Midwest Covenant Home, Inc.

Enrollment entity

Provider / enrollment organization Enrollment PAC 3779531447 Enrollment ID O20050110000461

Linked facilitiesFacilities

StatesStates

14 parties: 0 organizations · 14 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Fawn Ienn	9234659202	Individual	Operational/Managerial Control	—
David B Jameson	9335193986	Individual	Operational/Managerial Control; ADP of the SNF	—
Tamara Hutsell	6103284203	Individual	Corporate Officer; Corporate Director	0
Cheri Giannou	8022496702	Individual	Corporate Officer; Corporate Director	—
Phil Burke	7113305897	Individual	Corporate Officer; Corporate Director	—
Timothy Mcivor	9931587615	Individual	Corporate Officer; Corporate Director	—
Timothy V. Teegerstrom	8325568397	Individual	Corporate Director	0
Bonnie Schreiber	7911365010	Individual	Corporate Director	0
Richard Boroviak	5294193397	Individual	Corporate Director	0
Susan Cooksley	1850790361	Individual	Corporate Director	0
Sheila Bjerrum	3274956719	Individual	Corporate Director; ADP of the SNF	0
Mary Pinley	5193208494	Individual	Corporate Director	—
Terry Borg	3375026677	Individual	Corporate Director	—
Michelle Dubas	4284117581	Individual	Corporate Director	—

Fawn IennPAC 9234659202
IndividualOperational/Managerial Control
David B JamesonPAC 9335193986
IndividualOperational/Managerial Control; ADP of the SNF
Tamara HutsellPAC 6103284203
Individual0Corporate Officer; Corporate Director
Cheri GiannouPAC 8022496702
IndividualCorporate Officer; Corporate Director
Phil BurkePAC 7113305897
IndividualCorporate Officer; Corporate Director
Timothy McivorPAC 9931587615
IndividualCorporate Officer; Corporate Director
Timothy V. TeegerstromPAC 8325568397
Individual0Corporate Director
Bonnie SchreiberPAC 7911365010
Individual0Corporate Director
Richard BoroviakPAC 5294193397
Individual0Corporate Director
Susan CooksleyPAC 1850790361
Individual0Corporate Director
Sheila BjerrumPAC 3274956719
Individual0Corporate Director; ADP of the SNF
Mary PinleyPAC 5193208494
IndividualCorporate Director
Terry BorgPAC 3375026677
IndividualCorporate Director
Michelle DubasPAC 4284117581
IndividualCorporate Director

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
Midwest Covenant Home Midwest Covenant Home, Inc. 41 residents		Other disclo…	4.30	Ovr★★★☆☆Stf★★★★☆Ins★★★☆☆QM★★★☆☆	41

Midwest Covenant Home
Midwest Covenant Home, Inc.
Other disclosed role41 res4.30 HPRD
Overall 3Staffing Staff 4

Related CMS associates

Name match to Midwest Covenant Home, Inc. in FEC filings. Similar names may appear—confirm on FEC.gov.