Community Supports Inc Nursing Home Ownership

State	#
FL	1
Total	1

Enrollment entity. CMS facility enrollment PAC with linked owners, facilities, and any ownership transactions in CMS data.

Total Facilities

Overall rating

4.0

Total nurse HPRD

7.39

10 parties: 1 organizations · 9 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Tammi Frisbie	3870754120	Individual	Operational/Managerial Control; ADP of the SNF	0
Gregory Schultz	0547337396	Individual	Operational/Managerial Control; ADP of the SNF	—
Dsi Management LLC	4284660226	Organization	Operational/Managerial Control; ADP of the SNF	—
Donald Payton	8527440270	Individual	Corporate Director	0
Amber Folk	6800278557	Individual	Corporate Director	0
Raleigh Seay	7618359365	Individual	Corporate Director	0
Jonathan Hamrick	8921344417	Individual	Corporate Director	0
Shannon Koromilas	8820334311	Individual	Corporate Director	0
Kenneth Schultz	7315973369	Individual	Corporate Officer	—
Lowell Frederick Clark	3577473982	Individual	ADP of the SNF	—

Tammi FrisbiePAC 3870754120
Individual0Operational/Managerial Control; ADP of the SNF
Gregory SchultzPAC 0547337396
IndividualOperational/Managerial Control; ADP of the SNF
Dsi Management LLCPAC 4284660226
OrganizationOperational/Managerial Control; ADP of the SNF
Donald PaytonPAC 8527440270
Individual0Corporate Director
Amber FolkPAC 6800278557
Individual0Corporate Director
Raleigh SeayPAC 7618359365
Individual0Corporate Director
Jonathan HamrickPAC 8921344417
Individual0Corporate Director
Shannon KoromilasPAC 8820334311
Individual0Corporate Director
Kenneth SchultzPAC 7315973369
IndividualCorporate Officer
Lowell Frederick ClarkPAC 3577473982
IndividualADP of the SNF

Facility	Location	% Own.	HPRD	Ratings	Census	Flags
Lakeview Terrace Rehab and Health Care Center Community Supports Inc 28 residents		Other disclo…	7.39	Ovr★★★★☆Stf★★★★★Ins★★☆☆☆QM★★★★★	28

Lakeview Terrace Rehab and Health Care Center
Community Supports Inc
Other disclosed role28 res7.39 HPRD
Ovr 4Stf 5

1 CMS ownership change record (showing 1)

Effective	Facility	Buyer	Seller	Side
12/31/2016	Lakeview Terrace Rehabilitation and Health Care Center	Community Supports Inc	Lakeview Terrace Health Care Center LLC	Buyer

12/31/2016
Lakeview Terrace Rehabilitation and Health Care Center (Buyer)
Lakeview Terrace Health Care Center LLC → Community Supports Inc

Associated Owners · 1

Show associated owners

Name	Shared	Link
Lakeview Terrace Health Care Center LLC	1 CHOW	CMS ownership change

Name match to Community Supports Inc in FEC filings. Similar names may appear—confirm on FEC.gov.