Nsh Port Washington LLC

Enrollment entity

Provider / enrollment organization Enrollment PAC 8123394707 Enrollment ID O20171026000770

Linked facilitiesFacilities

StatesStates

5 parties: 2 organizations · 3 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
North Shore Healthcare LLC	3779867148	Organization	Operational/Managerial Control	100
Troy T Baumann	3870895907	Individual	5% or Greater Indirect Ownership Interest; Corporate Director; W-2 Managing Employee	40, 100
Nshf Operations LLC	9436425162	Organization	5% or Greater Direct Ownership Interest	100
Jeffrey C Hoehn	3678500899	Individual	5% or Greater Indirect Ownership Interest; Corporate Officer; Corporate Director	40, 100
David Mills	2567379241	Individual	5% or Greater Indirect Ownership Interest	20

North Shore Healthcare LLCPAC 3779867148
Organization100Operational/Managerial Control
Troy T BaumannPAC 3870895907
Individual40, 1005% or Greater Indirect Ownership Interest; Corporate Director
Nshf Operations LLCPAC 9436425162
Organization1005% or Greater Direct Ownership Interest
Jeffrey C HoehnPAC 3678500899
Individual40, 1005% or Greater Indirect Ownership Interest; Corporate Officer
David MillsPAC 2567379241
Individual205% or Greater Indirect Ownership Interest

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
Heritage Health Services Nsh Port Washington LLC 30 residents		Other disclo…	3.72	Ovr★★☆☆☆Stf★★★☆☆Ins★★☆☆☆QM★★☆☆☆	30

Heritage Health Services
Nsh Port Washington LLC
Other disclosed role30 res3.72 HPRD
Overall 2Staffing Staff 3

1 CMS ownership change record (showing 1)

Effective	Facility	Buyer	Seller	Side
10/01/2017	Heritage Health Services	Nsh Port Washington LLC	Fmg North Wisconsin Street Wisconsin LLC	Buyer

10/01/2017
Heritage Health Services (Buyer)
Fmg North Wisconsin Street Wisconsin LLC → Nsh Port Washington LLC

Related CMS associates

Name match to Nsh Port Washington LLC in FEC filings. Similar names may appear—confirm on FEC.gov.