Hammond Henry Dist Hospital

Enrollment entity

Provider / enrollment organization Enrollment PAC 0143115949 Enrollment ID O20080103000334

Linked facilitiesFacilities

StatesStates

7 parties: 0 organizations · 7 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Heather D Charlet	2668839911	Individual	Corporate Officer; Operational/Managerial Control; ADP of the SNF	60
Jodie Criswell	7113082520	Individual	Corporate Officer; Operational/Managerial Control	60
Thomas R Staley	3971790775	Individual	Operational/Managerial Control; ADP of the SNF	—
Wyatt Brieser	5597266411	Individual	Corporate Officer	60
Douglas Ford	4688019540	Individual	Corporate Officer	60
Kimberly Gehling	3779928635	Individual	Corporate Officer	60
Nancy Lang	5597100453	Individual	Corporate Officer	60

Heather D CharletPAC 2668839911
Individual60Corporate Officer; Operational/Managerial Control
Jodie CriswellPAC 7113082520
Individual60Corporate Officer; Operational/Managerial Control
Thomas R StaleyPAC 3971790775
IndividualOperational/Managerial Control; ADP of the SNF
Wyatt BrieserPAC 5597266411
Individual60Corporate Officer
Douglas FordPAC 4688019540
Individual60Corporate Officer
Kimberly GehlingPAC 3779928635
Individual60Corporate Officer
Nancy LangPAC 5597100453
Individual60Corporate Officer

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
HAMMOND-HENRY District Hsp Hammond Henry Dist Hospital 36 residents		Other disclo…	3.76	Ovr★★★★☆Stf★★★★★Ins★★☆☆☆QM★★★★★	36

HAMMOND-HENRY District Hsp
Hammond Henry Dist Hospital
Other disclosed role36 res3.76 HPRD
Overall 4Staffing Staff 5

Related CMS associates

Name match to Hammond Henry Dist Hospital in FEC filings. Similar names may appear—confirm on FEC.gov.