Fair Oaks Nursing and Rehab LLC

Enrollment entity

Provider / enrollment organization Enrollment PAC 0446515944 Enrollment ID O20180605000716

Linked facilitiesFacilities

StatesStates

6 parties: 0 organizations · 6 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Mordechai Polstein	3375844673	Individual	5% or Greater Direct Ownership Interest; Operational/Managerial Control	19, 90
Samuel W Quam	0547536914	Individual	Operational/Managerial Control	5
Pamela D Rice	0345518460	Individual	Operational/Managerial Control	0.5
Maxim Stesel	5193966208	Individual	5% or Greater Direct Ownership Interest	56
Dan Feinstein	5597036509	Individual	5% or Greater Direct Ownership Interest	15
Rostislav Pukshansky	4688945694	Individual	5% or Greater Direct Ownership Interest	10

Mordechai PolsteinPAC 3375844673
Individual19, 905% or Greater Direct Ownership Interest; Operational/Managerial Control
Samuel W QuamPAC 0547536914
Individual5Operational/Managerial Control
Pamela D RicePAC 0345518460
Individual0.5Operational/Managerial Control
Maxim SteselPAC 5193966208
Individual565% or Greater Direct Ownership Interest
Dan FeinsteinPAC 5597036509
Individual155% or Greater Direct Ownership Interest
Rostislav PukshanskyPAC 4688945694
Individual105% or Greater Direct Ownership Interest

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
Fair Oaks Lodge Fair Oaks Nursing and Rehab LLC 43 residents		Other disclo…	4.44	Ovr★★☆☆☆Stf★★★★☆Ins★★☆☆☆QM★★☆☆☆	43

Fair Oaks Lodge
Fair Oaks Nursing and Rehab LLC
Other disclosed role43 res4.44 HPRD
Overall 2Staffing Staff 4

Related CMS associates

Name match to Fair Oaks Nursing and Rehab LLC in FEC filings. Similar names may appear—confirm on FEC.gov.