Pierre Sd Skilled Nursing Facility, LLC

Mixed CMS roles

Provider / enrollment organization Enrollment PAC 0941538003 Enrollment ID O20190827003655

Linked facilitiesFacilities

StatesStates

15 parties: 7 organizations · 8 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Truist Bank	9335631274	Organization	5% or Greater Security Interest; Operational/Managerial Control	100
Chase Watson	6709362692	Individual	Operational/Managerial Control; ADP of the SNF	—
Chaim Rajchenbach	4284547977	Individual	Operational/Managerial Control; Managing Control - Governing Body; ADP of the SNF	—
Darrell W Plumage	1254380728	Individual	Operational/Managerial Control; ADP of the SNF	—
Menachem Shabat	3072526219	Individual	Operational/Managerial Control; Managing Control - Governing Body; ADP of the SNF	—
Doros Generation Trust U/A/D 1/3/12	6901110428	Organization	5% or Greater Direct Ownership Interest; ADP of the SNF	42.5
Gpn Family Trust U/A/D 4/28/08	5294988994	Organization	5% or Greater Direct Ownership Interest; ADP of the SNF	42.5
Oakway Operations LLC	6103212279	Organization	5% or Greater Direct Ownership Interest	15
Unknown party	7517443401	Individual	Indirect Ownership Interest	4.9
Unknown party	9335625227	Individual	Indirect Ownership Interest	4.9
Unknown party	0244716132	Individual	Indirect Ownership Interest	2.6
Unknown party	8426534314	Individual	Indirect Ownership Interest	2.6
Pierre Sd Property Holdings, LLC	3375038839	Organization	5% or Greater Security Interest; ADP of the SNF	100
Roth & Co, LLP	3173053162	Organization	ADP of the SNF	—
Legacy Healthcare Financial Services LLC	5799046132	Organization	ADP of the SNF	—

Truist BankPAC 9335631274
Organization1005% or Greater Security Interest; Operational/Managerial Control
Chase WatsonPAC 6709362692
IndividualOperational/Managerial Control; ADP of the SNF
Chaim RajchenbachPAC 4284547977
IndividualOperational/Managerial Control; Managing Control - Governing Body
Darrell W PlumagePAC 1254380728
IndividualOperational/Managerial Control; ADP of the SNF
Menachem ShabatPAC 3072526219
IndividualOperational/Managerial Control; Managing Control - Governing Body
Doros Generation Trust U/A/D 1/3/12PAC 6901110428
Organization42.55% or Greater Direct Ownership Interest; ADP of the SNF
Gpn Family Trust U/A/D 4/28/08PAC 5294988994
Organization42.55% or Greater Direct Ownership Interest; ADP of the SNF
Oakway Operations LLCPAC 6103212279
Organization155% or Greater Direct Ownership Interest
Unknown partyPAC 7517443401
Individual4.9Indirect Ownership Interest
Unknown partyPAC 9335625227
Individual4.9Indirect Ownership Interest
Unknown partyPAC 0244716132
Individual2.6Indirect Ownership Interest
Unknown partyPAC 8426534314
Individual2.6Indirect Ownership Interest
Pierre Sd Property Holdings, LLCPAC 3375038839
Organization1005% or Greater Security Interest; ADP of the SNF
Roth & Co, LLPPAC 3173053162
OrganizationADP of the SNF
Legacy Healthcare Financial Services LLCPAC 5799046132
OrganizationADP of the SNF

Facility	Location	% Own.	HPRD	Ratings	Census	Flags
Avantara Pierre Pierre Sd Skilled Nursing Facility, LLC 59 residents		Other disclo…	2.81	Ovr★★☆☆☆Stf★★★☆☆Ins★★☆☆☆QM★★☆☆☆	59

Avantara Pierre
Pierre Sd Skilled Nursing Facility, LLC
Other disclosed role59 res2.81 HPRD
Overall 2Staffing Staff 3

1 CMS ownership change record (showing 1)

Effective	Facility	Buyer	Seller	Side
07/01/2019	Avantara Pierre	Pierre Sd Skilled Nursing Facility, LLC	Pierre Care and Rehabilitation Center LLC	Buyer

07/01/2019
Avantara Pierre (Buyer)
Pierre Care and Rehabilitation Center LLC → Pierre Sd Skilled Nursing Facility, LLC

Related CMS associates

Name match to Pierre Sd Skilled Nursing Facility, LLC in FEC filings. Similar names may appear—confirm on FEC.gov.