Siloam Healthcare LLC

Enrollment entity

Provider / enrollment organization Enrollment PAC 7618223827 Enrollment ID O20180809000841

Linked facilitiesFacilities

StatesStates

16 parties: 4 organizations · 12 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Wellspring Healthcare LLC	9931455151	Organization	Operational/Managerial Control; ADP of the SNF	100
Kimberly J Weaver	4183845001	Individual	Operational/Managerial Control; ADP of the SNF	—
Lance Lee Hamilton	1658356456	Individual	Operational/Managerial Control; ADP of the SNF	—
Chaim Shapiro	2062722804	Individual	5% or Greater Direct Ownership Interest; Corporate Officer	15
Isaac Gutman	1658627872	Individual	5% or Greater Direct Ownership Interest; Corporate Officer; ADP of the SNF	14.67
Jacob Taub	3577849546	Individual	5% or Greater Direct Ownership Interest; ADP of the SNF	14.67
Alexander Hoffman	4789018417	Individual	5% or Greater Direct Ownership Interest; ADP of the SNF	14.66
Esther Safrin	5092061218	Individual	5% or Greater Direct Ownership Interest; ADP of the SNF	10.1
Chaim Kurz	0244433365	Individual	5% or Greater Direct Ownership Interest; ADP of the SNF	6.7
Helen Hoffman	5991051112	Individual	5% or Greater Direct Ownership Interest; ADP of the SNF	6.7
Solomon Kurz	0446506661	Individual	5% or Greater Direct Ownership Interest; ADP of the SNF	6.7
Unknown party	7810481033	Individual	Direct Ownership Interest	4
Unknown party	9638663859	Individual	Direct Ownership Interest	4
Unknown party	1658865860	Organization	Direct Ownership Interest	1.4
Unknown party	9830683044	Organization	Direct Ownership Interest	1.4
Siloam Realty LLC	8921592130	Organization	ADP of the SNF	—

Wellspring Healthcare LLCPAC 9931455151
Organization100Operational/Managerial Control; ADP of the SNF
Kimberly J WeaverPAC 4183845001
IndividualOperational/Managerial Control; ADP of the SNF
Lance Lee HamiltonPAC 1658356456
IndividualOperational/Managerial Control; ADP of the SNF
Chaim ShapiroPAC 2062722804
Individual155% or Greater Direct Ownership Interest; Corporate Officer
Isaac GutmanPAC 1658627872
Individual14.675% or Greater Direct Ownership Interest; Corporate Officer
Jacob TaubPAC 3577849546
Individual14.675% or Greater Direct Ownership Interest; ADP of the SNF
Alexander HoffmanPAC 4789018417
Individual14.665% or Greater Direct Ownership Interest; ADP of the SNF
Esther SafrinPAC 5092061218
Individual10.15% or Greater Direct Ownership Interest; ADP of the SNF
Chaim KurzPAC 0244433365
Individual6.75% or Greater Direct Ownership Interest; ADP of the SNF
Helen HoffmanPAC 5991051112
Individual6.75% or Greater Direct Ownership Interest; ADP of the SNF
Solomon KurzPAC 0446506661
Individual6.75% or Greater Direct Ownership Interest; ADP of the SNF
Unknown partyPAC 7810481033
Individual4Direct Ownership Interest
Unknown partyPAC 9638663859
Individual4Direct Ownership Interest
Unknown partyPAC 1658865860
Organization1.4Direct Ownership Interest
Unknown partyPAC 9830683044
Organization1.4Direct Ownership Interest
Siloam Realty LLCPAC 8921592130
OrganizationADP of the SNF

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
Siloam Healthcare, LLC Siloam Healthcare LLC 86 residents		Other disclo…	4.27	Ovr★★☆☆☆Stf★★★★☆Ins★★☆☆☆QM★★★★☆	86

Siloam Healthcare, LLC
Siloam Healthcare LLC
Other disclosed role86 res4.27 HPRD
Overall 2Staffing Staff 4

1 CMS ownership change record (showing 1)

Effective	Facility	Buyer	Seller	Side
06/01/2018	Siloam Healthcare, LLC	Siloam Healthcare LLC	Crone Health Care, Inc.	Buyer

06/01/2018
Siloam Healthcare, LLC (Buyer)
Crone Health Care, Inc. → Siloam Healthcare LLC

Related CMS associates

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