MERCY-PHS Senior Housing, Inc.

Enrollment entity

Provider / enrollment organization Enrollment PAC 2860853330 Enrollment ID O20230731002974

Linked facilitiesFacilities

StatesStates

14 parties: 4 organizations · 10 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Mercy Medical Center	4183535271	Organization	Operational/Managerial Control; ADP of the SNF	50
Presbyterian Homes Housing and Assisted Living, Inc.	7618996059	Organization	Operational/Managerial Control; ADP of the SNF	50
Jonathan David Fletcher	4789194366	Individual	Corporate Officer; Corporate Director; Operational/Managerial Control	16.66
Duane W Larson	7810074366	Individual	Corporate Director; Operational/Managerial Control	16.66
Nancy Hill-davis	1850752320	Individual	Corporate Director; Operational/Managerial Control	16.66
Claire Shaffer	8123477270	Individual	Operational/Managerial Control; ADP of the SNF	—
Casey T Stephens	9234327982	Individual	Operational/Managerial Control; ADP of the SNF	—
Vincent A Taeger	0941109359	Individual	Operational/Managerial Control; ADP of the SNF	—
Mark T Meyer	3274441639	Individual	Corporate Officer; Corporate Director; Operational/Managerial Control	—
Phs Management, LLC	5193901049	Organization	Operational/Managerial Control; ADP of the SNF	—
Nathan Vangenderen	9032209523	Individual	Corporate Officer; Corporate Director	16.66
Timothy J Quinn	3678464310	Individual	Corporate Director	16.66
Heidi A Peterson	5698285278	Individual	ADP of the SNF	—
Umb Bank National Association	6507080660	Organization	5% or Greater Mortgage Interest; 5% or Greater Security Interest	75

Mercy Medical CenterPAC 4183535271
Organization50Operational/Managerial Control; ADP of the SNF
Presbyterian Homes Housing and Assisted Living, Inc.PAC 7618996059
Organization50Operational/Managerial Control; ADP of the SNF
Jonathan David FletcherPAC 4789194366
Individual16.66Corporate Officer; Corporate Director
Duane W LarsonPAC 7810074366
Individual16.66Corporate Director; Operational/Managerial Control
Nancy Hill-davisPAC 1850752320
Individual16.66Corporate Director; Operational/Managerial Control
Claire ShafferPAC 8123477270
IndividualOperational/Managerial Control; ADP of the SNF
Casey T StephensPAC 9234327982
IndividualOperational/Managerial Control; ADP of the SNF
Vincent A TaegerPAC 0941109359
IndividualOperational/Managerial Control; ADP of the SNF
Mark T MeyerPAC 3274441639
IndividualCorporate Officer; Corporate Director
Phs Management, LLCPAC 5193901049
OrganizationOperational/Managerial Control; ADP of the SNF
Nathan VangenderenPAC 9032209523
Individual16.66Corporate Officer; Corporate Director
Timothy J QuinnPAC 3678464310
Individual16.66Corporate Director
Heidi A PetersonPAC 5698285278
IndividualADP of the SNF
Umb Bank National AssociationPAC 6507080660
Organization755% or Greater Mortgage Interest; 5% or Greater Security Interest

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
Hallmar Village MERCY-PHS Senior Housing, Inc. 53 residents		Other disclo…	4.46	Ovr★★☆☆☆Stf★★★★☆Ins★★☆☆☆QM★★★☆☆	53

Hallmar Village
MERCY-PHS Senior Housing, Inc.
Other disclosed role53 res4.46 HPRD
Overall 2Staffing Staff 4

Related CMS associates

Name match to MERCY-PHS Senior Housing, Inc. in FEC filings. Similar names may appear—confirm on FEC.gov.