North Shore Retirement Community

Enrollment entity
Provider / enrollment organization Enrollment PAC 0143329961 Enrollment ID O20070620000184

Details

Linked facilitiesFacilities
1
StatesStates
1

27 parties: 4 organizations · 23 individuals

Owners & control parties

NameOwner/control PACTypeRole(s)%
Otterbein Home7113834045Organization5% or Greater Indirect Ownership Interest; Operational/Managerial Control; ADP of the SNF100
Becky Bayliff0648781070IndividualOperational/Managerial Control
Daniel Burke9234659483IndividualOperational/Managerial Control
Heidi Glosser1951458561IndividualOperational/Managerial Control
John E Pierce5395738777IndividualOperational/Managerial Control; ADP of the SNF
Ralph Reed Fraley4981518636IndividualOperational/Managerial Control
Robert Coleman8628144102IndividualOperational/Managerial Control
Steve Vonderhaar9739588542IndividualOperational/Managerial Control
Tomas Hazelbaker4587184734IndividualOperational/Managerial Control
Victoria Bartlett2163579772IndividualOperational/Managerial Control
William Brownson2961922117IndividualOperational/Managerial Control
Functional Pathways of Tennessee LLC5193255008OrganizationOperational/Managerial Control; ADP of the SNF
Lynn App9537485511IndividualCorporate Director; Operational/Managerial Control
Jennifer Lenthe0345566329IndividualOperational/Managerial Control; ADP of the SNF
Rita C Hawkins4385873298IndividualOperational/Managerial Control
James Christopher Green8224137047IndividualCorporate Officer; Operational/Managerial Control
Carolyn Pytlik8921512344IndividualManaging Control - Governing Body; Trustee of the SNF
Keb Bell3577077999IndividualManaging Control - Governing Body; Trustee of the SNF
Scot Ocke7012421431IndividualManaging Control - Governing Body; Trustee of the SNF
Becky Johnson5395259717IndividualManaging Control - Governing Body; Trustee of the SNF
Robyn Palmer6204340623IndividualManaging Control - Governing Body; Trustee of the SNF
Elizabeth Sibbring0749794162IndividualManaging Control - Governing Body; Trustee of the SNF
Marilyn Faris4486168804IndividualManaging Control - Governing Body; Trustee of the SNF
Otterbein Lsc, LLC4981981263Organization5% or Greater Direct Ownership Interest100
Jason E Miller1658500566IndividualCorporate Officer
Show all 27 parties (2 more)
NameOwner/control PACTypeRole(s)%
Otterbein Home7113834045Organization5% or Greater Indirect Ownership Interest; Operational/Managerial Control; ADP of the SNF100
Becky Bayliff0648781070IndividualOperational/Managerial Control
Daniel Burke9234659483IndividualOperational/Managerial Control
Heidi Glosser1951458561IndividualOperational/Managerial Control
John E Pierce5395738777IndividualOperational/Managerial Control; ADP of the SNF
Ralph Reed Fraley4981518636IndividualOperational/Managerial Control
Robert Coleman8628144102IndividualOperational/Managerial Control
Steve Vonderhaar9739588542IndividualOperational/Managerial Control
Tomas Hazelbaker4587184734IndividualOperational/Managerial Control
Victoria Bartlett2163579772IndividualOperational/Managerial Control
William Brownson2961922117IndividualOperational/Managerial Control
Functional Pathways of Tennessee LLC5193255008OrganizationOperational/Managerial Control; ADP of the SNF
Lynn App9537485511IndividualCorporate Director; Operational/Managerial Control
Jennifer Lenthe0345566329IndividualOperational/Managerial Control; ADP of the SNF
Rita C Hawkins4385873298IndividualOperational/Managerial Control
James Christopher Green8224137047IndividualCorporate Officer; Operational/Managerial Control
Carolyn Pytlik8921512344IndividualManaging Control - Governing Body; Trustee of the SNF
Keb Bell3577077999IndividualManaging Control - Governing Body; Trustee of the SNF
Scot Ocke7012421431IndividualManaging Control - Governing Body; Trustee of the SNF
Becky Johnson5395259717IndividualManaging Control - Governing Body; Trustee of the SNF
Robyn Palmer6204340623IndividualManaging Control - Governing Body; Trustee of the SNF
Elizabeth Sibbring0749794162IndividualManaging Control - Governing Body; Trustee of the SNF
Marilyn Faris4486168804IndividualManaging Control - Governing Body; Trustee of the SNF
Otterbein Lsc, LLC4981981263Organization5% or Greater Direct Ownership Interest100
Jason E Miller1658500566IndividualCorporate Officer
Jill Wilson5496662264IndividualCorporate Officer
Polaris Pharmacy Services of Ohio LLC0941743348OrganizationADP of the SNF

Linked facilities

Facility Location Role / stake HPRD Ratings Census Flags
Otterbein North Shore
North Shore Retirement Community
19 residents
Other disclo…
4.80Ovr★★★★★Stf★★★★★Ins★★★★QM★★★★19
  • North Shore Retirement Community
    Other disclosed role19 res4.80 HPRD
    Overall 5Staffing Staff 5
Related CMS associates

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Name match to North Shore Retirement Community in FEC filings. Similar names may appear—confirm on FEC.gov.