Shamrock Care Centers LLC

Enrollment entity

Provider / enrollment organization Enrollment PAC 4082880927 Enrollment ID O20190920000916

Linked facilitiesFacilities

StatesStates

26 parties: 11 organizations · 15 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Peggy Wahweah	3779062864	Individual	Operational/Managerial Control	—
Chase Thrower	7315426418	Individual	Operational/Managerial Control	—
Lori Lipska	6305844424	Individual	Operational/Managerial Control; ADP of the SNF	—
Rhiannon Snyder	8224517321	Individual	Operational/Managerial Control	—
Ronald Marion Cable	7618975947	Individual	Operational/Managerial Control; ADP of the SNF	—
Kristel Jordan	5597244681	Individual	Operational/Managerial Control	—
Ashley Munoz	6406335595	Individual	Operational/Managerial Control	—
Lisa Sutton	4688153778	Individual	Operational/Managerial Control	—
Bgm Estate LLC	6608159512	Organization	5% or Greater Direct Ownership Interest; ADP of the SNF	37.5
Philip M. Green Revocable Trust	6507088903	Organization	5% or Greater Direct Ownership Interest; ADP of the SNF	25
Tiffany Seay Exempt Tr	3971039264	Organization	5% or Greater Direct Ownership Interest; ADP of the SNF	13.67
Angelus Holdings LLC	2668959842	Organization	5% or Greater Direct Ownership Interest; ADP of the SNF	12.5
Philip Marion Green Exempt Tr Cu Gilbert F Green Tr	9739554858	Organization	5% or Greater Direct Ownership Interest; ADP of the SNF	11.33
Angela Tabor	9234197146	Individual	5% or Greater Indirect Ownership Interest; ADP of the SNF	9.38
Kelly Mitchell	9032190400	Individual	5% or Greater Indirect Ownership Interest; ADP of the SNF	9.38
Marcinda Mitchell	0143288050	Individual	5% or Greater Indirect Ownership Interest; ADP of the SNF	9.38
Robert Mitchell	0749245447	Individual	5% or Greater Indirect Ownership Interest; ADP of the SNF	9.38
Jaci Pitts	4385171883	Individual	Corporate Officer	—
Miranda Belt	5294262796	Individual	Corporate Officer	—
Sandra Taylor	4981879004	Individual	Corporate Officer	—
Advanced Wound Therapy	5890168447	Organization	ADP of the SNF	—
Ns Group Consulting Division	5092292888	Organization	ADP of the SNF	—
Mobile Wound Care LLC	4486028685	Organization	ADP of the SNF	—
Pharmcareok of Durant Inc	7517129786	Organization	ADP of the SNF	—
Stein Ancillary Services, LLC	1153374046	Organization	ADP of the SNF	—

Peggy WahweahPAC 3779062864
IndividualOperational/Managerial Control
Chase ThrowerPAC 7315426418
IndividualOperational/Managerial Control
Lori LipskaPAC 6305844424
IndividualOperational/Managerial Control; ADP of the SNF
Rhiannon SnyderPAC 8224517321
IndividualOperational/Managerial Control
Ronald Marion CablePAC 7618975947
IndividualOperational/Managerial Control; ADP of the SNF
Kristel JordanPAC 5597244681
IndividualOperational/Managerial Control
Ashley MunozPAC 6406335595
IndividualOperational/Managerial Control
Lisa SuttonPAC 4688153778
IndividualOperational/Managerial Control
Bgm Estate LLCPAC 6608159512
Organization37.55% or Greater Direct Ownership Interest; ADP of the SNF
Philip M. Green Revocable TrustPAC 6507088903
Organization255% or Greater Direct Ownership Interest; ADP of the SNF
Tiffany Seay Exempt TrPAC 3971039264
Organization13.675% or Greater Direct Ownership Interest; ADP of the SNF
Angelus Holdings LLCPAC 2668959842
Organization12.55% or Greater Direct Ownership Interest; ADP of the SNF
Philip Marion Green Exempt Tr Cu Gilbert F Green TrPAC 9739554858
Organization11.335% or Greater Direct Ownership Interest; ADP of the SNF
Angela TaborPAC 9234197146
Individual9.385% or Greater Indirect Ownership Interest; ADP of the SNF
Kelly MitchellPAC 9032190400
Individual9.385% or Greater Indirect Ownership Interest; ADP of the SNF
Marcinda MitchellPAC 0143288050
Individual9.385% or Greater Indirect Ownership Interest; ADP of the SNF
Robert MitchellPAC 0749245447
Individual9.385% or Greater Indirect Ownership Interest; ADP of the SNF
Jaci PittsPAC 4385171883
IndividualCorporate Officer
Miranda BeltPAC 5294262796
IndividualCorporate Officer
Sandra TaylorPAC 4981879004
IndividualCorporate Officer
Advanced Wound TherapyPAC 5890168447
OrganizationADP of the SNF
Ns Group Consulting DivisionPAC 5092292888
OrganizationADP of the SNF
Mobile Wound Care LLCPAC 4486028685
OrganizationADP of the SNF
Pharmcareok of Durant IncPAC 7517129786
OrganizationADP of the SNF
Stein Ancillary Services, LLCPAC 1153374046
OrganizationADP of the SNF

Show all 26 parties (1 more)

Name	Owner/control PAC	Type	Role(s)	%
Peggy Wahweah	3779062864	Individual	Operational/Managerial Control	—
Chase Thrower	7315426418	Individual	Operational/Managerial Control	—
Lori Lipska	6305844424	Individual	Operational/Managerial Control; ADP of the SNF	—
Rhiannon Snyder	8224517321	Individual	Operational/Managerial Control	—
Ronald Marion Cable	7618975947	Individual	Operational/Managerial Control; ADP of the SNF	—
Kristel Jordan	5597244681	Individual	Operational/Managerial Control	—
Ashley Munoz	6406335595	Individual	Operational/Managerial Control	—
Lisa Sutton	4688153778	Individual	Operational/Managerial Control	—
Bgm Estate LLC	6608159512	Organization	5% or Greater Direct Ownership Interest; ADP of the SNF	37.5
Philip M. Green Revocable Trust	6507088903	Organization	5% or Greater Direct Ownership Interest; ADP of the SNF	25
Tiffany Seay Exempt Tr	3971039264	Organization	5% or Greater Direct Ownership Interest; ADP of the SNF	13.67
Angelus Holdings LLC	2668959842	Organization	5% or Greater Direct Ownership Interest; ADP of the SNF	12.5
Philip Marion Green Exempt Tr Cu Gilbert F Green Tr	9739554858	Organization	5% or Greater Direct Ownership Interest; ADP of the SNF	11.33
Angela Tabor	9234197146	Individual	5% or Greater Indirect Ownership Interest; ADP of the SNF	9.38
Kelly Mitchell	9032190400	Individual	5% or Greater Indirect Ownership Interest; ADP of the SNF	9.38
Marcinda Mitchell	0143288050	Individual	5% or Greater Indirect Ownership Interest; ADP of the SNF	9.38
Robert Mitchell	0749245447	Individual	5% or Greater Indirect Ownership Interest; ADP of the SNF	9.38
Jaci Pitts	4385171883	Individual	Corporate Officer	—
Miranda Belt	5294262796	Individual	Corporate Officer	—
Sandra Taylor	4981879004	Individual	Corporate Officer	—
Advanced Wound Therapy	5890168447	Organization	ADP of the SNF	—
Ns Group Consulting Division	5092292888	Organization	ADP of the SNF	—
Mobile Wound Care LLC	4486028685	Organization	ADP of the SNF	—
Pharmcareok of Durant Inc	7517129786	Organization	ADP of the SNF	—
Stein Ancillary Services, LLC	1153374046	Organization	ADP of the SNF	—
Forvis Mazars LLP	7416866603	Organization	ADP of the SNF	—

Peggy WahweahPAC 3779062864
IndividualOperational/Managerial Control
Chase ThrowerPAC 7315426418
IndividualOperational/Managerial Control
Lori LipskaPAC 6305844424
IndividualOperational/Managerial Control; ADP of the SNF
Rhiannon SnyderPAC 8224517321
IndividualOperational/Managerial Control
Ronald Marion CablePAC 7618975947
IndividualOperational/Managerial Control; ADP of the SNF
Kristel JordanPAC 5597244681
IndividualOperational/Managerial Control
Ashley MunozPAC 6406335595
IndividualOperational/Managerial Control
Lisa SuttonPAC 4688153778
IndividualOperational/Managerial Control
Bgm Estate LLCPAC 6608159512
Organization37.55% or Greater Direct Ownership Interest; ADP of the SNF
Philip M. Green Revocable TrustPAC 6507088903
Organization255% or Greater Direct Ownership Interest; ADP of the SNF
Tiffany Seay Exempt TrPAC 3971039264
Organization13.675% or Greater Direct Ownership Interest; ADP of the SNF
Angelus Holdings LLCPAC 2668959842
Organization12.55% or Greater Direct Ownership Interest; ADP of the SNF
Philip Marion Green Exempt Tr Cu Gilbert F Green TrPAC 9739554858
Organization11.335% or Greater Direct Ownership Interest; ADP of the SNF
Angela TaborPAC 9234197146
Individual9.385% or Greater Indirect Ownership Interest; ADP of the SNF
Kelly MitchellPAC 9032190400
Individual9.385% or Greater Indirect Ownership Interest; ADP of the SNF
Marcinda MitchellPAC 0143288050
Individual9.385% or Greater Indirect Ownership Interest; ADP of the SNF
Robert MitchellPAC 0749245447
Individual9.385% or Greater Indirect Ownership Interest; ADP of the SNF
Jaci PittsPAC 4385171883
IndividualCorporate Officer
Miranda BeltPAC 5294262796
IndividualCorporate Officer
Sandra TaylorPAC 4981879004
IndividualCorporate Officer
Advanced Wound TherapyPAC 5890168447
OrganizationADP of the SNF
Ns Group Consulting DivisionPAC 5092292888
OrganizationADP of the SNF
Mobile Wound Care LLCPAC 4486028685
OrganizationADP of the SNF
Pharmcareok of Durant IncPAC 7517129786
OrganizationADP of the SNF
Stein Ancillary Services, LLCPAC 1153374046
OrganizationADP of the SNF
Forvis Mazars LLPPAC 7416866603
OrganizationADP of the SNF

Linked facilities

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
First Shamrock Care Center Shamrock Care Centers LLC 38 residents		Other disclo…	3.26	Ovr★☆☆☆☆Stf★☆☆☆☆Ins★☆☆☆☆QM★☆☆☆☆	38

First Shamrock Care Center
Shamrock Care Centers LLC
Other disclosed role38 res3.26 HPRD
Overall 1Staffing Staff 1

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Owners & control parties

Linked facilities

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