Pelican Bay Retirement Services 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

5.0

Total nurse HPRD

4.88

12 parties: 2 organizations · 10 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Daniel Gomez	2466773593	Individual	Operational/Managerial Control	0
Life Care Services LLC	3577472711	Organization	Operational/Managerial Control; ADP of the SNF	0
Luke Bjorklund	1759887888	Individual	Operational/Managerial Control; ADP of the SNF	—
John Pennisi	9830485705	Individual	Operational/Managerial Control; ADP of the SNF	—
Pelican Bay Cooperative Housing Corp	8224203385	Organization	5% or Greater Direct Ownership Interest	100
Elizabeth Smith	9931605060	Individual	Corporate Officer; Corporate Director	0
Michael H Levy	5395070718	Individual	Corporate Officer; Corporate Director	0
Chuck Morris	5991142747	Individual	Corporate Officer; Corporate Director	0
David Fey	2264879014	Individual	Corporate Officer; Corporate Director	0
Judith Lipnick	3173960929	Individual	Corporate Officer	0
Forest Samuel Smith	4587029780	Individual	Corporate Officer	0
Edna Bensen	9830506252	Individual	Corporate Officer; Corporate Director	0

Daniel GomezPAC 2466773593
Individual0Operational/Managerial Control
Life Care Services LLCPAC 3577472711
Organization0Operational/Managerial Control; ADP of the SNF
Luke BjorklundPAC 1759887888
IndividualOperational/Managerial Control; ADP of the SNF
John PennisiPAC 9830485705
IndividualOperational/Managerial Control; ADP of the SNF
Pelican Bay Cooperative Housing CorpPAC 8224203385
Organization1005% or Greater Direct Ownership Interest
Elizabeth SmithPAC 9931605060
Individual0Corporate Officer; Corporate Director
Michael H LevyPAC 5395070718
Individual0Corporate Officer; Corporate Director
Chuck MorrisPAC 5991142747
Individual0Corporate Officer; Corporate Director
David FeyPAC 2264879014
Individual0Corporate Officer; Corporate Director
Judith LipnickPAC 3173960929
Individual0Corporate Officer
Forest Samuel SmithPAC 4587029780
Individual0Corporate Officer
Edna BensenPAC 9830506252
Individual0Corporate Officer; Corporate Director

Facility	Location	% Own.	HPRD	Ratings	Census	Flags
Premier Place at the Glenview Pelican Bay Retirement Services Inc 39 residents		Other disclo…	4.88	Ovr★★★★★Stf★★★★★Ins★★★★★QM★★★★★	39

Premier Place at the Glenview
Pelican Bay Retirement Services Inc
Other disclosed role39 res4.88 HPRD
Ovr 5Stf 5

Name match to Pelican Bay Retirement Services Inc in FEC filings. Similar names may appear—confirm on FEC.gov.