Evergreen SNF Healthcare LLC

Enrollment entity
Provider / enrollment organization Enrollment PAC 4789123175 Enrollment ID O20240829001753

Details

Linked facilitiesFacilities
1
StatesStates
1

14 parties: 6 organizations · 8 individuals

Owners & control parties

NameOwner/control PACTypeRole(s)%
Russell Carnagie8426592338IndividualOperational/Managerial Control; ADP of the SNF
David P Larson4688608565IndividualOperational/Managerial Control; ADP of the SNF
Tracy Brzycki2466961602IndividualOperational/Managerial Control
Frederick G Apt4486043916IndividualOperational/Managerial Control
John T Mitchell0648429498IndividualOperational/Managerial Control
Joshua O Jergensen6800024092IndividualOperational/Managerial Control
Providence Group Nh, LLC5294198396Organization5% or Greater Direct Ownership Interest100
Pacs Group, Inc.7911360011Organization5% or Greater Indirect Ownership Interest100
Pacs Holdings, LLC6103289202Organization5% or Greater Indirect Ownership Interest100
Jason H Murray0648228304Individual5% or Greater Indirect Ownership Interest35.2
Mark D Hancock9830337005Individual5% or Greater Indirect Ownership Interest35.2
Portland 8643 Realty LLC7315456555OrganizationADP of the SNF
Providence Administrative Consulting Services Inc6406094671OrganizationADP of the SNF
Truist Bank6709306079Organization5% or Greater Security Interest100

Linked facilities

Facility Location Role / stake HPRD Ratings Census Flags
Evergreen Post Acute
Evergreen SNF Healthcare LLC
52 residents
Other disclo…
4.94Ovr★★☆☆☆Stf★★★☆☆Ins★★☆☆☆QM★★☆☆☆52
  • Evergreen SNF Healthcare LLC
    Other disclosed role52 res4.94 HPRD
    Overall 2Staffing Staff 3

Ownership history

1 CMS ownership change record (showing 1)

EffectiveFacilityBuyerSellerSide
09/01/2024Evergreen Post AcuteEvergreen SNF Healthcare LLCCare Center (Park Forest), Inc.Buyer
  1. 09/01/2024
    Care Center (Park Forest), Inc.Evergreen SNF Healthcare LLC
Related CMS associates

FEC political contributions FEC contributions Beta

Name match to Evergreen SNF Healthcare LLC in FEC filings. Similar names may appear—confirm on FEC.gov.