Spectrum Health - Leffingwell Avenue

Enrollment entity

Provider / enrollment organization Enrollment PAC 4183091929 Enrollment ID O20221107003128

Linked facilitiesFacilities

StatesStates

19 parties: 2 organizations · 17 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Spectrum Health Continuing Care	8224035670	Organization	5% or Greater Direct Ownership Interest; Operational/Managerial Control; ADP of the SNF	100
Karen R Pakkala	0143274209	Individual	Corporate Officer; Operational/Managerial Control; ADP of the SNF	0
Iris F Boettcher	9133157175	Individual	Operational/Managerial Control; ADP of the SNF	—
Ryan Zank	0143527283	Individual	Operational/Managerial Control; ADP of the SNF	—
Corewell Health	5092745745	Organization	5% or Greater Indirect Ownership Interest; ADP of the SNF	100
Matthew E Cox	4789682121	Individual	Corporate Officer	0
Christina Freese Decker	0446414148	Individual	Corporate Officer; ADP of the SNF	—
Christopher B Port	1658340419	Individual	Corporate Director	0
Mark Wilson	4981613544	Individual	Corporate Director	0
Talawnda L Bragg	1254489743	Individual	Corporate Director	0
Annica Euurand Waalkes	3072525237	Individual	Corporate Director	0
Bill P Pink	8628319092	Individual	Corporate Director	0
Johannie M Torres	5395700868	Individual	Corporate Director	0
John Buckley	7719144989	Individual	Corporate Director	0
Lynnette Ferrell-robinson	8921998675	Individual	Corporate Director	0
Mary Doornbos	5890112130	Individual	Corporate Director	0
Ronald M Hofman	1850694209	Individual	Corporate Director	0
Sam R Watson	8628214756	Individual	Corporate Director	0
Simin Beg	8729082508	Individual	Corporate Director	0

Spectrum Health Continuing CarePAC 8224035670
Organization1005% or Greater Direct Ownership Interest; Operational/Managerial Control
Karen R PakkalaPAC 0143274209
Individual0Corporate Officer; Operational/Managerial Control
Iris F BoettcherPAC 9133157175
IndividualOperational/Managerial Control; ADP of the SNF
Ryan ZankPAC 0143527283
IndividualOperational/Managerial Control; ADP of the SNF
Corewell HealthPAC 5092745745
Organization1005% or Greater Indirect Ownership Interest; ADP of the SNF
Matthew E CoxPAC 4789682121
Individual0Corporate Officer
Christina Freese DeckerPAC 0446414148
IndividualCorporate Officer; ADP of the SNF
Christopher B PortPAC 1658340419
Individual0Corporate Director
Mark WilsonPAC 4981613544
Individual0Corporate Director
Talawnda L BraggPAC 1254489743
Individual0Corporate Director
Annica Euurand WaalkesPAC 3072525237
Individual0Corporate Director
Bill P PinkPAC 8628319092
Individual0Corporate Director
Johannie M TorresPAC 5395700868
Individual0Corporate Director
John BuckleyPAC 7719144989
Individual0Corporate Director
Lynnette Ferrell-robinsonPAC 8921998675
Individual0Corporate Director
Mary DoornbosPAC 5890112130
Individual0Corporate Director
Ronald M HofmanPAC 1850694209
Individual0Corporate Director
Sam R WatsonPAC 8628214756
Individual0Corporate Director
Simin BegPAC 8729082508
Individual0Corporate Director

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
Corewell Health Rehabilitation & Nursing Center - Spectrum Health - Leffingwell Avenue 69 residents		Other disclo…	5.00	Ovr★★★★★Stf★★★★★Ins★★★★★QM★★★★★	69

Corewell Health Rehabilitation & Nursing Center -
Spectrum Health - Leffingwell Avenue
Other disclosed role69 res5.00 HPRD
Overall 5Staffing Staff 5

Related CMS associates

Name match to Spectrum Health - Leffingwell Avenue in FEC filings. Similar names may appear—confirm on FEC.gov.