Fordsville Opco LLC

Enrollment entity

Provider / enrollment organization Enrollment PAC 8426302944 Enrollment ID O20181119001837

Linked facilitiesFacilities

StatesStates

11 parties: 2 organizations · 9 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Kristy Felitsky	3072944032	Individual	W-2 Managing Employee; Operational/Managerial Control	0, 33
Myra J Raymer	8426468422	Individual	Operational/Managerial Control	33
Moshe Kelman	5092068171	Individual	Operational/Managerial Control	33
Paul T Shepard	9234270745	Individual	W-2 Managing Employee; Operational/Managerial Control	33
Amy M Blair	6406110006	Individual	Operational/Managerial Control; ADP of the SNF	—
Benjamin Landa	7810804515	Individual	5% or Greater Direct Ownership Interest	43.5
Goldie Platschek	4183795149	Individual	5% or Greater Direct Ownership Interest	24.5
Alexander Platschek	0547218208	Individual	5% or Greater Direct Ownership Interest	15
David Rubenstein	6305035296	Individual	5% or Greater Direct Ownership Interest	7
Cibc Bank Usa	8426229584	Organization	5% or Greater Security Interest	100
Metropolitan Commercial Bank	6002169182	Organization	5% or Greater Security Interest	100

Kristy FelitskyPAC 3072944032
Individual0, 33W-2 Managing Employee; Operational/Managerial Control
Myra J RaymerPAC 8426468422
Individual33Operational/Managerial Control
Moshe KelmanPAC 5092068171
Individual33Operational/Managerial Control
Paul T ShepardPAC 9234270745
Individual33W-2 Managing Employee; Operational/Managerial Control
Amy M BlairPAC 6406110006
IndividualOperational/Managerial Control; ADP of the SNF
Benjamin LandaPAC 7810804515
Individual43.55% or Greater Direct Ownership Interest
Goldie PlatschekPAC 4183795149
Individual24.55% or Greater Direct Ownership Interest
Alexander PlatschekPAC 0547218208
Individual155% or Greater Direct Ownership Interest
David RubensteinPAC 6305035296
Individual75% or Greater Direct Ownership Interest
Cibc Bank UsaPAC 8426229584
Organization1005% or Greater Security Interest
Metropolitan Commercial BankPAC 6002169182
Organization1005% or Greater Security Interest

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
Fordsville Nursing and Rehabilitation Center Fordsville Opco LLC 60 residents		Other disclo…	3.39	Ovr★★★★☆Stf★★★☆☆Ins★★★★☆QM★★☆☆☆	60

Fordsville Nursing and Rehabilitation Center
Fordsville Opco LLC
Other disclosed role60 res3.39 HPRD
Overall 4Staffing Staff 3

Related CMS associates

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