Lakeside SNF Operations LLC

Enrollment entity

Provider / enrollment organization Enrollment PAC 3375922883 Enrollment ID O20220613002981

Linked facilitiesFacilities

StatesStates

14 parties: 9 organizations · 5 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Lakeside SNF Opco Manager LLC	8729467238	Organization	Operational/Managerial Control	0
Deanna Jones	9133489784	Individual	W-2 Managing Employee	0
Lakeside SNF Operations Holdings LLC	9638558141	Organization	5% or Greater Direct Ownership Interest	100
ICC Lakeside SNF Operations Holdings LLC	1456730969	Organization	5% or Greater Indirect Ownership Interest	85
Sk Lakeside Holdings LLC	2365821873	Organization	5% or Greater Indirect Ownership Interest	38.25
Seam Trust	7719366228	Organization	5% or Greater Indirect Ownership Interest	36.34
Ch Lakeside Holdings LLC	4183003692	Organization	5% or Greater Indirect Ownership Interest	17.21
Chava Wolofsky	7315340544	Individual	5% or Greater Indirect Ownership Interest	17.21
Cw Lakeside Holdings LLC	5092194506	Organization	5% or Greater Indirect Ownership Interest	17.21
Yisroel E Herzka	7618243155	Individual	5% or Greater Indirect Ownership Interest	17.21
Mead Family LLC	0547649055	Organization	5% or Greater Indirect Ownership Interest	15
Robert Mead	9436302429	Individual	5% or Greater Indirect Ownership Interest	15
Ed Lakeside Holdings LLC	6901285410	Organization	5% or Greater Indirect Ownership Interest	8.5
Ezriel Drebin	2860722907	Individual	5% or Greater Indirect Ownership Interest	8.5

Lakeside SNF Opco Manager LLCPAC 8729467238
Organization0Operational/Managerial Control
Deanna JonesPAC 9133489784
Individual0W-2 Managing Employee
Lakeside SNF Operations Holdings LLCPAC 9638558141
Organization1005% or Greater Direct Ownership Interest
ICC Lakeside SNF Operations Holdings LLCPAC 1456730969
Organization855% or Greater Indirect Ownership Interest
Sk Lakeside Holdings LLCPAC 2365821873
Organization38.255% or Greater Indirect Ownership Interest
Seam TrustPAC 7719366228
Organization36.345% or Greater Indirect Ownership Interest
Ch Lakeside Holdings LLCPAC 4183003692
Organization17.215% or Greater Indirect Ownership Interest
Chava WolofskyPAC 7315340544
Individual17.215% or Greater Indirect Ownership Interest
Cw Lakeside Holdings LLCPAC 5092194506
Organization17.215% or Greater Indirect Ownership Interest
Yisroel E HerzkaPAC 7618243155
Individual17.215% or Greater Indirect Ownership Interest
Mead Family LLCPAC 0547649055
Organization155% or Greater Indirect Ownership Interest
Robert MeadPAC 9436302429
Individual155% or Greater Indirect Ownership Interest
Ed Lakeside Holdings LLCPAC 6901285410
Organization8.55% or Greater Indirect Ownership Interest
Ezriel DrebinPAC 2860722907
Individual8.55% or Greater Indirect Ownership Interest

Facility	Location	% Own.	HPRD	Ratings	Census	Flags
Lakeside Center for Rehabilitation and Healing Lakeside SNF Operations LLC 108 residents		Other disclo…	3.56	Ovr★★★★☆Stf★★☆☆☆Ins★★★★☆QM★★★★☆	108

Lakeside Center for Rehabilitation and Healing
Lakeside SNF Operations LLC
Other disclosed role108 res3.56 HPRD
Overall 4Staffing Staff 2

1 CMS ownership change record (showing 1)

Effective	Facility	Buyer	Seller	Side
04/14/2022	Lakeside Center for Rehabilitation and Healing	Lakeside SNF Operations LLC	Five Points Healthcare Ltd	Buyer

04/14/2022
Lakeside Center for Rehabilitation and Healing (Buyer)
Five Points Healthcare Ltd → Lakeside SNF Operations LLC

Related CMS associates

Name match to Lakeside SNF Operations LLC in FEC filings. Similar names may appear—confirm on FEC.gov.