Casa Pacifica Nursing Center LLC

Enrollment entity

Provider / enrollment organization Enrollment PAC 5294911061 Enrollment ID O20110511000544

Linked facilitiesFacilities

StatesStates

30 parties: 14 organizations · 16 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Kristina Kuizon	8022256403	Individual	Operational/Managerial Control; Managing Control - Governing Body; ADP of the SNF	—
Robert D Koontz	8325269087	Individual	Operational/Managerial Control; Managing Control - Governing Body; ADP of the SNF	—
Paulina Salazar	5991190654	Individual	Operational/Managerial Control; ADP of the SNF	—
Win Win Enterprises, LLC	1759293608	Organization	5% or Greater Direct Ownership Interest; ADP of the SNF	56.67
Shersher LP	3577749449	Organization	5% or Greater Direct Ownership Interest	22.22
Ira E Smedra Living Trust	0345635017	Organization	5% or Greater Direct Ownership Interest	20
Sherry Latt Lowy Living Trust Utd July 31, 1992	8123071362	Organization	5% or Greater Indirect Ownership Interest	22.22
Ira Smedra	2668384512	Individual	5% or Greater Indirect Ownership Interest	20
Daniel Wintner	0749192698	Individual	5% or Greater Indirect Ownership Interest; ADP of the SNF	11.33
Elizabeth Wintner	2567374416	Individual	5% or Greater Indirect Ownership Interest; ADP of the SNF	11.33
Jeremy Wintner	3375455223	Individual	5% or Greater Indirect Ownership Interest; ADP of the SNF	11.33
Mark Wintner	6103738059	Individual	5% or Greater Indirect Ownership Interest; ADP of the SNF	11.33
Phillip Wintner	8921910878	Individual	5% or Greater Indirect Ownership Interest; ADP of the SNF	11.33
Daniel Wintner 2020 Irrevocable Gift Trust Dated November 23, 2020	7012304256	Organization	5% or Greater Indirect Ownership Interest; ADP of the SNF	5.67
Elizabeth Wintner 2020 Irrevocable Gift Trust Dated November 23, 2020	1658768890	Organization	5% or Greater Indirect Ownership Interest; ADP of the SNF	5.67
Jeremy Wintner 2020 Irrevocable Gift Trust Dated November 23, 2020	0749677987	Organization	5% or Greater Indirect Ownership Interest; ADP of the SNF	5.67
Mark Wintner 2020 Irrevocable Gift Trust Dated November 23, 2020	9830586072	Organization	5% or Greater Indirect Ownership Interest; ADP of the SNF	5.67
Phillip Wintner 2020 Irrevocable Gift Trust Dated November 23, 2020	6204223449	Organization	5% or Greater Indirect Ownership Interest; ADP of the SNF	5.67
Unknown party	3072097799	Organization	Direct Ownership Interest	1.11
Francine Wintner	4284546136	Individual	Indirect Ownership Interest	0.56
Jacob Wintner	4587090436	Individual	Indirect Ownership Interest	0.56
Jacob Wintner	4385556232	Individual	Corporate Officer	0.56
Cambridge Healthcare Services LLC	2264617562	Organization	ADP of the SNF	—
Preferred Bank	0244741130	Organization	ADP of the SNF	—
Julie Butenko	6002327996	Individual	ADP of the SNF	—

Kristina KuizonPAC 8022256403
IndividualOperational/Managerial Control; Managing Control - Governing Body
Robert D KoontzPAC 8325269087
IndividualOperational/Managerial Control; Managing Control - Governing Body
Paulina SalazarPAC 5991190654
IndividualOperational/Managerial Control; ADP of the SNF
Win Win Enterprises, LLCPAC 1759293608
Organization56.675% or Greater Direct Ownership Interest; ADP of the SNF
Shersher LPPAC 3577749449
Organization22.225% or Greater Direct Ownership Interest
Ira E Smedra Living TrustPAC 0345635017
Organization205% or Greater Direct Ownership Interest
Sherry Latt Lowy Living Trust Utd July 31, 1992PAC 8123071362
Organization22.225% or Greater Indirect Ownership Interest
Ira SmedraPAC 2668384512
Individual205% or Greater Indirect Ownership Interest
Daniel WintnerPAC 0749192698
Individual11.335% or Greater Indirect Ownership Interest; ADP of the SNF
Elizabeth WintnerPAC 2567374416
Individual11.335% or Greater Indirect Ownership Interest; ADP of the SNF
Jeremy WintnerPAC 3375455223
Individual11.335% or Greater Indirect Ownership Interest; ADP of the SNF
Mark WintnerPAC 6103738059
Individual11.335% or Greater Indirect Ownership Interest; ADP of the SNF
Phillip WintnerPAC 8921910878
Individual11.335% or Greater Indirect Ownership Interest; ADP of the SNF
Daniel Wintner 2020 Irrevocable Gift Trust Dated November 23, 2020PAC 7012304256
Organization5.675% or Greater Indirect Ownership Interest; ADP of the SNF
Elizabeth Wintner 2020 Irrevocable Gift Trust Dated November 23, 2020PAC 1658768890
Organization5.675% or Greater Indirect Ownership Interest; ADP of the SNF
Jeremy Wintner 2020 Irrevocable Gift Trust Dated November 23, 2020PAC 0749677987
Organization5.675% or Greater Indirect Ownership Interest; ADP of the SNF
Mark Wintner 2020 Irrevocable Gift Trust Dated November 23, 2020PAC 9830586072
Organization5.675% or Greater Indirect Ownership Interest; ADP of the SNF
Phillip Wintner 2020 Irrevocable Gift Trust Dated November 23, 2020PAC 6204223449
Organization5.675% or Greater Indirect Ownership Interest; ADP of the SNF
Unknown partyPAC 3072097799
Organization1.11Direct Ownership Interest
Francine WintnerPAC 4284546136
Individual0.56Indirect Ownership Interest
Jacob WintnerPAC 4587090436
Individual0.56Indirect Ownership Interest
Jacob WintnerPAC 4385556232
Individual0.56Corporate Officer
Cambridge Healthcare Services LLCPAC 2264617562
OrganizationADP of the SNF
Preferred BankPAC 0244741130
OrganizationADP of the SNF
Julie ButenkoPAC 6002327996
IndividualADP of the SNF

Show all 30 parties (5 more)

Name	Owner/control PAC	Type	Role(s)	%
Kristina Kuizon	8022256403	Individual	Operational/Managerial Control; Managing Control - Governing Body; ADP of the SNF	—
Robert D Koontz	8325269087	Individual	Operational/Managerial Control; Managing Control - Governing Body; ADP of the SNF	—
Paulina Salazar	5991190654	Individual	Operational/Managerial Control; ADP of the SNF	—
Win Win Enterprises, LLC	1759293608	Organization	5% or Greater Direct Ownership Interest; ADP of the SNF	56.67
Shersher LP	3577749449	Organization	5% or Greater Direct Ownership Interest	22.22
Ira E Smedra Living Trust	0345635017	Organization	5% or Greater Direct Ownership Interest	20
Sherry Latt Lowy Living Trust Utd July 31, 1992	8123071362	Organization	5% or Greater Indirect Ownership Interest	22.22
Ira Smedra	2668384512	Individual	5% or Greater Indirect Ownership Interest	20
Daniel Wintner	0749192698	Individual	5% or Greater Indirect Ownership Interest; ADP of the SNF	11.33
Elizabeth Wintner	2567374416	Individual	5% or Greater Indirect Ownership Interest; ADP of the SNF	11.33
Jeremy Wintner	3375455223	Individual	5% or Greater Indirect Ownership Interest; ADP of the SNF	11.33
Mark Wintner	6103738059	Individual	5% or Greater Indirect Ownership Interest; ADP of the SNF	11.33
Phillip Wintner	8921910878	Individual	5% or Greater Indirect Ownership Interest; ADP of the SNF	11.33
Daniel Wintner 2020 Irrevocable Gift Trust Dated November 23, 2020	7012304256	Organization	5% or Greater Indirect Ownership Interest; ADP of the SNF	5.67
Elizabeth Wintner 2020 Irrevocable Gift Trust Dated November 23, 2020	1658768890	Organization	5% or Greater Indirect Ownership Interest; ADP of the SNF	5.67
Jeremy Wintner 2020 Irrevocable Gift Trust Dated November 23, 2020	0749677987	Organization	5% or Greater Indirect Ownership Interest; ADP of the SNF	5.67
Mark Wintner 2020 Irrevocable Gift Trust Dated November 23, 2020	9830586072	Organization	5% or Greater Indirect Ownership Interest; ADP of the SNF	5.67
Phillip Wintner 2020 Irrevocable Gift Trust Dated November 23, 2020	6204223449	Organization	5% or Greater Indirect Ownership Interest; ADP of the SNF	5.67
Unknown party	3072097799	Organization	Direct Ownership Interest	1.11
Francine Wintner	4284546136	Individual	Indirect Ownership Interest	0.56
Jacob Wintner	4587090436	Individual	Indirect Ownership Interest	0.56
Jacob Wintner	4385556232	Individual	Corporate Officer	0.56
Cambridge Healthcare Services LLC	2264617562	Organization	ADP of the SNF	—
Preferred Bank	0244741130	Organization	ADP of the SNF	—
Julie Butenko	6002327996	Individual	ADP of the SNF	—
Heidi Capela	9638680523	Individual	ADP of the SNF	—
Lance A Hassell	2062551484	Individual	ADP of the SNF	—
861 South Harbor Blvd.	2062996788	Organization	ADP of the SNF	—
Professional Directions for Health Care	5890299150	Organization	ADP of the SNF	—
Linda Lutz	0446761332	Individual	ADP of the SNF	—

Kristina KuizonPAC 8022256403
IndividualOperational/Managerial Control; Managing Control - Governing Body
Robert D KoontzPAC 8325269087
IndividualOperational/Managerial Control; Managing Control - Governing Body
Paulina SalazarPAC 5991190654
IndividualOperational/Managerial Control; ADP of the SNF
Win Win Enterprises, LLCPAC 1759293608
Organization56.675% or Greater Direct Ownership Interest; ADP of the SNF
Shersher LPPAC 3577749449
Organization22.225% or Greater Direct Ownership Interest
Ira E Smedra Living TrustPAC 0345635017
Organization205% or Greater Direct Ownership Interest
Sherry Latt Lowy Living Trust Utd July 31, 1992PAC 8123071362
Organization22.225% or Greater Indirect Ownership Interest
Ira SmedraPAC 2668384512
Individual205% or Greater Indirect Ownership Interest
Daniel WintnerPAC 0749192698
Individual11.335% or Greater Indirect Ownership Interest; ADP of the SNF
Elizabeth WintnerPAC 2567374416
Individual11.335% or Greater Indirect Ownership Interest; ADP of the SNF
Jeremy WintnerPAC 3375455223
Individual11.335% or Greater Indirect Ownership Interest; ADP of the SNF
Mark WintnerPAC 6103738059
Individual11.335% or Greater Indirect Ownership Interest; ADP of the SNF
Phillip WintnerPAC 8921910878
Individual11.335% or Greater Indirect Ownership Interest; ADP of the SNF
Daniel Wintner 2020 Irrevocable Gift Trust Dated November 23, 2020PAC 7012304256
Organization5.675% or Greater Indirect Ownership Interest; ADP of the SNF
Elizabeth Wintner 2020 Irrevocable Gift Trust Dated November 23, 2020PAC 1658768890
Organization5.675% or Greater Indirect Ownership Interest; ADP of the SNF
Jeremy Wintner 2020 Irrevocable Gift Trust Dated November 23, 2020PAC 0749677987
Organization5.675% or Greater Indirect Ownership Interest; ADP of the SNF
Mark Wintner 2020 Irrevocable Gift Trust Dated November 23, 2020PAC 9830586072
Organization5.675% or Greater Indirect Ownership Interest; ADP of the SNF
Phillip Wintner 2020 Irrevocable Gift Trust Dated November 23, 2020PAC 6204223449
Organization5.675% or Greater Indirect Ownership Interest; ADP of the SNF
Unknown partyPAC 3072097799
Organization1.11Direct Ownership Interest
Francine WintnerPAC 4284546136
Individual0.56Indirect Ownership Interest
Jacob WintnerPAC 4587090436
Individual0.56Indirect Ownership Interest
Jacob WintnerPAC 4385556232
Individual0.56Corporate Officer
Cambridge Healthcare Services LLCPAC 2264617562
OrganizationADP of the SNF
Preferred BankPAC 0244741130
OrganizationADP of the SNF
Julie ButenkoPAC 6002327996
IndividualADP of the SNF
Heidi CapelaPAC 9638680523
IndividualADP of the SNF
Lance A HassellPAC 2062551484
IndividualADP of the SNF
861 South Harbor Blvd.PAC 2062996788
OrganizationADP of the SNF
Professional Directions for Health CarePAC 5890299150
OrganizationADP of the SNF
Linda LutzPAC 0446761332
IndividualADP of the SNF

Linked facilities

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
Harbor Villa Care Center Casa Pacifica Nursing Center LLC 90 residents		Other disclo…	4.09	Ovr★★☆☆☆Stf★★★☆☆Ins★★☆☆☆QM★★★★☆	90

Harbor Villa Care Center
Casa Pacifica Nursing Center LLC
Other disclosed role90 res4.09 HPRD
Overall 2Staffing Staff 3

Related CMS associates

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Owners & control parties

Linked facilities

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