Country Lane Manor LLC

Mixed CMS roles
Provider / enrollment organization Enrollment PAC 0941721344 Enrollment ID O20250228003125

Facilities by state

  • IA1

Details

Linked facilitiesFacilities
1

17 parties: 14 organizations · 3 individuals

Owners & control parties

NameOwner/control PACTypeRole(s)%
Calla Mallett6608354063IndividualOperational/Managerial Control; ADP of the SNF
Dana R Brecount2062674427IndividualOperational/Managerial Control; ADP of the SNF
Amaranthine Holdings LLC2769904622Organization5% or Greater Direct Ownership Interest100
Iowa 5784 LLC2163944034Organization5% or Greater Indirect Ownership Interest52
Cedar View Holdings LLC9739572397Organization5% or Greater Indirect Ownership Interest24
Cedar View Tr4284027848Organization5% or Greater Indirect Ownership Interest24
Samara Fam Tr1456742022Organization5% or Greater Indirect Ownership Interest; ADP of the SNF24
Samara Family Holdings LLC9638560204Organization5% or Greater Indirect Ownership Interest; ADP of the SNF24
819 Country Lane Road Propco LLC2668972944OrganizationADP of the SNF
Caresage Administrative Consulting, LLC5395194518OrganizationADP of the SNF
Clinical Consulting Services LLC9537681408OrganizationADP of the SNF
Jsj 2020 Fam Tr1456752583OrganizationADP of the SNF
Jsj Family Trust6406356799OrganizationADP of the SNF
Jsj Property LLC2961924832OrganizationADP of the SNF
Summation Financial Services LLC6406199447OrganizationADP of the SNF
The Bryn Mawr Trust Company of Delaware5698142156OrganizationADP of the SNF
David T Gamzeh0446419196IndividualTrustee of the SNF

Linked facilities

Facility Location % Own. HPRD Ratings Census Flags
Country Lane Manor
Country Lane Manor LLC
51 residents
Other disclo…
3.22Ovr☆☆☆☆Stf☆☆☆☆Ins☆☆☆☆QM★★★★51
  • Country Lane Manor LLC
    Other disclosed role51 res3.22 HPRD
    Overall 1Staffing Staff 1

Ownership history

1 CMS ownership change record (showing 1)

EffectiveFacilityBuyerSellerSide
01/01/2025Country Lane ManorCountry Lane Manor LLCOpco Keosauqua, Ia, LLCBuyer
  1. 01/01/2025
    Opco Keosauqua, Ia, LLCCountry Lane Manor LLC
Related CMS associates

FEC political contributions FEC contributions Beta

Name match to Country Lane Manor LLC in FEC filings. Similar names may appear—confirm on FEC.gov.