Pavilion on Main Street LLC

Enrollment entity

Provider / enrollment organization Enrollment PAC 6002288875 Enrollment ID O20230206001030

Linked facilitiesFacilities

StatesStates

15 parties: 6 organizations · 9 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Marcella Graf	2769659846	Individual	Operational/Managerial Control; Direct Ownership Interest	3
Nancy Mcdonald	7113066671	Individual	Operational/Managerial Control; ADP of the SNF	—
Jason Robin	3870501422	Individual	Operational/Managerial Control; ADP of the SNF	—
Jonathan Aaron	5890843643	Individual	Operational/Managerial Control; Managing Control - Governing Body	—
Jonathan H Aaron Revocable Trust	2860857919	Organization	5% or Greater Direct Ownership Interest	23.5
Emst LLC	4587156997	Organization	5% or Greater Direct Ownership Interest	15
Todd a Stern 2015 Irrv Ins Tr	3274944848	Organization	5% or Greater Direct Ownership Interest	13.81
Stern Family Investment Tr	6901112168	Organization	5% or Greater Direct Ownership Interest	13.8
Ilana D Aaron Trust C/U Maurice Aaron 2014 Family Gift Trust	1052781671	Organization	5% or Greater Direct Ownership Interest	12.11
Ilana D Aaron Trust C/U Maurice Aaron 2014 Legacy Gift Trust	2961872585	Organization	5% or Greater Direct Ownership Interest	9
Kenneth Ripstein	6507861192	Individual	Direct Ownership Interest	4.78
Gabriel Kroll	3577631209	Individual	Direct Ownership Interest	2
Katherine A Proctor	6800200304	Individual	Direct Ownership Interest	1
Shimon Goldstein	7113195751	Individual	Direct Ownership Interest	1
Shoshana Gross	9436686987	Individual	Direct Ownership Interest	1

Marcella GrafPAC 2769659846
Individual3Operational/Managerial Control; Direct Ownership Interest
Nancy McdonaldPAC 7113066671
IndividualOperational/Managerial Control; ADP of the SNF
Jason RobinPAC 3870501422
IndividualOperational/Managerial Control; ADP of the SNF
Jonathan AaronPAC 5890843643
IndividualOperational/Managerial Control; Managing Control - Governing Body
Jonathan H Aaron Revocable TrustPAC 2860857919
Organization23.55% or Greater Direct Ownership Interest
Emst LLCPAC 4587156997
Organization155% or Greater Direct Ownership Interest
Todd a Stern 2015 Irrv Ins TrPAC 3274944848
Organization13.815% or Greater Direct Ownership Interest
Stern Family Investment TrPAC 6901112168
Organization13.85% or Greater Direct Ownership Interest
Ilana D Aaron Trust C/U Maurice Aaron 2014 Family Gift TrustPAC 1052781671
Organization12.115% or Greater Direct Ownership Interest
Ilana D Aaron Trust C/U Maurice Aaron 2014 Legacy Gift TrustPAC 2961872585
Organization95% or Greater Direct Ownership Interest
Kenneth RipsteinPAC 6507861192
Individual4.78Direct Ownership Interest
Gabriel KrollPAC 3577631209
Individual2Direct Ownership Interest
Katherine A ProctorPAC 6800200304
Individual1Direct Ownership Interest
Shimon GoldsteinPAC 7113195751
Individual1Direct Ownership Interest
Shoshana GrossPAC 9436686987
Individual1Direct Ownership Interest

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
Pavilion on Main Street, the Pavilion on Main Street LLC 92 residents		Other disclo…	2.98	Ovr★★☆☆☆Stf★★☆☆☆Ins★★☆☆☆QM★★★☆☆	92

Pavilion on Main Street, the
Pavilion on Main Street LLC
Other disclosed role92 res2.98 HPRD
Overall 2Staffing Staff 2

1 CMS ownership change record (showing 1)

Effective	Facility	Buyer	Seller	Side
12/19/2022	Pavilion on Main Street, the	Pavilion on Main Street LLC	Willow Crest Nursing Pavillion, Ltd.	Buyer

12/19/2022
Pavilion on Main Street, the (Buyer)
Willow Crest Nursing Pavillion, Ltd. → Pavilion on Main Street LLC

Related CMS associates

Name match to Pavilion on Main Street LLC in FEC filings. Similar names may appear—confirm on FEC.gov.