Streamwood Skilled Nursing Facility, LLC

Mixed CMS roles

Provider / enrollment organization Enrollment PAC 9234469446 Enrollment ID O20191001000454

Linked facilitiesFacilities

15 parties: 7 organizations · 8 individuals

Owners & control parties

Name	Owner/control PAC	Type	Role(s)	%
Bokf, Na	0648188896	Organization	5% or Greater Security Interest; Operational/Managerial Control	100
Debbie Randon	8527469899	Individual	Operational/Managerial Control; ADP of the SNF	—
Legacy Healthcare Financial Services LLC	5799046132	Organization	Operational/Managerial Control; ADP of the SNF	—
Menachem Shabat	3072526219	Individual	Operational/Managerial Control; Managing Control - Governing Body; ADP of the SNF	—
Rajiv K Sood	1052368412	Individual	Operational/Managerial Control; ADP of the SNF	—
Doros Generation Trust U/A/D 1/3/12	6901110428	Organization	5% or Greater Direct Ownership Interest; ADP of the SNF	42.5
Gpn Family Trust U/A/D 4/28/08	5294988994	Organization	5% or Greater Direct Ownership Interest; ADP of the SNF	42.5
Oakway Operations LLC	6103212279	Organization	5% or Greater Direct Ownership Interest	15
Unknown party	0244712941	Individual	Indirect Ownership Interest	4.9
Unknown party	6608358304	Individual	Indirect Ownership Interest	4.9
Unknown party	4880176585	Individual	Indirect Ownership Interest	2.6
Unknown party	7416439112	Individual	Indirect Ownership Interest	2.6
Streamwood Property Holdings, LLC	5294217998	Organization	5% or Greater Security Interest; ADP of the SNF	100
Roth & Co, LLP	3173053162	Organization	ADP of the SNF	—
Unknown party	4082196787	Individual	ADP of the SNF	—

Bokf, NaPAC 0648188896
Organization1005% or Greater Security Interest; Operational/Managerial Control
Debbie RandonPAC 8527469899
IndividualOperational/Managerial Control; ADP of the SNF
Legacy Healthcare Financial Services LLCPAC 5799046132
OrganizationOperational/Managerial Control; ADP of the SNF
Menachem ShabatPAC 3072526219
IndividualOperational/Managerial Control; Managing Control - Governing Body
Rajiv K SoodPAC 1052368412
IndividualOperational/Managerial Control; ADP of the SNF
Doros Generation Trust U/A/D 1/3/12PAC 6901110428
Organization42.55% or Greater Direct Ownership Interest; ADP of the SNF
Gpn Family Trust U/A/D 4/28/08PAC 5294988994
Organization42.55% or Greater Direct Ownership Interest; ADP of the SNF
Oakway Operations LLCPAC 6103212279
Organization155% or Greater Direct Ownership Interest
Unknown partyPAC 0244712941
Individual4.9Indirect Ownership Interest
Unknown partyPAC 6608358304
Individual4.9Indirect Ownership Interest
Unknown partyPAC 4880176585
Individual2.6Indirect Ownership Interest
Unknown partyPAC 7416439112
Individual2.6Indirect Ownership Interest
Streamwood Property Holdings, LLCPAC 5294217998
Organization1005% or Greater Security Interest; ADP of the SNF
Roth & Co, LLPPAC 3173053162
OrganizationADP of the SNF
Unknown partyPAC 4082196787
IndividualADP of the SNF

Facility	Location	% Own.	HPRD	Ratings	Census	Flags
Bella Terra Streamwood Streamwood Skilled Nursing Facility, LLC 129 residents		Other disclo…	3.28	Ovr★★★★★Stf★★☆☆☆Ins★★★★★QM★★★☆☆	129

Bella Terra Streamwood
Streamwood Skilled Nursing Facility, LLC
Other disclosed role129 res3.28 HPRD
Overall 5Staffing Staff 2

1 CMS ownership change record (showing 1)

Effective	Facility	Buyer	Seller	Side
09/01/2019	Bella Terra Streamwood	Streamwood Skilled Nursing Facility, LLC	Lexington Health Care Center of Streamwood Inc	Buyer

09/01/2019
Bella Terra Streamwood (Buyer)
Lexington Health Care Center of Streamwood Inc → Streamwood Skilled Nursing Facility, LLC

Related CMS associates

Name match to Streamwood Skilled Nursing Facility, LLC in FEC filings. Similar names may appear—confirm on FEC.gov.