrollment id
O20210517000103
Associate id
8820407216
Organization name
THE PAVILION AT JACKSONVILLE FOR NURSING AND REHABILITATION LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2021-05-01
First name - owner
RAFAEL
Last name - owner
MOERMAN
Enrollment id
O20210517000103
Associate id
8820407216
Organization name
THE PAVILION AT JACKSONVILLE FOR NURSING AND REHABILITATION LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2021-05-01
First name - owner
RAFAEL
Last name - owner
MOERMAN
Enrollment id
O20210517000103
Associate id
8820407216
Organization name
THE PAVILION AT JACKSONVILLE FOR NURSING AND REHABILITATION LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
86
Role text - owner
INDIRECT OWNERSHIP INTEREST
Association date - owner
2021-05-01
First name - owner
RAFAEL
Last name - owner
MOERMAN
Percentage ownership
35
Enrollment id
O20250318001083
Associate id
5597287730
Organization name
PAVILION AT STOW, LLC.
Associate id - owner
7012283047
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2025-02-06
First name - owner
RAFAEL
Last name - owner
MOERMAN
Title - owner
CEO
Percentage ownership
55.5
Enrollment id
O20250318001083
Associate id
5597287730
Organization name
PAVILION AT STOW, LLC.
Associate id - owner
7012283047
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2025-02-06
First name - owner
RAFAEL
Last name - owner
MOERMAN
Enrollment id
O20250318001083
Associate id
5597287730
Organization name
PAVILION AT STOW, LLC.
Associate id - owner
7012283047
Type - owner
I
Role code - owner
63
Role text - owner
MANAGING CONTROL - GOVERNING BODY
Association date - owner
2025-02-06
First name - owner
RAFAEL
Last name - owner
MOERMAN
Title - owner
CEO
Enrollment id
O20250318001083
Associate id
5597287730
Organization name
PAVILION AT STOW, LLC.
Associate id - owner
7012283047
Type - owner
I
Role code - owner
72
Role text - owner
ADP OF THE SNF
Association date - owner
2025-02-06
First name - owner
RAFAEL
Last name - owner
MOERMAN
Enrollment id
O20250714001054
Associate id
1456866037
Organization name
PAVILION AT CANAL FULTON LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2024-12-16
First name - owner
RAFAEL
Last name - owner
MOERMAN
Percentage ownership
55.5
Enrollment id
O20250714001054
Associate id
1456866037
Organization name
PAVILION AT CANAL FULTON LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2024-12-16
First name - owner
RAFAEL
Last name - owner
MOERMAN
Enrollment id
O20250714001054
Associate id
1456866037
Organization name
PAVILION AT CANAL FULTON LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
63
Role text - owner
MANAGING CONTROL - GOVERNING BODY
Association date - owner
2024-12-16
First name - owner
RAFAEL
Last name - owner
MOERMAN
Title - owner
CEO
Enrollment id
O20260130002154
Associate id
7113405150
Organization name
PAVILION AT EDGEFIELD LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
35
Role text - owner
5% OR GREATER INDIRECT OWNERSHIP INTEREST
Association date - owner
2024-12-16
First name - owner
RAFAEL
Last name - owner
MOERMAN
Percentage ownership
55.5
Enrollment id
O20260130002154
Associate id
7113405150
Organization name
PAVILION AT EDGEFIELD LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
43
Role text - owner
OPERATIONAL/MANAGERIAL CONTROL
Association date - owner
2024-12-16
First name - owner
RAFAEL
Last name - owner
MOERMAN
Enrollment id
O20260130002154
Associate id
7113405150
Organization name
PAVILION AT EDGEFIELD LLC
Associate id - owner
7012283047
Type - owner
I
Role code - owner
63
Role text - owner
MANAGING CONTROL - GOVERNING BODY
Association date - owner
2024-12-16
First name - owner
RAFAEL
Last name - owner
MOERMAN
Title - owner
CEO

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