Otterbein at Granville

Enrollment entity
Provider / enrollment organization Enrollment PAC 4183676224 Enrollment ID O20050216000683

Details

Linked facilitiesFacilities
1
StatesStates
1

33 parties: 4 organizations · 29 individuals

Owners & control parties

NameOwner/control PACTypeRole(s)%
Otterbein Home7113834045Organization5% or Greater Indirect Ownership Interest; Operational/Managerial Control; ADP of the SNF100
Becky Bayliff0648781070IndividualOperational/Managerial Control
Daniel Burke9234659483IndividualOperational/Managerial Control
Heidi Glosser1951458561IndividualOperational/Managerial Control
Jonathan Hollister4880627256IndividualOperational/Managerial Control; ADP of the SNF
Lynn App9537485511IndividualOperational/Managerial Control
Ralph Reed Fraley4981518636IndividualOperational/Managerial Control
Robert Coleman8628144102IndividualOperational/Managerial Control
Steve Vonderhaar9739588542IndividualOperational/Managerial Control
Tomas Hazelbaker4587184734IndividualOperational/Managerial Control
Victoria Bartlett2163579772IndividualOperational/Managerial Control
William Brownson2961922117IndividualCorporate Director; Operational/Managerial Control
Functional Pathways of Tennessee LLC5193255008OrganizationOperational/Managerial Control; ADP of the SNF
Derik R Kroeze2062926330IndividualOperational/Managerial Control; ADP of the SNF
Dale Lewellen9032623301IndividualManaging Control - Governing Body; Trustee of the SNF
Anne Peterson4981704798IndividualManaging Control - Governing Body; Trustee of the SNF
Nancy Neely8224214192IndividualManaging Control - Governing Body; Trustee of the SNF
Stephen Layman6406360775IndividualManaging Control - Governing Body; Trustee of the SNF
Todd Ware3678087947IndividualManaging Control - Governing Body; Trustee of the SNF
Christie Vargo2769996032IndividualManaging Control - Governing Body; Trustee of the SNF
Greg Sharkey1850805128IndividualManaging Control - Governing Body; Trustee of the SNF
Andy Crawford4688188956IndividualManaging Control - Governing Body; Trustee of the SNF
Connie Hawk5597279869IndividualManaging Control - Governing Body; Trustee of the SNF
Richard Johnston2567799703IndividualManaging Control - Governing Body; Trustee of the SNF
Talya R Greathouse4688611577IndividualManaging Control - Governing Body; Trustee of the SNF
Show all 33 parties (8 more)
NameOwner/control PACTypeRole(s)%
Otterbein Home7113834045Organization5% or Greater Indirect Ownership Interest; Operational/Managerial Control; ADP of the SNF100
Becky Bayliff0648781070IndividualOperational/Managerial Control
Daniel Burke9234659483IndividualOperational/Managerial Control
Heidi Glosser1951458561IndividualOperational/Managerial Control
Jonathan Hollister4880627256IndividualOperational/Managerial Control; ADP of the SNF
Lynn App9537485511IndividualOperational/Managerial Control
Ralph Reed Fraley4981518636IndividualOperational/Managerial Control
Robert Coleman8628144102IndividualOperational/Managerial Control
Steve Vonderhaar9739588542IndividualOperational/Managerial Control
Tomas Hazelbaker4587184734IndividualOperational/Managerial Control
Victoria Bartlett2163579772IndividualOperational/Managerial Control
William Brownson2961922117IndividualCorporate Director; Operational/Managerial Control
Functional Pathways of Tennessee LLC5193255008OrganizationOperational/Managerial Control; ADP of the SNF
Derik R Kroeze2062926330IndividualOperational/Managerial Control; ADP of the SNF
Dale Lewellen9032623301IndividualManaging Control - Governing Body; Trustee of the SNF
Anne Peterson4981704798IndividualManaging Control - Governing Body; Trustee of the SNF
Nancy Neely8224214192IndividualManaging Control - Governing Body; Trustee of the SNF
Stephen Layman6406360775IndividualManaging Control - Governing Body; Trustee of the SNF
Todd Ware3678087947IndividualManaging Control - Governing Body; Trustee of the SNF
Christie Vargo2769996032IndividualManaging Control - Governing Body; Trustee of the SNF
Greg Sharkey1850805128IndividualManaging Control - Governing Body; Trustee of the SNF
Andy Crawford4688188956IndividualManaging Control - Governing Body; Trustee of the SNF
Connie Hawk5597279869IndividualManaging Control - Governing Body; Trustee of the SNF
Richard Johnston2567799703IndividualManaging Control - Governing Body; Trustee of the SNF
Talya R Greathouse4688611577IndividualManaging Control - Governing Body; Trustee of the SNF
Otterbein Lsc, LLC4981981263Organization5% or Greater Direct Ownership Interest100
James Christopher Green8224137047IndividualCorporate Officer
Jason E Miller1658500566IndividualCorporate Officer
Molly C Ingold9931371945IndividualCorporate Officer; Corporate Director
Jill Wilson5496662264IndividualCorporate Officer
Rita C Hawkins4385873298IndividualCorporate Officer
Jennifer Weekly3072566470IndividualCorporate Director
Polaris Pharmacy Services of Ohio LLC0941743348OrganizationADP of the SNF

Linked facilities

Facility Location Role / stake HPRD Ratings Census Flags
Other disclo…
4.46Ovr★★★★★Stf★★★★Ins★★★★★QM★★★★★21
  • Other disclosed role21 res4.46 HPRD
    Overall 5Staffing Staff 4
Related CMS associates

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Name match to Otterbein at Granville in FEC filings. Similar names may appear—confirm on FEC.gov.