Pacific Manor, LLC

Enrollment entity

Provider / enrollment organization Enrollment PAC 1951637545 Enrollment ID O20190718003472

Linked facilitiesFacilities

StatesStates

4 parties: 1 organizations · 3 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Ltc Management Services LLC	6901967710	Organization	Operational/Managerial Control	100
Kevin Wayne Hudson	3072054725	Individual	W-2 Managing Employee	100
James C Lincoln	7315856572	Individual	5% or Greater Direct Ownership Interest	50
Judy L Lincoln	9537141445	Individual	5% or Greater Direct Ownership Interest	50

Ltc Management Services LLCPAC 6901967710
Organization100Operational/Managerial Control
Kevin Wayne HudsonPAC 3072054725
Individual100W-2 Managing Employee
James C LincolnPAC 7315856572
Individual505% or Greater Direct Ownership Interest
Judy L LincolnPAC 9537141445
Individual505% or Greater Direct Ownership Interest

Facility	Location	% Own.	HPRD	Ratings	Census	Flags
Pacific Care Center Pacific Manor, LLC 54 residents		Other disclo…	2.40	Ovr★☆☆☆☆Stf★☆☆☆☆Ins★★★☆☆QM★☆☆☆☆	54

Pacific Care Center
Pacific Manor, LLC
Other disclosed role54 res2.40 HPRD
Overall 1Staffing Staff 1

1 CMS ownership change record (showing 1)

Effective	Facility	Buyer	Seller	Side
07/01/2019	Pacific Care Center	Pacific Manor, LLC	Pacific Care Center, LLC	Buyer

07/01/2019
Pacific Care Center (Buyer)
Pacific Care Center, LLC → Pacific Manor, LLC

Related CMS associates

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