La Brea Rehabilitation Center LLC

Enrollment entity

Provider / enrollment organization Enrollment PAC 5395025969 Enrollment ID O20161219000310

Linked facilitiesFacilities

StatesStates

15 parties: 7 organizations · 8 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Jasper Troy Pasumbal	7315434768	Individual	Operational/Managerial Control; ADP of the SNF	—
Meir Hakimi	1850783861	Individual	Operational/Managerial Control; ADP of the SNF	—
Consuelo A. Gomonit	9234429168	Individual	Operational/Managerial Control; ADP of the SNF	—
Elias Saadat	5698262046	Individual	Operational/Managerial Control; ADP of the SNF	—
Samuel Dominguez	6507353950	Individual	Operational/Managerial Control; ADP of the SNF	—
Citrus Administrative Services, Inc.	8426545872	Organization	Operational/Managerial Control; ADP of the SNF	—
Sr Investments LLC	2163748153	Organization	5% or Greater Direct Ownership Interest	60
La Brea SNF Holdings LLC	6002196672	Organization	5% or Greater Direct Ownership Interest	40
La Brea SNF LLC	0547540114	Organization	5% or Greater Indirect Ownership Interest	40
Ruth Berger	3072839067	Individual	5% or Greater Indirect Ownership Interest	30
Steven Berger	8729246202	Individual	5% or Greater Indirect Ownership Interest; Corporate Officer	30
Unknown party	4880181239	Organization	ADP of the SNF	—
La Brea Master Tenant LLC	1153818505	Organization	ADP of the SNF	—
Unknown party	8224525670	Individual	ADP of the SNF	—
Unknown party	3971090325	Organization	ADP of the SNF	—

Jasper Troy PasumbalPAC 7315434768
IndividualOperational/Managerial Control; ADP of the SNF
Meir HakimiPAC 1850783861
IndividualOperational/Managerial Control; ADP of the SNF
Consuelo A. GomonitPAC 9234429168
IndividualOperational/Managerial Control; ADP of the SNF
Elias SaadatPAC 5698262046
IndividualOperational/Managerial Control; ADP of the SNF
Samuel DominguezPAC 6507353950
IndividualOperational/Managerial Control; ADP of the SNF
Citrus Administrative Services, Inc.PAC 8426545872
OrganizationOperational/Managerial Control; ADP of the SNF
Sr Investments LLCPAC 2163748153
Organization605% or Greater Direct Ownership Interest
La Brea SNF Holdings LLCPAC 6002196672
Organization405% or Greater Direct Ownership Interest
La Brea SNF LLCPAC 0547540114
Organization405% or Greater Indirect Ownership Interest
Ruth BergerPAC 3072839067
Individual305% or Greater Indirect Ownership Interest
Steven BergerPAC 8729246202
Individual305% or Greater Indirect Ownership Interest; Corporate Officer
Unknown partyPAC 4880181239
OrganizationADP of the SNF
La Brea Master Tenant LLCPAC 1153818505
OrganizationADP of the SNF
Unknown partyPAC 8224525670
IndividualADP of the SNF
Unknown partyPAC 3971090325
OrganizationADP of the SNF

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
La Brea Rehabilitation Center La Brea Rehabilitation Center LLC 133 residents		Other disclo…	4.55	Ovr★☆☆☆☆Stf★★★★☆Ins★☆☆☆☆QM★★☆☆☆	133

La Brea Rehabilitation Center
La Brea Rehabilitation Center LLC
Other disclosed role133 res4.55 HPRD
Overall 1Staffing Staff 4

1 CMS ownership change record (showing 1)

Effective	Facility	Buyer	Seller	Side
12/12/2016	La Brea Rehabilitation Center	La Brea Rehabilitation Center LLC	Hancock Park Rehabilitation Center, LLC	Buyer

12/12/2016
La Brea Rehabilitation Center (Buyer)
Hancock Park Rehabilitation Center, LLC → La Brea Rehabilitation Center LLC

Related CMS associates

Name match to La Brea Rehabilitation Center LLC in FEC filings. Similar names may appear—confirm on FEC.gov.