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Hospice & Home Health Record Maps

agency

PROVIDENCE HOSPICE, INC

Saint John, IN

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CMS quality evidence by agency type

Hospice Care Index (0-10)
9 Source
Visits in last days of life
68 Source
Last-days measure denominator
188 Source
Process composite
98 Source
Process measure denominator
132 Source
Hospice average daily census
39 Source
Care Index period
01/01/2023-12/31/2024 Source

CMS enrollment and reported ownership

Enrolled legal organization
REST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOME Source
Enrolled DBA name
PROVIDENCE HOSPICE, INC. Source
Enrolled NPI
1548614910 Source
Organization structure
CORPORATION Source
Incorporation date and state
1956-04-06 (IL) Source
Enrollment proprietary status
Non-profit Source
CMS enrollment records
1 Source
Distinct reported owners
19 Source
Reported owner relationships
19 Source
Owner roles, dates, shares, and classifications
AMY MOSORIAK [Individual; CMS owner ID 8820252828]; role: W-2 MANAGING EMPLOYEE; associated: 2020-02-07; ownership: not reported; PE: not reported; REIT: not reported, BARRY VANDERGENUGTEN [Individual; CMS owner ID 3971762667]; role: OPERATIONAL/MANAGERIAL CONTROL; associated: 2016-04-28; ownership: not reported; PE: not reported; REIT: not reported, DARREN VAN ESSEN [Individual; CMS owner ID 1153709555]; role: CORPORATE DIRECTOR; associated: 2022-04-02; ownership: not reported; PE: not reported; REIT: not reported, DAVID VOSS [Individual; CMS owner ID 3971981374]; role: CORPORATE DIRECTOR; associated: 2022-04-02; ownership: not reported; PE: not reported; REIT: not reported, EDWARD DAMSTRA [Individual; CMS owner ID 3072991470]; role: CORPORATE DIRECTOR; associated: 2022-04-02; ownership: not reported; PE: not reported; REIT: not reported, EMILY MCMASTER [Individual; CMS owner ID 5991135501]; role: CORPORATE DIRECTOR; associated: 2022-04-02; ownership: not reported; PE: not reported; REIT: not reported, JACOB J GROENEWOLD [Individual; CMS owner ID 3173953783]; role: CORPORATE DIRECTOR; associated: 2022-04-02; ownership: not reported; PE: not reported; REIT: not reported, JOHANNA ZANDSTRA [Individual; CMS owner ID 1153580840]; role: OPERATIONAL/MANAGERIAL CONTROL; associated: 2016-04-28; ownership: 0%; PE: not reported; REIT: not reported, KAREN HUIZENGA [Individual; CMS owner ID 4981082385]; role: CORPORATE DIRECTOR; associated: 2022-04-02; ownership: not reported; PE: not reported; REIT: not reported, KENNETH ALAN HOVING [Individual; CMS owner ID 941110365]; role: CORPORATE DIRECTOR; associated: 2022-04-02; ownership: not reported; PE: not reported; REIT: not reported, KYLE YONKER [Individual; CMS owner ID 6305224999]; role: CORPORATE DIRECTOR; associated: 2022-04-02; ownership: not reported; PE: not reported; REIT: not reported, PATRICIA L JABAAY [Individual; CMS owner ID 8426436825]; role: CORPORATE DIRECTOR; associated: 2022-04-02; ownership: not reported; PE: not reported; REIT: not reported, PAUL BUIKEMA [Individual; CMS owner ID 2163800566]; role: CORPORATE DIRECTOR; associated: 2022-04-02; ownership: not reported; PE: not reported; REIT: not reported, PAUL KATS [Individual; CMS owner ID 2466364625]; role: CORPORATE DIRECTOR; associated: 2022-04-02; ownership: 0%; PE: not reported; REIT: not reported, REST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOME [Organization; CMS owner ID 1052221470]; role: 5% OR GREATER DIRECT OWNERSHIP INTEREST; associated: 2016-06-15; ownership: 100%; PE: no; REIT: no, ROGER BOEREMA [Individual; CMS owner ID 3678483096]; role: CORPORATE DIRECTOR; associated: 2022-04-02; ownership: not reported; PE: not reported; REIT: not reported, SHERYL HAMMER [Individual; CMS owner ID 4082044698]; role: CORPORATE DIRECTOR; associated: 2022-04-02; ownership: not reported; PE: not reported; REIT: not reported, THEODORE EARLE FEENSTRA [Individual; CMS owner ID 2860870458]; role: CORPORATE DIRECTOR; associated: 2022-04-02; ownership: not reported; PE: not reported; REIT: not reported, WILLIAM ZANDSTRA [Individual; CMS owner ID 6204129554]; role: CORPORATE DIRECTOR; associated: 2016-04-28; ownership: 0%; PE: not reported; REIT: not reported Source
Owners CMS marks as private equity
0 Source
Owners CMS marks as REITs
0 Source

CMS identity

Agency type
Hospice Source
Ownership type
For-Profit Source
Phone
(800) 509-2800 Source
CMS address
10700 PARK PLACE Source
ZIP code
46373 Source

Pricing

Published prices

Average submitted charges per hospice service day

$279.26

per hospice service day / provider-submitted charges divided by source utilization for Original Medicare fee-for-service claims

Current source Checked 2026-08-11 / Fiscal year 2024

Includes: CMS final-action Medicare fee-for-service Part A claims included in the PAC public-use file.

Excludes: A patient quote, beneficiary out-of-pocket amount, Medicaid or self-pay services, and current availability.

Calculated from CMS provider totals: 15,152 hospice service days, 176 distinct beneficiaries, $4,231,416 submitted charges, and $2,640,529 Medicare payment. Claims context only; not a provider price or patient cost.

CMS Medicare Post-Acute Care Utilization - Hospice by Geography and Provider source

Average Medicare payment per hospice service day

$174.27

per hospice service day / Medicare payment divided by source utilization for Original Medicare fee-for-service claims

Current source Checked 2026-08-11 / Fiscal year 2024

Includes: CMS final-action Medicare fee-for-service Part A claims included in the PAC public-use file.

Excludes: A patient quote, beneficiary out-of-pocket amount, Medicaid or self-pay services, and current availability.

Calculated from CMS provider totals: 15,152 hospice service days, 176 distinct beneficiaries, $4,231,416 submitted charges, and $2,640,529 Medicare payment. Claims context only; not a provider price or patient cost.

CMS Medicare Post-Acute Care Utilization - Hospice by Geography and Provider source

Market benchmarks

Average Medicare payment per hospice service day

$181.27

per hospice service day / Medicare payment divided by source utilization from CMS geographic totals

IN state benchmark / Hospice / Original Medicare fee-for-service beneficiaries in the CMS PAC public-use file

Current source Effective Fiscal year 2024 / Checked 2026-08-11

Weighted calculation from 3,016,286 hospice service days and 41,253 distinct beneficiaries. Claims context only; not a provider price, patient cost, or quote.

CMS Medicare Post-Acute Care Utilization - Hospice by Geography and Provider source

Average submitted charges per hospice service day

$309.98

per hospice service day / provider-submitted charges divided by source utilization from CMS geographic totals

IN state benchmark / Hospice / Original Medicare fee-for-service beneficiaries in the CMS PAC public-use file

Current source Effective Fiscal year 2024 / Checked 2026-08-11

Weighted calculation from 3,016,286 hospice service days and 41,253 distinct beneficiaries. Claims context only; not a provider price, patient cost, or quote.

CMS Medicare Post-Acute Care Utilization - Hospice by Geography and Provider source

Benchmarks describe the named market, not this provider's quoted price.

Source trail

Research workflow

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