Independence Community Healthcare LLC

Enrollment entity
Provider / enrollment organization Enrollment PAC 0749725570 Enrollment ID O20240716003544

Details

Linked facilitiesFacilities
1
StatesStates
1

13 parties: 6 organizations · 7 individuals

Owners & control parties

NameOwner/control PACTypeRole(s)%
Matthew Bushman8224551817IndividualOperational/Managerial Control; ADP of the SNF
Sol A Enriquez8426008376IndividualOperational/Managerial Control; ADP of the SNF
Harris Gregson Lachance7911442751IndividualOperational/Managerial Control
John T Mitchell0648429498IndividualCorporate Officer; Operational/Managerial Control
Joshua O Jergensen6800024092IndividualCorporate Officer; Operational/Managerial Control
Mark D Hancock9830337005Individual5% or Greater Indirect Ownership Interest; ADP of the SNF35.2
Bluebird Master Tenant LLC5395280200OrganizationDirect Ownership Interest100
Pacs Group, Inc.7911360011OrganizationADP of the SNF; Indirect Ownership Interest100
Pacs Holdings, LLC6103289202OrganizationADP of the SNF; Indirect Ownership Interest100
Jason H Murray0648228304IndividualCorporate Director; ADP of the SNF; Indirect Ownership Interest35.2
3980 South Jackson Drive LLC3678096211OrganizationADP of the SNF
Providence Administrative Consulting Services Inc6406094671OrganizationADP of the SNF
Zenzoo LLC0143742767OrganizationADP of the SNF

Linked facilities

Facility Location Role / stake HPRD Ratings Census Flags
Villages of Jackson Creek
Independence Community Healthcare LLC
107 residents
Other disclo…
3.36Ovr★★☆☆☆Stf★★☆☆☆Ins★★☆☆☆QM★★★★107
  • Independence Community Healthcare LLC
    Other disclosed role107 res3.36 HPRD
    Overall 2Staffing Staff 2

Ownership history

1 CMS ownership change record (showing 1)

EffectiveFacilityBuyerSellerSide
03/01/2024Jackson Creek Post AcuteIndependence Community Healthcare LLCVillages of Jackson Creek LLCBuyer
  1. 03/01/2024
    Villages of Jackson Creek LLCIndependence Community Healthcare LLC
Related CMS associates

FEC political contributions FEC contributions Beta

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