Willow Ridge Healthcare LLC

Enrollment entity

Provider / enrollment organization Enrollment PAC 0143515379 Enrollment ID O20160826000111

Linked facilitiesFacilities

StatesStates

5 parties: 2 organizations · 3 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Jacob Stern	7517115090	Individual	5% or Greater Direct Ownership Interest; 5% or Greater Indirect Ownership Interest; Operational/Managerial Control	100
Adam R Bealer	6406141639	Individual	Operational/Managerial Control	100
Cch Healthcare LLC	1951696186	Organization	5% or Greater Indirect Ownership Interest	100
Forbright Bank	7113238049	Organization	5% or Greater Security Interest	—
Thomas Neshek	5496907495	Individual	Other	0

Jacob SternPAC 7517115090
Individual1005% or Greater Direct Ownership Interest; 5% or Greater Indirect Ownership Interest
Adam R BealerPAC 6406141639
Individual100Operational/Managerial Control
Cch Healthcare LLCPAC 1951696186
Organization1005% or Greater Indirect Ownership Interest
Forbright BankPAC 7113238049
Organization5% or Greater Security Interest
Thomas NeshekPAC 5496907495
Individual0Other

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
Willow Ridge of Nc Willow Ridge Healthcare LLC 118 residents		Other disclo…	3.88	Ovr★★☆☆☆Stf★★★☆☆Ins★★☆☆☆QM★★★★☆	118

Willow Ridge of Nc
Willow Ridge Healthcare LLC
Other disclosed role118 res3.88 HPRD
Overall 2Staffing Staff 3

1 CMS ownership change record (showing 1)

Effective	Facility	Buyer	Seller	Side
06/01/2016	Willow Ridge of Nc	Willow Ridge Healthcare LLC	Willow Ridge of Nc, LLC	Buyer

06/01/2016
Willow Ridge of Nc (Buyer)
Willow Ridge of Nc, LLC → Willow Ridge Healthcare LLC

Related CMS associates

Name match to Willow Ridge Healthcare LLC in FEC filings. Similar names may appear—confirm on FEC.gov.