Southern Charm Healthcare LLC

Enrollment entity

Provider / enrollment organization Enrollment PAC 5991092801 Enrollment ID O20160921000112

Linked facilitiesFacilities

StatesStates

21 parties: 5 organizations · 16 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Jose Rodriguez	7618442377	Individual	Operational/Managerial Control; ADP of the SNF	—
Soon Burnam	9739195553	Individual	Corporate Officer; Managing Control - Governing Body	0
Khurram Rashid	7315171170	Individual	Managing Control - Governing Body; ADP of the SNF	—
Hopewell Healthcare, Inc.	8123328291	Organization	5% or Greater Direct Ownership Interest	100
The Ensign Group Inc	3476460494	Organization	5% or Greater Indirect Ownership Interest; ADP of the SNF	100
Chad Keetch	6507082955	Individual	Corporate Officer	0
Barry Port	2466457627	Individual	Corporate Officer	0
Forrest Peterson	3779625447	Individual	Corporate Officer	0
Spencer W Burton	7810131604	Individual	Corporate Officer	0
Christopher R Christensen	5193632107	Individual	Corporate Officer	0
Suzanne D Snapper	7719025261	Individual	Corporate Officer	0
Beverly B Wittekind	8820004641	Individual	Corporate Officer	0
Mark V Parkinson	5890681118	Individual	Corporate Director	0
John O Agwunobi	2668527953	Individual	Corporate Director	0
Swati Abbott	6901335330	Individual	Corporate Director	0
Ann Scott Blouin	1456693217	Individual	Corporate Director	0
Barry M Smith	0648415562	Individual	Corporate Director	0
Daren Shaw	6002072196	Individual	Corporate Director	0
Agape Health Holdings LLC	2769957828	Organization	ADP of the SNF	—
Standard Bearer Healthcare Op, LP	7012433535	Organization	ADP of the SNF	—
Ensign Services Inc	3577089093	Organization	ADP of the SNF	—

Jose RodriguezPAC 7618442377
IndividualOperational/Managerial Control; ADP of the SNF
Soon BurnamPAC 9739195553
Individual0Corporate Officer; Managing Control - Governing Body
Khurram RashidPAC 7315171170
IndividualManaging Control - Governing Body; ADP of the SNF
Hopewell Healthcare, Inc.PAC 8123328291
Organization1005% or Greater Direct Ownership Interest
The Ensign Group IncPAC 3476460494
Organization1005% or Greater Indirect Ownership Interest; ADP of the SNF
Chad KeetchPAC 6507082955
Individual0Corporate Officer
Barry PortPAC 2466457627
Individual0Corporate Officer
Forrest PetersonPAC 3779625447
Individual0Corporate Officer
Spencer W BurtonPAC 7810131604
Individual0Corporate Officer
Christopher R ChristensenPAC 5193632107
Individual0Corporate Officer
Suzanne D SnapperPAC 7719025261
Individual0Corporate Officer
Beverly B WittekindPAC 8820004641
Individual0Corporate Officer
Mark V ParkinsonPAC 5890681118
Individual0Corporate Director
John O AgwunobiPAC 2668527953
Individual0Corporate Director
Swati AbbottPAC 6901335330
Individual0Corporate Director
Ann Scott BlouinPAC 1456693217
Individual0Corporate Director
Barry M SmithPAC 0648415562
Individual0Corporate Director
Daren ShawPAC 6002072196
Individual0Corporate Director
Agape Health Holdings LLCPAC 2769957828
OrganizationADP of the SNF
Standard Bearer Healthcare Op, LPPAC 7012433535
OrganizationADP of the SNF
Ensign Services IncPAC 3577089093
OrganizationADP of the SNF

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
Opus Post Acute Rehabilitation Southern Charm Healthcare LLC 84 residents		Other disclo…	3.78	Ovr★★★☆☆Stf★★★☆☆Ins★★★☆☆QM★★★☆☆	84

Opus Post Acute Rehabilitation
Southern Charm Healthcare LLC
Other disclosed role84 res3.78 HPRD
Overall 3Staffing Staff 3

Related CMS associates

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