Stonegate Healthcare LLC

Enrollment entity

Provider / enrollment organization Enrollment PAC 8820461916 Enrollment ID O20230311000331

Linked facilitiesFacilities

StatesStates

14 parties: 8 organizations · 6 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Lisa M Hensley	2668458589	Individual	Operational/Managerial Control; ADP of the SNF	—
Independence Arkansas Hcm LLC	1850828062	Organization	Operational/Managerial Control; ADP of the SNF	—
Tim M Simon	9537194980	Individual	Operational/Managerial Control; ADP of the SNF	—
Cutlass Op Holdings LLC	6709259054	Organization	5% or Greater Direct Ownership Interest; ADP of the SNF; Direct Ownership Interest	45
Ardj LLC	4880067131	Organization	5% or Greater Direct Ownership Interest; ADP of the SNF	33
Sri Nightingale LLC	8224433412	Organization	5% or Greater Direct Ownership Interest; ADP of the SNF	22
David Jakobowitch	6901221209	Individual	5% or Greater Indirect Ownership Interest; ADP of the SNF	33
Cutlass Op Family Trust II	5496104077	Organization	5% or Greater Indirect Ownership Interest	22.5
Dov B Braun	4284039470	Individual	5% or Greater Indirect Ownership Interest	22.5
Cutlass Op Family Trust I	9032568613	Organization	5% or Greater Indirect Ownership Interest	22.5
Steven Isaac	2163731647	Individual	5% or Greater Indirect Ownership Interest; ADP of the SNF	11
Sri Family Irrevocable Trust	0840649422	Organization	5% or Greater Indirect Ownership Interest; ADP of the SNF	11
Aviva Braun	8123551892	Individual	Indirect Ownership Interest	22.5
Stonegate Realty Holdings LLC	2961910914	Organization	ADP of the SNF	—

Lisa M HensleyPAC 2668458589
IndividualOperational/Managerial Control; ADP of the SNF
Independence Arkansas Hcm LLCPAC 1850828062
OrganizationOperational/Managerial Control; ADP of the SNF
Tim M SimonPAC 9537194980
IndividualOperational/Managerial Control; ADP of the SNF
Cutlass Op Holdings LLCPAC 6709259054
Organization455% or Greater Direct Ownership Interest; ADP of the SNF
Ardj LLCPAC 4880067131
Organization335% or Greater Direct Ownership Interest; ADP of the SNF
Sri Nightingale LLCPAC 8224433412
Organization225% or Greater Direct Ownership Interest; ADP of the SNF
David JakobowitchPAC 6901221209
Individual335% or Greater Indirect Ownership Interest; ADP of the SNF
Cutlass Op Family Trust IIPAC 5496104077
Organization22.55% or Greater Indirect Ownership Interest
Dov B BraunPAC 4284039470
Individual22.55% or Greater Indirect Ownership Interest
Cutlass Op Family Trust IPAC 9032568613
Organization22.55% or Greater Indirect Ownership Interest
Steven IsaacPAC 2163731647
Individual115% or Greater Indirect Ownership Interest; ADP of the SNF
Sri Family Irrevocable TrustPAC 0840649422
Organization115% or Greater Indirect Ownership Interest; ADP of the SNF
Aviva BraunPAC 8123551892
Individual22.5Indirect Ownership Interest
Stonegate Realty Holdings LLCPAC 2961910914
OrganizationADP of the SNF

Facility	Location	Role / stake	HPRD	Ratings	Census	Flags
Nightingale at Stonegate Stonegate Healthcare LLC 59 residents		Other disclo…	2.94	Ovr★★★★★Stf★★★★☆Ins★★★★★QM★★★☆☆	59

Nightingale at Stonegate
Stonegate Healthcare LLC
Other disclosed role59 res2.94 HPRD
Overall 5Staffing Staff 4

1 CMS ownership change record (showing 1)

Effective	Facility	Buyer	Seller	Side
08/31/2022	Nightingale at Stonegate	Stonegate Healthcare LLC	Community Compassion Stonegate	Buyer

08/31/2022
Nightingale at Stonegate (Buyer)
Community Compassion Stonegate → Stonegate Healthcare LLC

Related CMS associates

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