Oklahoma State Department of HealthHealth Resource Development Services
Listing of Facilities Owned by an Owner (Excluding Former Owners)
for Nursing Homes
As of: July 24, 2017
Owner NameFacilities Owned
NH5578 405-635-9961315 S.W. 80th Street Oklahoma City, OK 73139
Accel at Crystal Park
100% Cruse Five, LLC eff 1/24/17
Stockholders/partners Who Are Officers
P.O. Box 890396 Okla. City, OK 73139
Anthony Cruse Oklahoma Limited Partnership
45.80% WRI, LP; 59.9% LCCP, LP;
100% LC General Partner,LLC
Stockholders/partners -- Not Officers
1500 Waters Ridge Dr 200 Lewisville, TX 75077
Taylor John F.
30.32% WRI, LP eff 1/24/17
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, TX 75057
Lake Creek Capital Partners, LP
10.79% WRI,LP eff 1/24/17
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, TX 75057
Fisher James (Jim)
10.06% WRI,LP eff 1/24/17
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, TX 75057
Pierce Paula
0.1% LCCP, LP eff 1/24/2017
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, TX 75057
LC General Partner, LLC
eff 1/24/17
Contracted Management
1500 Waters Ridge Drive 200 Lewisville, TX 75057
Stonegate Senior Living, LLC
3.09% WRI, LP; 20% LCCP, LP eff
1/24/17
Stockholders/partners -- Not Officers
1500 Waters Ridge Dt Lewisville, TX 75057
Taylor John P.
100% SWALK Operations, LLC eff
1/24/17
Stockholders/partners -- Not Officers
1500 Waters Ridge Dr. 200 Lewisville, TX 75057
Southwest SNF Holdings, LLC (SW SNFH)
100% Southwest SNF Holdings, LLC eff
1/24/17
Stockholders/partners -- Not Officers
1500 Waters Ridge Dirve 200 Lewisville, TX 75057
WR Investments, LP (WRI, LP)
100% WRIGPM,I & Gen. Partner of WR
Investments, LP eff 1/24/17
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, TX 75057
WR Investments GP, Inc.
20% LCCP, LP eff 1/24/17
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, TX 75057
Campbell Scott
100% of Stonegate Senior Living, LLC
eff 1/24/17
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, OK 75057
SGSL Management Holdings, LLC
1/24/17
Operating Entity
1500 Waters Ridge Drive, Suite 200 Lewisville, TX 75057
SWALK Operations, LLC
Page 1 of 265
Owner NameFacilities Owned
Managing Member SWALK Operations,
LLC & (SW SNFH) eff 1/24/17
Officers Who Do Not Hold Stock
1500 waters Ridge Dr. Lewisville, TX 75057
WR Investments GP Manager, Inc. (WRIGPMI)
eff 1/24/17
Lessor Or Real Estate Owner
8100 S. Walker, Building A Oklahoma City, OK 73129
Cruse Five, LLC
NH6201 580-332-3631931 North Country Club Road Ada, OK 74820
Ada Care Center
Mgr Ada RE& Ada CC & 100% Mgng
Mbr BKS-RE&BKS eff. 02/01/2012
Officers Who Do Not Hold Stock
131 North Broadway Ada, OK 74820
Reed Bart
100% Ada Care Center, LLC
Stockholders/partners -- Not Officers
131 North Broadway Ada, OK 74820
BK Strategies, LLC
100% Member Ada Real Estate, LLC eff
02/01/2012
Officers Who Do Not Hold Stock
131 North Broadway Ada, OK 74820
BK Strategies Real Estate, LLC
UPL Mgr. eff. 6/30/2017
Contracted Management
131 North Broadway Ada, OK 74820
Ada Care Center, LLC
100% RE eff.02/01/2012
Lessor Or Real Estate Owner
131 North Broadway Ada, OK 74820
Ada Real Estate, LLC
UPL Owner eff. 6/30/2017
Operating Entity
100 W. Paul Avenue Pauls Valley, OK 73075
City of Pauls Valley
NH7406 918-331-05506006 SE Adams Blvd Bartlesville, OK 74006
Adams PARC
100% of Senior Comfort Corp. eff.
04/25/2011
Stockholders/partners -- Not Officers
1825 E. 15th Tulsa, OK 74104
Jiles Jon P.
70% of OP, eff. 04/25/2011
Stockholders/partners -- Not Officers
1825 East 15th Street Tulsa, OK 74104
Senior Comfort Corp.
20% of OP, eff.04/25/2011
Stockholders/partners -- Not Officers
2080 Verona Way Edmond, OK 73034
Kittco, LLC
10% of OP, eff.04/25/2011
Stockholders/partners -- Not Officers
PO Box 768 Sallisaw, OK 74955
Sullivan, Jr. Frank
Lessor Or Real Estate Owner
18831 Von Karman Ave. 400 Irvine, CA 92612
Sabra Health Care Holding I, LLC
100% of Sabra Holdings III
Member
18831 Von Karman Ave 400 Irvine, CA 92612
Sabra Health Care Limited Partnership
1% of Sabra Health Limited Partnership
Limited Partner
18831 Von Karman Ave 400 Irvine, CA 92612
Sabra Health Care, LLC
Page 2 of 265
Owner NameFacilities Owned
99% of Sabra Health Limited Partnership
General Partner
18831 Von Karman Ave. 400 Irvine, CA 92612
Sabra Health Care REIT, Inc.
eff 06-01-11
Operating Entity
6006 SE Adams Blvd Bartlesville, OK 74006
ConHold of Bartlesville, LLC
100% of Kittco LLC eff. 04/25/2011
Stockholders/partners -- Not Officers
2617 Warwick Pl Edmond, OK 73013
Wakeley Kitt
Lessor Or Real Estate Owner
18831 Von Karman Ave 400 Irvine, CA 92612
Sabra Health Care Holdings III, LLC
Pres. Sabra health Holdings III, Sabra,
LLC, and REIT
Officers Who Do Not Hold Stock
18500 Von Karman Avenue 550 Lrvine, CA 92612
Matros Richard
CFO Sabra Holdings III, Sabra Health
Care and REIT
Officers Who Do Not Hold Stock
18500 Von Karman Ave 550 Irvine, CA 92612
Andrews, Jr. Harold
CFO & Sec Sabra Holdings, Sabra Health
Care & REIT
Officers Who Do Not Hold Stock
18500 Von Karman Ave 550 Irvine, CA 92612
Nevo-Hacohen Talya
NH5204 580 725-3400205 E. Maple Billings, OK 74630
Albert Hall
45% OP / RE President eff. 1/23/2015
Stockholders/partners Who Are Officers
PO Box 367 Billings, OK 74630
Hardin Kelly
20% OP / RE eff. 1/23/2015
Stockholders/partners -- Not Officers
108 Saskatchewan Roland, OK 74954
Pitchford Linda
10% OP / RE eff. 1/23/2015
Stockholders/partners -- Not Officers
1821 West Lincoln Street Broken Arrow, OK 74012
Adams Diane
5% OP / RE VP eff 1/23/2015
Stockholders/partners Who Are Officers
603 N. 7th Tonkawa, OK 74653
Lewallen Barry
10% OP / RE Sec. eff 1/23/2015
Stockholders/partners Who Are Officers
112566 S. 4750 Rd. Muldrow, OK 72908
Kelton Gary
5% OP / RE eff. 1/23/2015
Stockholders/partners -- Not Officers
2170 CR3212 Jacksonville, TX 75766
Kombos Britni
5% OP / RE eff. 1/23/2015
Stockholders/partners -- Not Officers
2829 Falcon Crest Enid, OK 73703
Hardin Chase
eff. 1/23/2015
Operating Entity
205 E. Maple Billings, OK 74630
Fairchild Home & Community Based Services, LLC
eff. 1/23/2015
Lessor Or Real Estate Owner
205 E. Maple Billings, OK 74630
Capitol Long Term Investments
Page 3 of 265
Owner NameFacilities Owned
NH5410 918-650-9393318 E "A" Street Weleetka, OK 74880
Alcis Place
amended corp. name (fkaProdetik, Inc.)
eff 02-05-08
Operating Entity
P.O. Box 217 Weleetka, OK 74880
The Reach Corporation
Non-Profit Board President of The Reach
Corporation 1-8-08
Officers Who Do Not Hold Stock
P.O. Box 790 Uniontown, KY 42461
Welsh Richard
Non-Profit Board VP of The Reach
Corporation
Officers Who Do Not Hold Stock
PO Box 790 UnionTown, KY 42461
Bailey M. Geoffry
Non-Profit Board Sec/Treas of The Reach
Corporation
Officers Who Do Not Hold Stock
PO Box 790 Uniontown, KY 42461
Pyle William "Bill"
authorized agent for The Reach
Corporation
Officers Who Do Not Hold Stock
1201 West Trudgeon Place Henryetta, OK 74437
Bentley Roy
eff. 8-15-07
Lessor Or Real Estate Owner
P.O. Box 409 Sturgis, KY 42459
Maricopa Properties, LLC
100% of RE
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Maricopa Partners, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Rock River, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
MMB, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Lovenest, LLC
30.959% of Rock River, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gary
16.025% of Rock River, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Lisa
32.88% of MMB, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Tim
17.455% of MMB, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Vicki
29.421% of Lovenest, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Robert
13.957% of Lovenest, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Laura
53.016% of Rock River, LLC - 4 children
w/13.254% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
4 Irrevocable Trusts
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O.Box 409 Sturgis, KY 42459
Ervin Mallory
Page 4 of 265
Owner NameFacilities Owned
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Jade
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Luke
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gabe
49.665% of MMB, LLC - 5 children
w/9.933% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
3 Irrevocable Trusts
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Max
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box Sturgis, KY 42459
Linenger Jessica
20% of 3 Irrevocable Trusts
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mitch
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Linenger Jennifer
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Brock
56.623% of Lovenest, LLC - 7 children
w/8.089% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
7 Irrevocable Trusts
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Thea
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugris, KY 42459
Ervin Issac
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugis, KY 42459
Ervin Samuel
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Elijah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Saul
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Micah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mathias
NH7201 918-743-89781340 East 61st Street Tulsa, OK 74136
Ambassador Manor Nursing Center
Page 5 of 265
Owner NameFacilities Owned
Mgr OP/RE/Amity Care, L.LC
Managing Member
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Greiner Don
Mgr OP/RE/Amity Care, L.LC
Managing Member
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Dimond Mike
Management EFF 3/01/2016
Contracted Management
4350 Will Rogers Parkway 300 Okc, OK 73108
Amity Care, L.L.C.
99% OP & 78% Amity Care
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Don Greiner Trustee Kenneth D.Greiner III Revocable Trust, Don Greiner
Benef/Trustee
58% RE
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Clarity Properties, LLC
52% of Renew - Mike Dimond, Trustee
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Stalwort Trust
100% Clarity Properties 48% Renew
Prop/22% Mngr
Stockholders/partners -- Not Officers
4530 Will Rogers Parkway 300 OKC, OK 73108
Don Greiner Family Trust, Don Greiner Trustee
42% RE
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Renew Properties, L.L.C.
OP EFF 3/1/2016
Operating Entity
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Ambassador Operations, L.L.C.
RE EFF 3/1/2016
Lessor Or Real Estate Owner
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Ambassador Properties, L.L.C.
NH6401 580-298-3294511 East Main Antlers, OK 74523
Antlers Manor
Beneficiary of Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Green Trust Philip Riley
25% BGM &
4thSuccesTrustee&BeneficiaryDelores O
Mitchell Revoc
Stockholders/partners -- Not Officers
P.O. Box 330 Muldrow, OK 74948
Tabor Angela
25%BGM & SuccesTrustee &
Beneficiary- Delores O Mitchell Revoc
Stockholders/partners -- Not Officers
111522 S. 4740 Rd. Muldrow, OK 74948
Mitchell Robert Michael
25% BGM & 3rd
SucceTruste&Beneficiary-
DeloresMitchell RevocTru
Stockholders/partners -- Not Officers
412 S. Dogwood Sallisaw, OK 74955
Mitchell Marcinda
25% BGM 2nd
SuccesTrustee&Beneficiary Delores O
Mitchell Revoc
Officers Who Do Not Hold Stock
7240 Chase Oaks Blvd 121 Plano, TX 75025
Mitchell Kelly O.
Trustee of Delores O. Mitchell Revocable
Trust
Trustee
412 South Dogwood Sallisaw, OK 74955
Mitchell Delores O.
Page 6 of 265
Owner NameFacilities Owned
UPL Mgr. eff 6/30/2017
Contracted Management
PO Box 939 Antlers, OK 74523
Antlers Manor, LLC
Beneficiary of Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Green Reba
Beneficiary of GIlbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Ellis, fka Seay Tiffany Renee
Beneficiary of Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Thurman Bronson Owen
Beneficiary of Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, Ok 74955
Tiffany Ellis, fka Seay Trust
Beneficiary of Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Thurman Trust, Gilbert F. Green, Trustee Bronson
Beneficiary of Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Michelle Green Lori
50%
Stockholders/partners -- Not Officers
P.O. Box 1090 Sallisaw, OK 74955
Gilbert F. Green Trust
Manager of Antlers Manor, LLC
Manager
Box 939 Antlers, OK 74523
Bibbs Charlotte
Trustee of Gilbert F. Green Trust
Trustee
P.O. Box 1090 Sallisaw, OK 74955
Green Gilbert F.
25%
Stockholders/partners -- Not Officers
412 S. Dogwood Sallisaw, OK 74955
Delores O. Mitchell Revocable Trust
25.00% OP eff 9-16-16
Stockholders/partners -- Not Officers
,
BGM Estate, LLC
UPL Owner eff. 6/30/2017
Operating Entity
201 S. 2nd Street Hugo, OK 74743
City of Hugo
NH1903 918-224-6012310 West Taft Sapulpa, OK 74066
Arbor Village
100% of Sapulpa Holding, LLC
Stockholders/partners Who Are Officers
PO Box 990 Edmond, OK 73013
Diakonos Group, LLC
49% OP/99% Diakonos Group,
LLC/100% Servant Holding Corporation.
Stockholders/partners Who Are Officers
PO Box 990 Edmond, OK 73013
Pilgrim Scott
1% Diakonos Group, LLC
Stockholders/partners Who Are Officers
P.O Box 990 Edmond, OK 73034
Servent Holding Corporation
sub-lessee eff. 3-1-10
Operating Entity
P.O.Box 990 Edmond, OK 73083
Arbor Village Nursing, LLC
Page 7 of 265
Owner NameFacilities Owned
1st lessee of property ONLY
eff.7-29-09-not reviewed by CN
Lessor Or Real Estate Owner
3325 French Park Dr. 6 Edmond, OK 73034
Sapulpa Holding, LLC
51% OP, Managing member
eff.02/01/2013
Stockholders/partners Who Are Officers
P.O. Box 990 Edmond, OK 73083
Pilgrim Lee E.
NH5001 580-622-20301415 West 15th Street Sulphur, OK 73086
Artesian Home
Operating Entity
1415 W. 15th Sulphur, OK 73086
Artesian Home, Inc.
65% Pres, eff. 07/17/2012
Stockholders/partners Who Are Officers
1908 12th Ave N.W. E Ardmore, OK 73401
Coble Tom C.
35% VP eff.07/17/12.
Stockholders/partners Who Are Officers
1908 12th Ave NW Ardmore, OK 73401
Jackson Don N.
100% Op.Ent.
Stockholders/partners -- Not Officers
1908 12th Avenue, N W E Ardmore, OK 73401
Elmbrook Properties, Inc.
NH3209 405-452-3271202 East First Street Wetumka, OK 74883
Aspen Place Living Center, LLC
Trustee Family Trust & Pres PNHHC,
Inc. eff 12/31/12
Stockholders/partners Who Are Officers
P.O. Box 488 Weleetka, OK 74880
Adkins Gerrol Dean
Trustee Family Trust & Sec. Pioneer
NHHC, Inc. eff 12/31/12
Stockholders/partners Who Are Officers
P.O. Box 488 Weleetka, OK 74880
Adkins Arbret June
Lessor Or Real Estate Owner
P.O. Box 488 Wetumka, OK 74880
Pioneer Nursing Home Of Hughes County, Inc.
Beneficiary CDM Irrevocable Trust. eff
12/31/12319 West 9th St. Weleetka, OK 74880
Majors Cynthia
Beneficiary DRS Irrevocable Trust
eff.12/31/12319 West 9th St Weleetka, OK 74880
Simmons Donna Renee
Beneficiary GDA II Irrevocable Trust
eff.12/31/12Rt. 1, Box 121A Weleetka, OK 74880
Adkins, II Gerrol D.
eff. 1-1-07
Operating Entity
P.O. Box 488 Weleetka, OK 74880
Aspen Place Living Center, LLC
100% OP manag.member
Stockholders/partners -- Not Officers
P.O. Box 488 Weleetka, OK 74880
Aspen Place Revocable Business Trust
Page 8 of 265
Owner NameFacilities Owned
52% of RE eff 12/31/12
Stockholders/partners -- Not Officers
P.O. Box 488 Weleetka, OK 74880
Gerrol Dean Adkins & Arbret June Adkins Family Trust (GDA/AJA)
16% RE eff 12/31/12
Stockholders/partners -- Not Officers
Rt 1 Box 121A Weleetka, OK 74880
Gerrol Dean Adkins II Irrevocable Trust dated 12/28/12
16% RE eff 12/31/12
Stockholders/partners -- Not Officers
Rt 1 Box 121A Weleekta, OK 74880
Cynthia Denise Majors Irrevocable Trust dated 12/28/12
16% RE eff 12/31/12
Stockholders/partners -- Not Officers
Rt 1 Box 121A Weleetka, OK 74880
Donna Renee Simmons Irrevocable Trust dated 12/28/12
Trustee eff 12/31/12
Trustee
523 W. Main Henryetta, OK 74437
Palmer, C.P.A. Reginald
Secretary Eff 12/14/12
Officers Who Do Not Hold Stock
603 N. 7th Tonkawa, OK 74653
Lewallen Barry
NH5416 918-650-9393102 North 9th Street Okemah, OK 74859
Atlanta Place
amended corp. name (fkaProdetik, Inc.)
eff 02-05-08
Operating Entity
P.O. Box 217 Weleetka, OK 74880
The Reach Corporation
Non-Profit Board President of The Reach
Corporation 1-8-08
Officers Who Do Not Hold Stock
P.O. Box 790 Uniontown, KY 42461
Welsh Richard
Non-Profit Board VP of The Reach
Corproation 1-8-08
Officers Who Do Not Hold Stock
PO Box 790 UnionTown, KY 42461
Bailey M. Geoffry
Non-Profit Board Sec/Tre of The Reach
Corporation
Officers Who Do Not Hold Stock
PO Box 790 Uniontown, KY 42461
Pyle William "Bill"
authorized agent for The Reach
Corporation
Officers Who Do Not Hold Stock
1201 West Trudgeon Place Henryetta, OK 74437
Bentley Roy
eff. 8-15-07
Lessor Or Real Estate Owner
P.O. Box 409 Sturgis, KY 42459
Maricopa Properties, LLC
100% of RE
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Maricopa Partners, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Rock River, LLC
33.33% of Maricopa Partnes, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
MMB, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Lovenest, LLC
30.959% of Rock River, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gary
Page 9 of 265
Owner NameFacilities Owned
16.025% of Rock River, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Lisa
32.88% of MMB, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Tim
17.455% of MMB, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Vicki
29.421% of Lovenest, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Robert
13.957% of Lovenest, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Laura
53.016% of Rock River, LLC - 4 children
w/13.254% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
4 Irrevocable Trusts
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O.Box 409 Sturgis, KY 42459
Ervin Mallory
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Jade
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Luke
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gabe
49.665% of MMB, LLC - 5 children
w/9.933% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
3 Irrevocable Trusts
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Max
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box Sturgis, KY 42459
Linenger Jessica
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mitch
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Linenger Jennifer
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Brock
56.623% of Lovenest, LLC - 7 children
w/8.089% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
7 Irrevocable Trusts
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Thea
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugris, KY 42459
Ervin Issac
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugis, KY 42459
Ervin Samuel
Page 10 of 265
Owner NameFacilities Owned
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Elijah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Saul
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Micah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mathias
NH0302 580-889-25001500 South Virginia Street Atoka, OK 74525
Atoka Manor
OP/RE
Operating Entity
1500 South Virginia Atoka, OK 74525
Atoka Manor, Inc.
Secretary of OP
Officers Who Do Not Hold Stock
405 Gary Avenue Atoka, OK 74525
Easley Sandra
Chairperson eff 07/11/11
Officers Who Do Not Hold Stock
150 W Hwy 7 Atoka, OK 74525
Walker Traci D
Governing Board Member eff 1-20-17
Officers Who Do Not Hold Stock
1500 S Virginia Ave Atoka, OK 74525
McCall Clay
Governing Board Member Eff 1-20-17
Officers Who Do Not Hold Stock
1500 S Virginia Ave Atoka, OK 74525
Sherrill Coby
Governing Board Member Eff 1/20/17
Officers Who Do Not Hold Stock
1500 S Virginia Ave Atoka, OK 74525
Hardison Clint
NH6609 918-283-49492700 North Hickory Street Claremore, OK 74017
Autumn Wood Memory Care
42.5 % member of Evergreen Senior
Holdings, LLC & Manager
Stockholders/partners Who Are Officers
PO Box 2107 Brentwood, TN 37024
Coates Christopher J.
RE, eff 08/30/13
Lessor Or Real Estate Owner
3232 Mckinney Ave 890 Dallas, TX 75204
RSF AS Wood Manor Realty V, LP
General Partner of RSF AS Wood Manor
Realty V, LP, eff 08/30/13
Stockholders/partners -- Not Officers
3232 McKinney Ave 890 Dallas, TX 75204
RSF REIT VB GP, LLC
100% of RFS AS Autumn Wood, Realty
V, LP eff 08/30/13
Stockholders/partners -- Not Officers
3232 McKinney Ave 890 Dallas, TX 75204
RSF REIT VB, LLC
Manager of RSF REIT VB, LLC eff
08/30/13
Stockholders/partners -- Not Officers
3232 McKinney Ave 890 Dallas, TX 75204
RSF Gen Par V, LLC
Page 11 of 265
Owner NameFacilities Owned
Manager of RSF Gen Par V, LLC eff
08/30/13
Stockholders/partners -- Not Officers
3232 McKinney Ave 890 Dallas, TX 75204
Mahowald Group V, LLC
98.4% of Mahowald Group V, LLC eff
08/30/13
Stockholders/partners Who Are Officers
3232 McKinney Ave 890 Dallas, TX 75204
Mahowald Christopher
OP, eff 08/30/2013
Operating Entity
3232 McKinney Ave 890 Dallas, TX 75204
Autumn Wood Opco, LLC
50% of AWMS, LLC Mgr
Stockholders/partners -- Not Officers
8500 West 110th Street 510 Overland Park, KS 662010
Wurth David
50% of AWMS, LLC Mgr
Stockholders/partners -- Not Officers
8500 West 110th Street 510 Overland Park, KS 66210
Wurth Charles
Sole Member of Manager (ERSM, LLP)
Contracted Management
1 Village Dr. Suite 400 Abilene, TX 79606
ER Senior Management, LLC
Sole member of ER Senior Mgr, LLC
Member
PO Box 2107 Brentwood, TN 37024
ESLP Management, LLC
Sole Member of ESLP Mgmt LLC
Member
,
Evergreen Senior Holdings, LLC
42.5% Member of Evergreen Senior
Holdings, LLC & Manager
Stockholders/partners Who Are Officers
PO Box 2107 Brentwood, TX 37024
Dowd Brian E.
15% member of Evergreen Senior
Holdings & LLC & Manager
Stockholders/partners Who Are Officers
3899 Maple Avenue 250 Dallas, TX 75219
RSF Partners VI, LP
Its General Partner
General Partner
3899 Maple Avenue 250 Dallas, TX 75219
RSF GenPar VI, LP
General Partner of RSF GenPar VI, LLC
General Partner
3899 Maple Avenue 250 Dallas, TX 75219
McKinney VI, LLC
Vice President of McKinney VI, LLC
Vice President
3899 Maple Avenue 250 Dallas, TX 75219
Read Kurt C.
NH3801 580-569-2258801 B Street Snyder, OK 73566
Ayers Nursing Home
Operating Entity
801 B. Street Synder, OK 73566
Ayers Nursing Home, Inc.
Pres 50%
Stockholders/partners Who Are Officers
Rt. 2 Box 49a Snyder, OK 73566
Ayers Norman Pat
V/pres 50%
Stockholders/partners Who Are Officers
115 8th Snyder, OK 73566
Ayers Jerry
Page 12 of 265
Owner NameFacilities Owned
NH6202 580-436-1414201 West 5th Street Ada, OK 74820
Ballard Nursing Center
President 100% Epecho Associates, Inc.
Stockholders/partners Who Are Officers
131 North Broadway Ada, OK 74820
Reed Gary
S/ Treasurer of Epecho Associates, Inc.
Officers Who Do Not Hold Stock
131 North Broadway Ada, OK 74820
Reed Lenora Kay
Pres 100% IHS Holding, Inc. & IHS
Management Consultants,Inc.
Stockholders/partners Who Are Officers
131 North Broadway Ada, OK 74820
Reed Bart
UPL Mgr. eff. 6/30/2017
Contracted Management
131 North Broadway Ada, OK 74820
IHS Ballard Nursing Center, Inc.
Lessor Or Real Estate Owner
131 North Broadway Ada, OK 74820
C N C Retirement Living, Inc.
100% RE
Stockholders/partners -- Not Officers
131 North Broadway Ada, OK 74820
Epecho Associates, Inc.
100% OP
Stockholders/partners -- Not Officers
131 North Broadway Ada, OK 74820
IHS Holding, Inc.
eff. 12-01-08
Contracted Management
131 North Broadway Ada, OK 74820
IHS Management Consultants, Inc.
Sec. of IHS Management Consultants,
Inc. eff.2/5/09
Officers Who Do Not Hold Stock
131 N. Broadway Ada, OK 74820
Camerer Beth Ann
Treasurer of IHS Management
Consultants, Inc. eff.2/8/09
Officers Who Do Not Hold Stock
131 North Broadway Ada, OK 74820
Taylor Amy
UPL Owner eff. 6/30/2017
Operating Entity
100 W. Paul Avenue Pauls Valley, OK 73075
City of Pauls Valley
NH1201 580-326-83831200 West Finley Hugo, OK 74743
Baptist Village of Hugo
President
Stockholders/partners Who Are Officers
3800 N. May Oklahoma City, OK 73112
Pierce William M.
Operating Entity
3800 N. May Oklahoma City, OK 73112
Baptist Village Retirement Communities of Oklahoma, Inc.
VP Operations
Officers Who Do Not Hold Stock
3800 N. May Ave. Okla. City, OK 73112
Eshelman Donald "Corky"
CFO
Officers Who Do Not Hold Stock
3800 North May Avenue Okla. City, OK 73112
Mills Kenneth D.
VP Planning/Projects
Officers Who Do Not Hold Stock
3800 North May Ave. Oklahoma City, OK 73112
Short Wendell
Page 13 of 265
Owner NameFacilities Owned
VP- Operations
Officers Who Do Not Hold Stock
3800 N. May Ave. Oklahoma City, OK 73112
Thomas Steve
Corporate Secretary
Officers Who Do Not Hold Stock
3800 N May Ave. Oklahoma City, OK 73112
Hughes Judy
NH5701 918-847-2572411 S. 4th Street Barnsdall, OK 74002
Barnsdall Nursing Home
Lessor Or Real Estate Owner
411 South Fourth Street Barnsdall, OK 74002
Osage Nursing Home Inc.
95% OP eff. 4-01-09 and 50% RE
Stockholders/partners -- Not Officers
1926 Glynwood Dr. Bartlesville, OK 74006
Hardin Janet
50% RE
Stockholders/partners -- Not Officers
P.O. Box 586 Sallisaw, OK 74955
Farmer Margaret Ann
Operating Entity
411 South 4th Barnsdall, OK 74002
Barnsdall Health Care, L.L.C.
5% OP eff. 4-01-09
Stockholders/partners -- Not Officers
411 South 4th Barnsdall, OK 74002
Jamison Susan
NH7403 918-333-95453434 Kentucky Place Bartlesville, OK 74006
Bartlesville Health and Rehabilitation Community
50% Mgng Mbr BHRC,LLC & 50% Pres
BCC, Inc. eff 12/03/2012
Stockholders/partners Who Are Officers
6445 Clearcrek Bartlesville, OK 74006
Dout Alex
Operating Entity
3434 Kentucky Pl. Bartlesville, OK 74006
Bartlesville Care Center, Inc.
50% Mgng Mbr BHRC,LLC & 50%
V.Pres BCC, Inc. eff 12/03/2012
Stockholders/partners Who Are Officers
2400 W. Camelback Duncan, OK 73553
Wilkins Tony
eff 12/03/2012
Lessor Or Real Estate Owner
3434 Kentucky Place Bartlesville, OK 74006
BHRC, LLC
NH7601 580-327-1274916 Noble Alva, OK 73717
Beadles Nursing Home
Operating Entity
916 Noble Alva, OK 73717
Beadles, Inc.
Page 14 of 265
Owner NameFacilities Owned
25% & Vice President, OP, eff
08/03/2012
Stockholders/partners Who Are Officers
916 Noble (P.O.Box 728) Alva, OK 73717
Mary Ruth Hiett Revocable Living Trust (MRHRLT)dated May 18,1999
25% & Secretary OP/ Beneficiary
MRHRLT, eff March 12, 2014
Stockholders/partners Who Are Officers
817 Noble Alva, OK 73717
Lynch Marietta
25% & President, OP/ Ben/Trste
MRHRLT, eff 08/03/2012
Stockholders/partners Who Are Officers
P.O. Box 62 Alva, OK 73717
Jordan Adam
25% & Treasurer OP/Beneficiary
MRHRLT, eff 08/03/2012
Stockholders/partners Who Are Officers
941 Baker Place (P.O. Box 134) Alva, OK 73717
Hiett Barbara
Beneficiary MRHRLT, eff 08/03/2012
Stockholders/partners -- Not Officers
915 Logan Alva, OK 73717
Swain Charlotte
NH6111 918-297-70001300 North Drive Hartshorne, OK 74547
Beare Manor
50% RE/OP
Stockholders/partners -- Not Officers
1929 Betty Jane Lane Muskogee, OK 74403
Montgomery Tom
Lessor Or Real Estate Owner
P.O. Box 1015 Hartshorne, OK 74547
Beare's Co., Inc.
25% RE/OP
Stockholders/partners -- Not Officers
P.O. Box 1015 Hartshorne, OK 74547
Beare Karen
Operating Entity
1929 Betty Jane Lane Muskogee, OK 74403
Hartshorne Health Services, L.L.C.
25% OP/RE eff.12-26-09
Stockholders/partners -- Not Officers
PO Box 1015 Hartshorne, Ok 74547
Estate of Mickey Beare
NH0401 580-625-4571200 East 8th Street Beaver, OK 73932
Beaver County Nursing Home
Operating Entity
200 E. 8th Beaver, OK 72932
Beaver County Hospital Authority
Chairman
Officers Who Do Not Hold Stock
Rr Beaver, OK 72932
Myers Neill
Lessor Or Real Estate Owner
111 West 2nd Street Beaver, OK 73932
Beaver County
Vice Chairman
Officers Who Do Not Hold Stock
Rt. 1, Box 34 Beaver, OK 73932
Collison Leslie
RE County Commissioner Eff 08/05/11
Officers Who Do Not Hold Stock
,
Rose Carl Jay
Page 15 of 265
Owner NameFacilities Owned
RE County Commissioner Eff 08/05/11
Officers Who Do Not Hold Stock
,
King Frank
RE County Commissioner Eff 08/05/11
Officers Who Do Not Hold Stock
,
Raven Brad
Secretary Board of Trustees OP eff
02/10/2014
Officers Who Do Not Hold Stock
902 Ave F Beaver, OK
Morrison Jack
Member Board of Trustees, eff. 07/30/12
Officers Who Do Not Hold Stock
RT 2 Box 86A Balko, OK
Grose Karen Sue
Member Board of Trustees Eff 02/10/14
Officers Who Do Not Hold Stock
P,P. BOX 1409 Beaver, OK
Parker Curtis
Administrator, eff 3/20/17
Officers Who Do Not Hold Stock
P.O. Box 220 Beaver, OK 73932
Barby Robin
NH0505 580-225-33352301 Bell Avenue Elk City, OK 73644
Bell Avenue Nursing Center
Lessor Or Real Estate Owner
10100 Santa Monica Blvd. 1300 Los Angeles, CA 90067
Elk II Associates, L. P.
100% OP
Stockholders/partners -- Not Officers
PO Box 990 Edmond, OK 73013
Diakonos Group, LLC
99% Diakonos Group, LLC
Managing Member
PO Box 990 Edmond, OK 73013
Pilgrim Scott
EFF 01/01/2016, Leasee of Elk City
Holding, LLC
Operating Entity
3325 French Park Drive 6 Edmond, OK 73034
Bell Avenue Nursing, LLC
subleasee of Elk II Assoc., L.P. Eff
01/01/2015
Lessor Or Real Estate Owner
3325 French Park Drive 6 Edmond, OK 73034
Elk City Holding, LLC
NH5502 405-767-65006500 North Portland Avenue Oklahoma City, OK
73116
Bellevue Health & Rehabilitation Center
1/6 Northwest Nursing and Convales.
Home, Inc.
Stockholders/partners -- Not Officers
7405 Clayton Drive Okla. City, OK 73132
Estate of Caroline Ann Harris, Allen K. Harris, personal represe
1/3 Northwest Nursing and convales.
Home, Inc.
Stockholders/partners -- Not Officers
400 N.E. 70th Oklaoma City, OK
Stout Hugh A. Jr.
14.28% Bellevue Convalescent Hospital,
Inc.
Stockholders/partners -- Not Officers
2925 Hemingford Lane Oklahoma City, OK 73126
Thompson, Jr. Norman L.
Page 16 of 265
Owner NameFacilities Owned
14.28% Bellevue Convalescent Hospital,
Inc.
Stockholders/partners -- Not Officers
2504 Brookdale Edmond, OK 73034
Burgess Diane
1/6 Northwest Nursing and Convales.
Home, Inc.
Stockholders/partners -- Not Officers
7405 Clayton Drive Okla. City, OK 73132
Harris Allan K.
2/3 OP/RE
Stockholders/partners -- Not Officers
c/o 7843 West Britton Rd. Okla. City, OK 73132
Northwest Nursing and Convalescent Home, Inc.
1/3 OP/RE
Stockholders/partners -- Not Officers
6500 North Portland Ave. Okla. City, OK 73116
Bellevue Convalescent Hospital, Inc.
14.28% Bellevue Convalescent Hospital,
Inc.
Stockholders/partners -- Not Officers
2925 Hemingford Lane Oklahoma City, OK 73120
Thompson David
14.28% Bellevue Convalescent Hospital,
Inc.
Stockholders/partners -- Not Officers
6500 N. Portland Oklahoma City, OK 73116
Thompson Robert
14.28% Bellevue Convalescent Hospital,
Inc.
Stockholders/partners -- Not Officers
11300 N. Penn Unit #124 Oklahoma City, OK 73120
Thompson Stephen C.
14.28% Bellevue Convalescent Hospital,
Inc.
Stockholders/partners -- Not Officers
14524 Salem Creek Edmond, OK 73013
Hardeman Nancy
1/3 Northwest Nursing & Conval. Home
Inc.
Stockholders/partners -- Not Officers
PO Box 1689 Elephant Butte, NM 87935
Jones Betty Jo
14.28% Bellevue Convalescent Hospital,
Inc.
Stockholders/partners -- Not Officers
6500 North Portland Okla. City, OK 73116
Price Sandra
Operating Entity
6500 North Portland Avenue Okla. City, OK 73116
Bellevue Northwest Nursing Center, an Oklahoma partnership
NH2101 918-786-22751400 South Main Street Grove, OK 74344
Betty Ann Nursing Center
100% Ban NH, LLC (OP/RE) eff
07/28/11
Stockholders/partners -- Not Officers
593 Atlanta Street Roswell, GA 30075
Brogdon Connie
100% of Marsh Pointe Mgmt and
Manager of Ban NH LLC
Stockholders/partners -- Not Officers
3050 Peachtree Rd 355 Atlanta, GA 30305
Brogdon Christopher
OP/RE Eff 07/28/11
Operating Entity
1400 S. Main St. Grove, OK 74344
Ban NH, LLC
Contracted Management eff 03-01-2014
Contracted Management
Two Buckhead Plaza, 3050 Peachtree Road NW 355 Atlanta, GA 30305
Marsh Pointe Managment, LLC
Page 17 of 265
Owner NameFacilities Owned
NH5413 918-650-9393732 East 3rd Street Weleetka, OK 74880
Beverly Place
amended corp. name (fkaProdetik, Inc.)
eff 02-05-08
Operating Entity
P.O. Box 217 Weleetka, OK 74880
The Reach Corporation
Non-Profit Board President of The Reach
Corporation 1-8-08
Officers Who Do Not Hold Stock
P.O. Box 790 Uniontown, KY 42461
Welsh Richard
Non-Profit Board VP of The Reach
Corporation 1-8-08
Officers Who Do Not Hold Stock
PO Box 790 UnionTown, KY 42461
Bailey M. Geoffry
Non-Profit Board Sec/Treas of The Reach
Corporation
Officers Who Do Not Hold Stock
PO Box 790 Uniontown, KY 42461
Pyle William "Bill"
authorized agent for The Reach
Corporation
Officers Who Do Not Hold Stock
1201 West Trudgeon Place Henryetta, OK 74437
Bentley Roy
eff. 8-15-07
Lessor Or Real Estate Owner
P.O. Box 409 Sturgis, KY 42459
Maricopa Properties, LLC
100% of RE
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Maricopa Partners, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Rock River, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
MMB, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Lovenest, LLC
30.959% of Rock River, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gary
16.025% of Rock River, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Lisa
32.88% of MMB, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Tim
17.455% of MMB, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Vicki
29.421% of Lovenest, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Robert
13.957% of Lovenest, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Laura
53.016% of Rock River, LLC - 4 children
w/13.254% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
4 Irrevocable Trusts
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O.Box 409 Sturgis, KY 42459
Ervin Mallory
Page 18 of 265
Owner NameFacilities Owned
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Jade
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Luke
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gabe
49.665% of MMB, LLC - 5 children
w/9.933% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
3 Irrevocable Trusts
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Max
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box Sturgis, KY 42459
Linenger Jessica
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mitch
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Linenger Jennifer
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Brock
56.623% of Lovenest, LLC - 7 children
w/8.089% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
7 Irrevocable Trusts
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Thea
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugris, KY 42459
Ervin Issac
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugis, KY 42459
Ervin Samuel
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Elijah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Saul
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Micah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mathias
NH5201 580-725-3533202 E Maple Billings, OK 74630
Billings Fairchild Center, Inc
Page 19 of 265
Owner NameFacilities Owned
Operating Entity
Highway 15 Billings, OK 74630
Billings Fairchild Center, Inc.
5%, V. President
Stockholders/partners -- Not Officers
112566 South 4750 Road Muldrow, OK 74948
Kelton Robin
60%; president eff. 06/18/2012
Stockholders/partners Who Are Officers
PO Box 367 Billings, OK 74630
Hardin Kelly
20%
Stockholders/partners -- Not Officers
108 Saskatchewan Roland, OK 74954
Pitchford Linda
S/tres 10% ended 06/17/2012; 10% eff.
06/18/2012
Stockholders/partners -- Not Officers
112669 South 4750 Road Muldrow, OK 74948
Kelton Gertrude
5%
Stockholders/partners -- Not Officers
1821 West Lincoln Street Broken Arrow, OK 74012
Adams Diane
NH0806 405-656-2302516 North Broadway Binger, OK 73009
Binger Nursing and Rehabilitation
Mgr. OP;
99%COHEA,LP;100%CLPMgt. Group
eff 5/28/15
Stockholders/partners Who Are Officers
750 S. Cherokee Catoosa, OK 74015
Risman Dandy
Mgr. BN&R, LLC, Trustee Abbott Family
Trust eff 5/28/15
Stockholders/partners Who Are Officers
Rt. 3, Box 112 Hydro, OK 73048
Abbott Kent
50% Binger Nursing Rehab LLC,
ABBRIS Prop LLC & KD Hlth Mg52815
Stockholders/partners -- Not Officers
PO Box 130 Hydro, OK 73048
Abbott Family, LLC
100% Abbott Fmly, LLC eff 5/28/15
Stockholders/partners -- Not Officers
PO Box 130 Hydro, OK 73048
Abbott Family Trust
effective Sept. 23, 2014
Manager
PO Box 70 Hydro, OK 73048
KD Health Managment, LLC
effective May 28, 2015
Operating Entity
P.O. Box 70 Hydro, OK 73048
Binger Nursing and Rehabilitation, LLC
effective May 28, 2015
Lessor Or Real Estate Owner
510 Arapaho Avenue Hydro, OK 73048
ABBRIS Properties, LLC
50% Binger Nursing & Rehab., LLC;
ABBRIS Prop., LLC, KD Hlth Mgt
Stockholders/partners -- Not Officers
P.O. Box 210 Ketchum, OK 74349
COHEA Limited Partners, LP
1% COHEA Limited Partners, LP eff
5/28/15
Stockholders/partners -- Not Officers
,
CLP Management Group, Inc.
Page 20 of 265
Owner NameFacilities Owned
NH3501 580-371-26361105 East Main Tishomingo, OK 73460
Blue River Healthcare, Inc.
100% Pres
Stockholders/partners Who Are Officers
2820 Ridgeway Ardmore, OK 73401
Walker Kenneth
eff01/27/2004
Operating Entity
HCR 70 Box 213A Ardmore, OK 73401
Blue River Healthcare, Inc.
NH3201 405-379-54431600 East Highway Holdenville, OK 74848
Boyce Manor Nursing Home
50% OP, eff May 02 2014
Stockholders/partners -- Not Officers
PO Box 568 Sallisaw, OK 74955
Estate of Bob G Mitchell - deceased, Marcinda Mitchell, Personal
UPL Mgr.eff. 6/30/2017
Contracted Management
1600 East Highway Holdenville, OK 74848
Medi-Plex Nursing Centers, Inc.
Gilbert F. Green Trust
Beneficiary
P.O. Box 330 Muldrow, OK 74948
Tabor Angela
Gilbert F. Green Trust
Beneficiary
111522 S. 4740 Rd. Muldrow, OK 74948
Mitchell Robert Michael
Gilbert F. Green Trust
Beneficiary
412 S. Dogwood Sallisaw, OK 74955
Mitchell Marcinda
Gilbert F. Green Trust
Beneficiary
7240 Chase Oaks Blvd 121 Plano, TX 75025
Mitchell Kelly O.
50% OP, Gilbert F. Green Trust 07/26/13
Stockholders/partners -- Not Officers
P.O. Box 1090 Sallisaw, OK 74955
Gilbert F. Green Trust
Trustee of Gilbert F. Green Trust
Trustee
P.O. Box 1090 Sallisaw, OK 74955
Green Gilbert F.
President/Director, Eff May 02 2014
Officers Who Do Not Hold Stock
1600 EAST HIGHWAY HOLDENVILLE, OK 74848
Williams Casey
President & Director
Officers Who Do Not Hold Stock
1600 E. Highway Holdenville, ok 74848
Carr Jennifer
UPL Owner eff 6/30/2017
Operating Entity
201 S. 2nd Street Hugo, OK 74743
City of Hugo
NH5111 918-683-8070841 North 38th Street Muskogee, OK 74401
Brentwood Extended Care & Rehab
100% Managing Member OpEnt and Real
Estate
Stockholders/partners Who Are Officers
1929 Betty Jane Lane Muskogee, OK 74401
Montgomery Montie
Page 21 of 265
Owner NameFacilities Owned
eff 1/11/07
Lessor Or Real Estate Owner
1925 Betty Jane Lane Muskogee, OK 74403
Bomont Properties, L.L.C.
eff 1/11/07
Operating Entity
1925 Betty Jane Lane Muskogee, OK 74403
Brentwood Extended Care & Rehab, LLC
NH1407 405-527-6519301 Broadway Lexington, OK 73051
Broadway Living Center
50% OP/RE
Stockholders/partners Who Are Officers
3548 Wellsite Drive Norman, OK 73069
Scearce Audra
50% OP/RE
Stockholders/partners -- Not Officers
3548 Wellsite Drive Norman, OK 73069
Scearce Joe
eff 9/1/04
Operating Entity
10217 Geronimo Norman, OK 73026
MM of Lexington LLC
eff. 03-04-08
Lessor Or Real Estate Owner
3548 Wellsite Drive Norman, OK 73069
Elder Health Care LLC
NH5101 918-683-28511622 East Broadway Muskogee, OK 74403
Broadway Manor Nursing Home
60% BHCP GP JV 2015, LLC, 7/1/16
Stockholders/partners Who Are Officers
1633 North Campbell Avenue Chicago, IL 60647
Birchwood Health Care Properties, LLC
Manager & 100% Mbr, Birchwood HCP
LLC& OK4 Manager, LLC 7/1/16
Stockholders/partners Who Are Officers
1633 North Campbell Avenue Chicago, IL 60647
Dole Isaac
Manager 7/1/16
Manager
415 US Hwy377 S 200 Argyle, TX 76226
Transition Health Services-OK, LLC
100% Lessor (Real Estate) & Lessee (OP)
7/1/16
Stockholders/partners -- Not Officers
1633 N. Campbell Ave Chicago, IL 60647
OK4 SNF HoldCo, LLC
100% OK4 SNF HoldCo, LLC, 7/1/16
Stockholders/partners -- Not Officers
1633 N. Campbell Ave Chicago, IL 60647
OK4 HH/H Master HoldCo, LLC
75%-100% OK4 HH/H Master HoldCo,
LLC 7/1/16
Stockholders/partners -- Not Officers
1633 N. Campbell Ave Chicago, IL 60647
BHCP OK4 HH/H JV, LLC
5% BHCP OK4 HH/H JV, LLC 7/1/16
Stockholders/partners -- Not Officers
1633 N. Campbell Ave Chicago, IL 60647
BHCP OK4 HH/H Sponsor, LLC
95% BHCP OK4 HH/H JV, LLC,7/1/16
Stockholders/partners -- Not Officers
1633 N. Campbell Ave Chicago, IL 60647
BHCP OK4 HH/H Investors, LLC
Will own greater percent BHCP OK4
HH/H Sponsor,LLC 7/1/16
Stockholders/partners -- Not Officers
1633 N. Campbell Ave Chicago, IL 60647
BHCP GP JV 2015, LLC
Page 22 of 265
Owner NameFacilities Owned
Mgr-Applicant,Lessor, OK4 SNF
HoldCo,LLC,OK4HH/H Master 7/1/16
Manager
1633 N. Campbell Ave Chicago, IL 60647
OK4 Manager, LLC
0-25% OK4 HH/H Master HoldCo, LLC,
7/1/16
Stockholders/partners -- Not Officers
415 US Hwy 377 S 200 Argyle, TX 76226
SBS of OK, LLC
33.33% Member & Manager SBSof
OK,LLC&THS-OK,LLC,7/1/16
Stockholders/partners Who Are Officers
415 US Hwy 377 S 200 Argyle, TX 76226
Bates Josh
33.33% Member & Manager SBSof
OK,LLC&THS-OK,LLC,7/1/16
Stockholders/partners Who Are Officers
415 US Hwy 377 S 200 Argyle, TX 76226
Shelton Chana
33.33% Member & Manager SBSof
OK,LLC&THS-OK,LLC,7/1/16
Stockholders/partners Who Are Officers
415 US Hwy 377 S 200 Argyle, TX 76226
Sims Debra
Eff 1/7/16
Operating Entity
1633 N. Campbell Ave Chicago, IL 60647
OK4 Broadway OpCo, LLC
eff 7/1/16
Lessor Or Real Estate Owner
1633 N. Campbell Ave Chicago, IL 60647
OK4 Broadway RealCo, LLC
NH7205 918-251-5343424 North Date Broken Arrow, OK 74012
Broken Arrow Nursing Home, Inc
Operating Entity
424 N. Date Broken Arrow, OK 74012
Broken Arrow Nursing Home, Inc.
88% Pres eff.7-2-07
Stockholders/partners Who Are Officers
424 N. Date Broken Arrow, OK 74012
Cooper Joannna
6% Sec eff. 7-2-07
Stockholders/partners Who Are Officers
Rt. 3 Broken Arrow, OK 74014
Cooper-Woodard Debra
6% Tres eff. 7-2-07
Stockholders/partners Who Are Officers
3610 Orange Circle Broken Arrow, OK 74012
Cooper-Poormon Paulie
NH4501 580-584-6433700 West Jones Broken Bow, OK 74728
Broken Bow Nursing Home
50% OP eff 02/07/2011
Stockholders/partners -- Not Officers
P.O. Box 2230 Waldron, AR 72958
Watts Fred
50% treasury st
Lessor Or Real Estate Owner
700 West Jones Broken Bow, OK 74728
Indian Nations Nursing Home, Inc.
86.5% RE & President Eff 3-23-16
Stockholders/partners Who Are Officers
P.O. Box 39 Sallisaw, OK 74955
Farmer Don
Page 23 of 265
Owner NameFacilities Owned
50% OP, Eff 02/07/11
Stockholders/partners -- Not Officers
200 Home Street Pocola, OK 744902
Hensley Chris
Eff 02/07/11
Operating Entity
700 W. Jones Broken Bow, OK 74728
Broken Bow Health and Rehabilitation, LLC
13.5% RE & VP Eff 3-23-2016
Stockholders/partners Who Are Officers
3520 east 110th Place Tulsa, OK 74137
Farmer Frederick Sinclair
NH1405 405-292-22731050 Rambling Oaks Drive Norman, OK 73072
Brookhaven Extensive Care
Operating Entity
1126 Rambling Oaks Drive Norman, OK 73072
Brookhaven Gardens, L.L.C.
100% Oklahoma Senior Care, LLC
Stockholders/partners -- Not Officers
1126 Rambling Oaks Dr. Norman, OK 73072
OHara Dirk
President and 100% Senior Comfort
Corp. Eff. 12/31/2015
Stockholders/partners Who Are Officers
1825 E. 15th Tulsa, OK 74104
Jiles Jon P.
50% of Vision Health, LLC eff
08/01/2016
Stockholders/partners -- Not Officers
1825 East 15th Street Tulsa, OK 74104
Senior Comfort Corp.
30% of Vision Health, LLC eff
08/01/2016
Stockholders/partners -- Not Officers
2080 Verona Way Edmond, OK 73034
Kittco, LLC
20% of Vision Health, LLC eff
08/01/2016
Stockholders/partners -- Not Officers
1126 Rambling Oaks Drive Norman, OK 73072
Oklahoma Senior Care, L.L.C.
100% of Sabra Health Care Holdings, III
Stockholders/partners -- Not Officers
18831 Von Karman Ave 400 Irvine, CA 92612
Sabra Health Care Limited Partnership
1% of Sabra Health Care Limited
Parnership eff 10/29/2014
Stockholders/partners -- Not Officers
18831 Von Karman Ave 400 Irvine, CA 92612
Sabra Health Care, LLC
100% RE eff 10/29/2014
Lessor Or Real Estate Owner
18831 Von Karman Ave 400 Irvine, CA 92612
Sabra Health Care Holdings III, LLC
CFO Sabra Holdings III, Sabra Health
Care and REIT
Officers Who Do Not Hold Stock
18500 Von Karman Ave 550 Irvine, CA 92612
Andrews, Jr. Harold
Manager and 100% of Kittco, LLC Eff.
12/31/2016
Stockholders/partners Who Are Officers
2080 Verona Way Edmond, ok 73034
Wakeley Christopher
100% of Brookhaven Gardens, LLC eff
08/01/2016
Stockholders/partners -- Not Officers
922 NW 5th Street Oklahoma City, OK 73106
Vision Health, LLC
Page 24 of 265
Owner NameFacilities Owned
NH4801 580-795-2100310 Brookside Drive Madill, OK 73446
Brookside Nursing Center
Board Member of Senior Care Group,
Inc.
Officers Who Do Not Hold Stock
1240 Marbella Plaza Drive #12 Tampa, FL 33619
Vaughan David R.
su-lessee eff. 11-01-06
Operating Entity
1240 Marbella Drive Tampa, FL 33619
SCG Madill Brookside, LLC
eff. 11-01-06
Lessor Or Real Estate Owner
1115 Marbella Plaza Drive Tampa, FL 33619
Investors in Real and Personal Property, Tenants in Common
eff. 11-01-06
Contracted Management
1240 Marbella Plaza Drive Tampa, FL 33619
SCG Red River Management, LLC
1.71% RE
Stockholders/partners -- Not Officers
1240Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Christy, LLC
2.29% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Fridrich, LLC
2.86% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Drobeck, LLC
1.21% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Correia, LLC
4.11% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Klatt, LLC
1.37% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Mealer, LLC
2.86% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Fish, LLC
3.43% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Page, LLC
2.29% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Stalker, LLC
3.43% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Pendleton, LLC
2.51% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Brauburger, LLC
1.71% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Mathews-Bingham, LLC
1.14% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - DeMane, LLC
1.14% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Crowley, LLC
2.11% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - May, LLC
Page 25 of 265
Owner NameFacilities Owned
4.57% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Young, LLC
2.29% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Robert Yeh, LLC
2.29% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Albert Yeh, LLC
5.39% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Levenson, LLC
2.86% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Wallace, LLC
3.75% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Evelyn Wallace, LLC
5.91% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Stangl, LLC
6.72% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Shull, LLC
1.14% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Restivo, LLC
2.29% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - McIntosh, LLC
2.29% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Essayli, LLC
3.43% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Hall, LLC
11.43% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Alexander, LLC
2.29% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Hijazi, LLC
1.26% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Wang, LLC
0.29% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Howard, LLC
1.0% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Roberts, LLC
1.71% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Sandra Shaner, LLC
4.92% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Kelley, LLC
100% SCG Madill Brookside, LLC
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Senior Care Group, Inc.
Page 26 of 265
Owner NameFacilities Owned
manager for TIC owners(real estate) eff.
1-01-08
Officers Who Do Not Hold Stock
2547 Mason Oaks Drive Valrico, FL 33596
Morgan Consulting Group, LLC
sole managing memeber Moran
Consulting Group, LLC
Officers Who Do Not Hold Stock
2547 Mason Oaks Drive Valrico, FL 33596
Moran Francis D.
CFO/Sec. Senior Care Group, Inc.
eff.3-23-10
Officers Who Do Not Hold Stock
1240 Marbella Plaza Drive Tampa, FL 33619
Chudow Katherine (Kathy)
master lessee eff. 9-26-06
Lessor Or Real Estate Owner
1240 Marbella Plaza Drive Tampa, FL 33619
SCG Red River, LLC
President eff 6/2/2017
Officers Who Do Not Hold Stock
1240 Marbella Plaza Drive Tampa, FL 33619
Vaughan Michelle
NH5565 405-677-38642901 Southeast 22nd Street Oklahoma City, OK 73129
Bryant Place
Operating Entity
3317 S.E. 18th Street Del City, OK 73115
Reliant Living Centers of Oklahoma, Inc.
Treas. EFF 02/15/2013
Officers Who Do Not Hold Stock
821 SW 38th Oklahoma City, OK 73109
Black Art
President EFF 02/15/2013
Officers Who Do Not Hold Stock
4932 North Portland Avenue Oklahoma City, OK 73113
Love Willa
Vice President EFF 02/15/2013
Officers Who Do Not Hold Stock
9804 Casa Linda Oklahoma City, OK 73139
Moon Tim
Exec Director
Officers Who Do Not Hold Stock
2901 S.E. 22nd Oklahoma City, OK 73129
Jernigan Janelle F.
Secretary EFF 02/15/2013
Officers Who Do Not Hold Stock
325 W. Pinesway Mustang, OK 73064
Ellis Scott
NH5002 580-369-2653505 South 7th Street Davis, OK 73030
Burford Manor
100% Davis Health & Rehab - RE eff.
05-01-08 end 11/01/11
Stockholders/partners Who Are Officers
PO Box 1831 Ocean Springs, MS 39566
fax 601-510-9727 Daves, Jr. William E. (Billy)
eff. 05-01-08
Operating Entity
26 Riviera Drive Hattiesburg, MS 39402
Davis Health and Rehabilitation, LLC
Eff 11/01/11
Lessor Or Real Estate Owner
303 W Madison St 2400 Chicago, IL 60606
Murray County, LLC
100% RE
Stockholders/partners -- Not Officers
,
AVIV Financing I, LLC
Page 27 of 265
Owner NameFacilities Owned
100% AVIV Financing I, LLC eff
11/01/11
Stockholders/partners -- Not Officers
,
AVIV Healthcare Properties Operating partnership I, LLC
0.1% AVIV HPOP I Inc;52.41%.AHPLP
eff 11/01/11
Stockholders/partners -- Not Officers
,
AVIV Reit, Inc
99.9% AVIV HPOP I, LP eff 11/1/11
Stockholders/partners -- Not Officers
,
AVIV Healthcare Properties Limited Partnership
35.17% AVIV HPLP eff 11/01/11
Stockholders/partners -- Not Officers
,
A Units
5.68% AVIV HPLP eff 11/01/11
Stockholders/partners -- Not Officers
,
F Units
6.22% AVIV HPLP eff 11/01/11
Stockholders/partners -- Not Officers
,
C Units
5.11% A Unit eff 11/01/11
Stockholders/partners -- Not Officers
303 W Madison 2400 Chicago, IL 60604
Zev Karkomi Gift Trust fbo Susan Karkomi u/a/d 12/9/1991
5.68% F Unit eff 11/01/11
Stockholders/partners -- Not Officers
303 W Madison 2400 Chicago, IL 60606
Craig M. Bernfiedl Business ABF, LLC
PresAVIV Reit, Inc; 100% Craig Bernfiel
Business ABF eff 11/1/11
Stockholders/partners Who Are Officers
303 W Madison 2400 Chicago, IL 60606
Bernfield Craig
Vice Pres AVIV Reit, Inc eff 11/01/11
Officers Who Do Not Hold Stock
303 W Madison 2400 Chicago, IL 60606
Chavez Leticia
Sec AVIV Reit, Inc eff 11/01/11
Officers Who Do Not Hold Stock
303 W Madison 2400 Chicago, IL 60606
Kovitz Samuel H.
Treas AVIV Reit, Inc eff 11/01/11
Officers Who Do Not Hold Stock
303 W Madison 2400 Chicago, IL 60606
Insoft Steven J.
52.1% AVIV Reit Inc eff 11/01/11
Stockholders/partners -- Not Officers
303 W Madison 2400 Chicago, IL 60606
G Units
Dir AVIV Reit, Inc eff 11/01/11
Officers Who Do Not Hold Stock
630 5th Ave, 30th floor New York, NY 10111
Dees Michael W.
Dir AVIV Reit, Inc eff 11/01/11
Officers Who Do Not Hold Stock
630 5th Ave, 30th floor New York, NY 10111
Goldberg Alan E.
Dir AVIV Reit, Inc eff 11/01/11
Officers Who Do Not Hold Stock
630 5th Ave, 30th floor New York, NY 10111
Lindsay Robert D.
Dir AVIV Reit, Inc eff 11/01/11
Officers Who Do Not Hold Stock
630 5th Ave, 30th floor New York, NY 10111
Triedman James Rusell
Dir AVIV Reit, Inc eff 11/01/11
Officers Who Do Not Hold Stock
10127 Wilshire Blvd 2001 Los Angeles, CA 90024
Ryan Ari
6.1656% G Units eff 11/01/11
Stockholders/partners -- Not Officers
630 5th Ave, 30th floor New York, NY 10111
Bessemer LGB LLC
Page 28 of 265
Owner NameFacilities Owned
NH0703 580-434-57271061 North Access Road Calera, OK 74730
Calera Manor
UPL Manager Eff 6/30/2017
Contracted Management
P.O. Box 367 Calera, OK 74730
Calera Manor, LLC
16.665% OP
Stockholders/partners -- Not Officers
808 North 4140 Road Hugo, OK 74743
McEwing Chance Gwendolyn
16.665% OP
Stockholders/partners -- Not Officers
3005 Candlestick Enid, OK 73703
McEwing Patrick
25% BGM Estate eff 9-16-16
Stockholders/partners -- Not Officers
P.O. Box 330 Muldrow, OK 74948
Tabor Angela
25% BGM Estate, LLC Eff 9-16-16
Stockholders/partners -- Not Officers
111522 S. 4740 Rd. Muldrow, OK 74948
Mitchell Robert Michael
4.1675%OP End 7/2016 25% BGM
Estate, eff 9-16-16
Stockholders/partners -- Not Officers
412 S. Dogwood Sallisaw, OK 74955
Mitchell Marcinda
4.1675% OP, eff 04/22/13 End eff.
7/2016 25% BGM Estate
Stockholders/partners -- Not Officers
7240 Chase Oaks Blvd 121 Plano, TX 75025
Mitchell Kelly O.
Trustee of Delores O. Mitchell Revocable
Trust
Trustee
412 South Dogwood Sallisaw, OK 74955
Mitchell Delores O.
33.33% of OP
Stockholders/partners -- Not Officers
P.O. Box 1090 Sallisaw, OK 74955
Gilbert F. Green Trust
Manager Eff. 7/2016
Officers Who Do Not Hold Stock
,
Mitchell Heather
16.67% of Calera Manor, LLC (UPL
Manager) eff 06/30/2017
Stockholders/partners -- Not Officers
412 S. Dogwood Sallisaw, OK 74955
Delores O. Mitchell Revocable Trust
16.67% UPL Manager eff 06/30/2017
Stockholders/partners -- Not Officers
,
BGM Estate, LLC
UPL Owner eff. 6/30/2017
Operating Entity
201 S. 2nd Street Hugo, OK 74743
City of Hugo
NH5003 580-622-24161300 West Lindsay Sulphur, OK 73086
Callaway Nursing Home
100% Pres/OP
Stockholders/partners Who Are Officers
P.O. Box 582 Sulphur, OK 73086
Jewell Samuel
Operating Entity
1300 West Lindsay Murray, OK 73086
Sulphur Manor, Inc.
Page 29 of 265
Owner NameFacilities Owned
100% RE
Lessor Or Real Estate Owner
P.O. Box 519 Sulphur, OK 73086
Callaway Nursing Home, Inc.
100% of Callaway Nursing Home, Inc.
(RE)
Stockholders/partners -- Not Officers
Sulphur, OK 73086
Hughes Brenda
NH0801 580-654-1439225 North Broadway Carnegie, OK 73015
Carnegie Nursing Home, Inc.
51% OP/50% RE
Stockholders/partners Who Are Officers
P.O. Box 538 Carnegie, OK 73015
Hilburn Sherri G.
Operating Entity
225 Broadway Carnegie, OK 73015
Carnegie Nursing Home Inc.
49% OP/50% RE
Stockholders/partners Who Are Officers
P.O. Box 538 Carnegie, OK 73015
Hilburn Lloyd
Lessor Or Real Estate Owner
502 Scott Carnegie, OK 73015
225 Broadway, L.L.C.
NH1409 405-329-6771600 24th Avenue Southwest Norman, OK 73069
Cedar Creek Nursing Center
Lessor Or Real Estate Owner
10100 Santa Monica Blvd. Los Angeles, CA 90067
No-more Associates, L.P.
100% Gary Creek, LLC
Stockholders/partners Who Are Officers
4921 Haley Lane Stillwater, OK 74074
Smart Gary
100% of BK Strategies eff 01/11/2016
Stockholders/partners -- Not Officers
131 North Broadway Ada, OK 74820
Reed Bart
100% Norman Cedar Creek Real Estate,
LLC eff 01/11/2016
Stockholders/partners -- Not Officers
131 North Broadway Ada, OK 74820
BK Strategies Real Estate, LLC
99% & GP of Sabra Health Care Limited
Partnership eff 10/29/14
General Partner
18831 Von Karman Ave. 400 Irvine, CA 92612
Sabra Health Care REIT, Inc.
100% RE eff 01/11/2016
Lessor Or Real Estate Owner
131 North Broadway Ada, OK 74820
Norman Cedar Creek Real Estate, LLC
UPL Mgr. eff 6/30/2017
Contracted Management
4921 Haley Lane Stillwater, OK 74074
Gary Creek, LLC
UPL Owner eff. 6/30/2017
Operating Entity
100 W. Paul Avenue Pauls Valley, OK 73075
City of Pauls Valley
Page 30 of 265
Owner NameFacilities Owned
NH1602 580-355-16161700 Northwest Fort Sill Blvd Lawton, OK 73507
Cedar Crest Manor
10% OP eff 03/30/11. 8.39% RE eff
08/23/11
Stockholders/partners -- Not Officers
3938 Saint Marks Road Durham, NC 27707
Bynum Paige
OP & 16.1466% RE eff 08/23/2011
Operating Entity
1700 Ft. Sill Blvd Lawton, OK 73567
Cedar Crest Manor, Inc.
0.1395% OP and beneficary of Mary A.
Abshere Rev. Trust
Stockholders/partners Who Are Officers
1827 S. State Hwy 65 Lawton, OK 73501
Abshere Aldridge Tarri Lynn
8.38%RE eff 8/23/11,29.9998 OP eff
06/01/2016
Stockholders/partners -- Not Officers
801 Pershing Drive Lawton, OK 73507
Matthey, II William A.
0.0930% eff 03/30/11 VP eff 0601/2016
Stockholders/partners Who Are Officers
1827 S. State Hwy 65 Lawton, OK 73501
Aldridge Lyn W.
6.6201%OP eff 03/30/11 Pres. 5.59% RE
eff 08/23/11
Stockholders/partners Who Are Officers
9609 Monticello Drive Granbury, TX 76049
Dennis David H.
0.2326%OP Eff 03/30/11.16.54%RE eff
08/23/11
Stockholders/partners -- Not Officers
5402 SW Lee Blvd Lawton, OK 73505
Aycock Alan E.
6.6667%OP eff 03/30/11.5. 59%RE eff
08/23/11
Stockholders/partners -- Not Officers
1842 Wood Road McAlester, OK 74501
Whipps Diane E.
6.6667% OP eff 03/30/11. 5.6%RE Eff
08/23/11
Stockholders/partners -- Not Officers
80634 Camino Santa Elise Indio, CA 92203
Demas Larry
6.6667% eff 03/30/11. 5.59%RE eff
08/23/11
Stockholders/partners -- Not Officers
P.O. Box 2945 Rancho de Taos, NM 87557
Demas Michael R.
6.6667% OP eff 03/30/11. 5.59%RE eff
08/23/11
Stockholders/partners -- Not Officers
P.O. Box 841 Adkins, TX 78101
Hunt Demas Pamela A.
0.0465%OP eff 03/30/11 Treas.
Stockholders/partners Who Are Officers
1317 NW Maple Ave. Lawton, OK 73507
Statts Jennifer
19.3023%OP eff 03/30/11. 16.19%RE eff
08/23/11
Stockholders/partners -- Not Officers
1703 S. State Hwy 65 Lawton, OK 73501
Mary A. Abshere Revocable Trust, Mary Alberta Abshere Trustee
0.2326% eff 03/30/11. Beneficary of
Mary A. Abshere Rev. Trust
Stockholders/partners -- Not Officers
138 NW 36th Street Lawton, OK 73501
Abshere Bobby W.
0.2326% eff 03/30/11. Beneficary of
Mary A. Abshere Rev. Trust
Stockholders/partners -- Not Officers
9003 SE Willow Lane Lawton, OK 73501
Abshere Charles G.
19.7208% eff.03/30/11 June is a Member
Stockholders/partners Who Are Officers
2 NW Cypress Lane Lawton, OK 73505
Aycock, JTWROS Keith & June
0.0465% eff 06/01/2016 Sec.
Stockholders/partners Who Are Officers
9609 Monticello Granbury, TX 76049
Dennis Barbara
Page 31 of 265
Owner NameFacilities Owned
Authorized Signatory Officer for Lawton
OPCO, LLC
Officer
330 Wabash Ave 3700 Chicago, IL 60611
Coleman Matthew
NH7224 918-251-32001306 East College Broken Arrow, OK 74012
Cedarcrest Care Center
33.34% OP 33 1/3% RE
Stockholders/partners -- Not Officers
124 S. Elm Place Broken Arrow, OK 74012
Ross LaDonna
23.6% OP
Stockholders/partners -- Not Officers
4123 E. 45st Place Tulsa, OK 74101
Heidinger Patricia
6.8% OP
Stockholders/partners -- Not Officers
1955 E. 45th Place Tulsa, OK 74101
Laura Heidinger Quest Trust
3% OP
Stockholders/partners -- Not Officers
4123 E. 41st Place Tulsa, OK
Heidinger Nicholas
Operating Entity
1306 E. College Broken Arrow, OK 74012
Senior Citizens Nursing Center, Inc.
16.63% OP 16.665% RE
Stockholders/partners -- Not Officers
1700 Southwest Blvd Tulsa, OK 74107
Bagwell Shelly
16.63% OP 16.665% RE
Stockholders/partners -- Not Officers
1700 Southwest Blvd 100 Tulsa, OK 74107
Franks, Jr. (aka J.L.Franks) Jerry Lynn
Lessor Or Real Estate Owner
1306 East College Broken Arrow, OK 74012
Senior Citizen Nursing Center Building, a General Partnership
33 1/3% RE
Stockholders/partners -- Not Officers
1955 E. 45th Place Tulsa, OK 74101
Anchor Ltd. Family Partnership
NH0901 405-263-4658635 West Texas Okarche, OK 73762
Center of Family Love
Operating Entity
6th And Texas Okarche, OK 73762
Center Of Family Love
President, eff 06/01/12
Officers Who Do Not Hold Stock
11701 N. Hasting Ave Yukon, OK 73099
Allen Ed
Treasurer, eff 06/01/12
Officers Who Do Not Hold Stock
P.O. Box 21000 Oklahoma City, ok 73156
Krittenbrink Jerry
V P, eff 06/01/12
Officers Who Do Not Hold Stock
2516 Somerset PL Oklahoma City, OK 73116
Cooper Steve
Executive Director
Officers Who Do Not Hold Stock
6404 Commodore Ln Oklahoma City, OK 73162
Espinoza Debbie
Page 32 of 265
Owner NameFacilities Owned
NH4102 405-258-1131601 West 1st Street Chandler, OK 74834
Chandler Therapy & Living Center, LLC
EFF 8/01/2016
Lessor Or Real Estate Owner
1150 S. Waldron Rd. Fort Smith, AR 72903
601 CH, LLC
OP EFF 8/1/2016
Operating Entity
601 W 1st Chandler, OK 74834
Chandler Therapy & Living Center, LLC
100% Manager RE/51%OP
Stockholders/partners Who Are Officers
1150 S. Waldron Rd Fort Smith, AR 72903
Kilgore Joshua
Member 49% OP
Stockholders/partners -- Not Officers
809 Bayonne Bridge Ct. Edmond, OK 73034
Morgan M. Brandon
NH4602 918-473-2251321 Southeast 2nd Street Checotah, OK 74426
Checotah Nursing Center
99% COHEA LP, 100% & GP of CLP
Management eff 10/27/2016
Stockholders/partners Who Are Officers
750 S. Cherokee Catoosa, OK 74015
Risman Dandy
Manager OP & Trustee Abbott Family
Trust eff 10/27/2016
Stockholders/partners Who Are Officers
Rt. 3, Box 112 Hydro, OK 73048
Abbott Kent
50% KD Health Management, LLC eff
02/14/2016
Stockholders/partners -- Not Officers
PO Box 130 Hydro, OK 73048
Abbott Family, LLC
100% Abbout Family, LLC eff
10/27/2016
Stockholders/partners -- Not Officers
PO Box 130 Hydro, OK 73048
Abbott Family Trust
Co-Trustee and Beneficiary of Abbott
Family Trust eff 10/27/2016
Trustee
PO Box 130 Hydro, OK 73048
Abbott Jaylee
50% Checotah Nursing & Rehab &
ABBRIS Properties II eff 10/27/20
Stockholders/partners -- Not Officers
P.O. Box 210 Ketchum, OK 74349
COHEA Limited Partners, LP
1% GP of COHEA LP eff 10/27/2016
General Partner
,
CLP Management Group, Inc.
OP eff 11-01-2015
Operating Entity
321 SE 2nd Checotah, OK 74426
Checotah Nursing and Rehabilitation, LLC
100% Real Estate Company eff
11/01/2016
Lessor Or Real Estate Owner
P.O. Box 130 Hydro, OK 73048
Abbris Properties II, LLC
Page 33 of 265
Owner NameFacilities Owned
NH1104 918-456-34561504 North Cedar Avenue Tahlequah, OK 74464
Cherokee County Nursing Center
Lessor Or Real Estate Owner
1504 N. Cedar Tahlequah, OK 74464
Ward Manor Inc.
president 100% OP/RE
Stockholders/partners Who Are Officers
415 Rogers Avenue Ft. Smith, AK 72902
Morton Michael
Operating Entity
1504 N. Cedar Ave. Tahlequah, OK 74464
Cherokee County Nursing Center, Inc.
NH0201 580-596-21411100 Memorial Drive Cherokee, OK 73728
Cherokee Manor
Operating Entity
P.O. Box 468 Nowata, OK 74048
Lightning Creek Investment Group, Inc.
33.3% OP/RE
Stockholders/partners Who Are Officers
Rt. 1, Box 546 Nowata, OK 74048
Maddux Douglas G.
33.3% OP/RE
Stockholders/partners Who Are Officers
Rt. 1, Box 210 Nowata, OK 74048
Krouse Johnny W.
33.3% OP/RE
Stockholders/partners Who Are Officers
4600 Centre Court Rogers, AK 72756
Honea Sherman D.
NH2602 405-224-35932701 South 9th Street Chickasha, OK 73018
Chickasha Nursing Center, Inc
Operating Entity
2700 South Street Chickasha, OK 73018
Chickasha Nursing Center, Inc.
16.66% eff 2/28/13 to 33.33% eff
8/31/15, pres Chickaha NC,Inc.
Stockholders/partners Who Are Officers
2423 Blackoak Court Blanchard, OK 73505
Brunt Acie
11.11% Chickasha NC, Inc eff
09-16-2013
Stockholders/partners -- Not Officers
1311 SW 45th Street Lawton, OK 73505
Allen Gary
11.11% Chickasha NC, Inc & Secretary
eff 09-16-2013
Stockholders/partners Who Are Officers
1311 SW 45th Street Lawton, OK 73505
Dunderdale Jeannie
11.11% Chickasha NC, Inc. & Treasurer
eff. 09-16-2013
Stockholders/partners Who Are Officers
1311 SW 45th Street Lawton, OK 73505
Harris (Allen) Janet
16.66% Chickasha Nursing Center, Inc eff
11-2015
Stockholders/partners -- Not Officers
818 West Alabama Chickasha, OK 73018
Shropshire Pamela K
Page 34 of 265
Owner NameFacilities Owned
16.66% Chickasha Nursing Center, Inc eff
11-2015
Stockholders/partners -- Not Officers
2701 South 9th Street Chickasha, OK 73018
Stephens Johnna F.
NH6402 580-298-5528400 Southwest O Street Antlers, OK 74523
Choctaw Nation Nursing Home
Lessor Or Real Estate Owner
P.o.drawer 1210 Durant, OK 74502-1210
Choctaw Nation Of Oklahoma
Trustee & Benef Delores O Mitchell Trust
25%BGM Est eff 10/25/16
Stockholders/partners -- Not Officers
P.O. Box 330 Muldrow, OK 74948
Tabor Angela
Trustee & Benef Delores O Mitchell Trust
25%BGM Est eff 10/25/16
Stockholders/partners Who Are Officers
111522 S. 4740 Rd. Muldrow, OK 74948
Mitchell Robert Michael
Trustee & Benef Delores O Mitchell Trust
25%BGM Est eff 10/25/16
Stockholders/partners -- Not Officers
412 S. Dogwood Sallisaw, OK 74955
Mitchell Marcinda
Trustee & Benef Delores O Mitchell Trust
25%BGM Est eff 10/25/16
Stockholders/partners -- Not Officers
7240 Chase Oaks Blvd 121 Plano, TX 75025
Mitchell Kelly O.
Delores Mitchell Trust, eff 071713
Trustee
412 S. Dogwood Sallisaw, OK 74955
Mitchell Delores
UPL Mgr. eff 6/30/2017
Contracted Management
400 S.W. O Street Antlers, OK 74523
Choctaw Nation Care Center, LLC
Beneficiary of Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Green Reba
Beneficiary of Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Ellis, fka Seay Tiffany Renee
50% of OP
Stockholders/partners -- Not Officers
P.O. Box 1090 Sallisaw, OK 74955
Gilbert F. Green Trust
manager of OP
Managing Member
400 SW O Street Antlers, OK 74523
McClendon Jill
Beneficiary of Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Green Philip M.
Trustee of Gilbert F. Green Trust
Trustee
P.O. Box 1090 Sallisaw, OK 74955
Green Gilbert F.
25% OP eff 7-17-2013
Stockholders/partners -- Not Officers
412 S. Dogwood Sallisaw, OK 74955
Delores O. Mitchell Revocable Trust
Beneficiary of Gilbert F. Green Trust eff
7/15/16
Beneficiary
P.O. box 1090 Sallisaw, OK 74955
Stewart Lori Green
Beneficiary of Gilbert F. Green Trust eff
7/15/16
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Green Philip R.
Page 35 of 265
Owner NameFacilities Owned
Chief of the Choctaw Nation of Oklahoma
eff 8/25/16
Officers Who Do Not Hold Stock
P.O. Box 1210 Durant, OK 74701-1210
Batton Gary
25.00% OP Eff 10/25/16
Stockholders/partners -- Not Officers
,
BGM Estate, LLC
Assistant Chief of Choctaw Nation of
Oklahoma
Officers Who Do Not Hold Stock
P.O Box 1210 Durant, OK 74701-1210
Austin Jr. Jack
UPL Owner eff 6/30/2017
Operating Entity
201 S. 2nd Street Hugo, OK 74743
City of Hugo
NH3704 405-375-6857905 Beall Road Kingfisher, OK 73750
Cimarron Nursing Center
37.5% OP, effective 10/26/2012
Stockholders/partners -- Not Officers
PO Box 568 Sallisaw, OK 74955
Estate of Bob G Mitchell - deceased, Marcinda Mitchell, Personal
12.5% OP
Stockholders/partners -- Not Officers
7240 Chase Oaks Blvd 121 Plano, TX 75025
Mitchell Kelly O.
UPL Mgr. 6/30/2017
Contracted Management
905 Beall Road Kingfisher, OK 73750
Great Plains Care Center, Inc.
25% OP
Stockholders/partners -- Not Officers
P.O. Box 1454 Sallisaw, OK 74955
Philip M. Green Revocable Trust
25% OP
Stockholders/partners -- Not Officers
P.O. Box 1090 Sallisaw, OK 74955
Gilbert F. Green Trust
Trustee Philip M. Green Revocable Trust
Trustee
P.O. Box 1090 Sallisaw, OK 74955
Green Philip M.
Trustee Gilbert F. Green Trust
Trustee
P.O. Box 1090 Sallisaw, OK 74955
Green Gilbert F.
Beneficiary 50% of Philp M. Green
Revocable Trust
Trustee
P.O. box 1090 Sallisaw, OK 74955
Stewart Lori Green
ben Philip M. Green Revocable Tr &
Trustee Philip Riley Green Tr
Trustee
P.O. Box 1090 Sallisaw, OK 74955
Green Philip R.
Director and President
Officers Who Do Not Hold Stock
905 Beall Rd Kingfisher, OK 73750
Kopacka Brendan
UPL Owner eff. 6/30/2017
Operating Entity
100 W. Paul Avenue Pauls Valley, OK 73075
City of Pauls Valley
NH1907 918-865-7701404 East Cimarron Mannford, OK 74044
Cimarron Pointe Care Center
Page 36 of 265
Owner NameFacilities Owned
100% RE, OP, Mgr. ManMem. OP/REeff
12/10/2010
Stockholders/partners Who Are Officers
PO Box 768 Sallisaw, OK 74955
Sullivan, Jr. Frank
Eff. 12/10/2010
Contracted Management
PO BOX 768 Sallisaw, OK 74955
Comprehensive Management Services Inc.
eff 12/10/2010
Lessor Or Real Estate Owner
P.O. Box 768 Sallisaw, OK 74955
Requip of Mannford, LLC
eff 12/10/2010
Operating Entity
P.O. Box 768 Sallisaw, OK 74955
ConHold of Mannford, LLC
NH6601 918-341-4857920 East 16th Street Claremore, OK 74017
Claremore Nursing Home
50% RE and 51% OP eff 07-21-2003
Stockholders/partners -- Not Officers
P.O. Box 1023 Claremore, OK 74017
Ronald L. Lessley Revocable Trust
Mangaer of Amity Care, LLC &
ReGlenpool, LLC eff 9/16/2015
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Greiner Don
50% RE and 49% OP, eff 07-21-2003 end
9/16/2015
Stockholders/partners -- Not Officers
PO Box 1023 Claremore, OK 74017
Brett L. Lessley Revocable Trust
Mangers of Amity Care, LLC &
ReGlenpool, LLC eff. 9/16/2015
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Dimond Mike
management company eff 9/16/2015
Contracted Management
4350 Will Rogers Parkway 300 Okc, OK 73108
Amity Care, L.L.C.
99% OP & 78% Amity Care eff
9/16/2015
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Don Greiner Trustee Kenneth D.Greiner III Revocable Trust, Don Greiner
Benef/Trustee
22% Amity Care, LLC eff.9/16/2015
ben/trustee Don Greiner Tr
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Okc, OK 73108
Don Greiner Trust
58% ReClaremorel, LLC eff 9/16/2015
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Clarity Properties, LLC
52% of Renew - Mike Dimond,Trustee eff
9/16/2015
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Stalwort Trust
42% ReClaremore, LLC eff 9/16/2015
Stockholders/partners -- Not Officers
4530 Will Rogers Park Way 300 OKC, OK 73108
Renew Properties, LLC
100% Clarity Properties 48% Renew
Prop. eff 9/16/2015
Stockholders/partners -- Not Officers
4530 Will Rogers Parkway 300 OKC, OK 73108
Don Greiner Family Trust, Don Greiner Trustee
eff. 9/16/2015
Operating Entity
4530 Will Rogers Park Way 300 OKC, OK 73108
Claremore Operations, LLC
eff 9/16/2015
Lessor Or Real Estate Owner
4530 Will Rogers Parkway OKC, Ok 73108
ReClaremore, LLC
Page 37 of 265
Owner NameFacilities Owned
NH5901 918-358-3135900 North Division Cleveland, OK 74020
Cleveland Manor Nursing & Rehab
eff. 7-13-06
Operating Entity
PO Box 9 Sallisaw, OK 74955
Sweet Town LLC
66 2/3 % managing memeber eff.
02/01/2016
Stockholders/partners -- Not Officers
P.O. Box 9 Sallisaw, OK 74955
Martin Melinda
33 1/3 % member eff. 02/01/2016
Stockholders/partners -- Not Officers
404 Ridge Dr Sallisaw, OK 74955
Martin Drew
NH2902 580-688-9431120 West Versa Hollis, OK 73550
Colonial Manor II
Operating Entity
120 West Versa Hollis, OK 73550
Harmon County Healthcare Authority
Chairman
Officers Who Do Not Hold Stock
Rt 2 Box 372 Hollis, OK 73550
Horton Kelly
Secretary
Officers Who Do Not Hold Stock
Box 125 Gould, OK 73544
Gallagher Judy
Vice Chairman
Officers Who Do Not Hold Stock
703 West Vivian Hollis, OK 73550
Cummins David
OP/RE board member eff.07-28-09
Officers Who Do Not Hold Stock
17311 East 1650 Road Hollis, OK 73550
Boone Nicky
NH7208 918-743-78381815 East Skelly Drive Tulsa, OK 74105
Colonial Manor Nursing Home, Inc.
Lessor Or Real Estate Owner
1815 East Skelly Drive Tulsa, OK 74015
Colonial Manor Nursing Home, Inc.
14.50% each OP/RE
Stockholders/partners -- Not Officers
14 Woodward Blvd. Tulsa, OK 74114
Anderson Robert L.
9.38% each OP/RE
Stockholders/partners -- Not Officers
1300 Canterbury Court Arlington, TX 76013
Lord Nancy
Vice/pres 8.20% OP/ RE
Stockholders/partners Who Are Officers
1815 East Skelly Dr. Tulsa, OK 74105
Rucker Ed
Page 38 of 265
Owner NameFacilities Owned
2.06% OP/RE
Stockholders/partners -- Not Officers
2716 East 39th Place Tulsa, OK 74105
Perryman Robert G.
2.08% OP/RE
Stockholders/partners -- Not Officers
2840 South Columbia Place Tulsa, OK 74114
Dunitz Scott E.
2.08% OP/RE
Stockholders/partners -- Not Officers
6585 South Yale 500 Tulsa, OK 74136
Bischoff James
1.14% each OP/RE
Stockholders/partners -- Not Officers
6733 South Gary Tulsa, OK 74136
Alexander Marjorie
13.27 % each OP/RE
Stockholders/partners -- Not Officers
66 Cedar Ridge Rod. Broken Arrow, OK 74011
Jack E. Thomas Trust,
13.27% each OP/RE
Stockholders/partners -- Not Officers
P.O. Box 2300 Tulsa, OK 74192
Ceylon S. Lewis, Jr., Trust A,
Operating Entity
1815 E. Skelly Dr. Tulsa, Ok 74105
Colonial Manor Management Company, L.L.C.
beneficiary of Genevieve K. Gary
Revocable Trust
Beneficiary
11711 South Braden Tulsa, OK 74137
Gary Richard
beneficiary of Genevieve K. Gary
Revocable Trust
Beneficiary
11711 South Braden Tulsa, OK 74137
Miles Deanna
beneficary of Genevieve K. Gary
Revocable Trust
Beneficiary
11711 South Braden Tulsa, OK 74137
Hughes Jenny
beneficary of Genevieve K. Gary
Revocable Trust
Beneficiary
11711 South Braden Tulsa, OK 74137
Rucker Edward
beneficiary of Ceylon S. Lewis Jr. Trust A
Beneficiary
,
Lewis Corinne H.
beneficary of Ceylon S. Lewis Jr. Trust A
Beneficiary
,
Lorenz Sarah Lee
benefiary of Ceylon S. Lewis, Jr. Trust A
Beneficiary
,
Lewis, III C. S.
benefiary of Ceylon S. Lewis, Jr. Trust A
Beneficiary
,
Kast Carol D.
beneficary of Jack E. Thomas Trust
Beneficiary
66 Cedar Ridge Road Tulsa, OK 74012
Thomas Betty J.
benefiary of Jack E. Thomas Trust
Beneficiary
66 Cedar ridge Road Tulsa, OK 74012
Meek Mary Jean
beneficary of Jack E. Thomas Trust
Beneficiary
66 Cedar Ridge Road Tulsa, OK 74012
Thomas Randall E.
benefiary of Jack E. Thomas Trust
Beneficiary
66 Cedar Ridge Road Tulsa, OK 74012
Waggenblatt Deborah Lynn
Page 39 of 265
Owner NameFacilities Owned
NH5405 918-623-1936600 West Frontage Road Okemah, OK 74859
Colonial Park Manor
Trustee Gerrol Dean Adkins & Arbret
June Adkins Family Trust
Trustee
P.O. Box 488 Weleetka, OK 74880
Adkins Gerrol Dean
Trustee Gerrol Dean Adkins & Arbret
June Adkins Family Trust
Trustee
P.O. Box 488 Weleetka, OK 74880
Adkins Arbret June
33% Colonial Park Manor & True North
Healthcare Management
Stockholders/partners -- Not Officers
Rt. 1, Box 105C Weleetka, OK 74880
Cynthia Denise Majors Revocable Trust
33% Colonial Park Manor & True North
Healthcare Management
Stockholders/partners -- Not Officers
Rt. 1, Box 114 Weleetka, ok 74880
Donna Renee Simmons Revocable Trust
Beneficiary GDA&AJAF-Trust & Trustee
Cynthia D Majors RevTrust
Officers Who Do Not Hold Stock
319 West 9th St. Weleetka, OK 74880
Majors Cynthia
Beneficiary GDA&AJAF-Trust & Trustee
DRSimmons RevTrust
Officers Who Do Not Hold Stock
319 West 9th St Weleetka, OK 74880
Simmons Donna Renee
Beneficiary Gerrol D Adkins & Arbret
June Adkins Fam Trust
Beneficiary
Rt. 1, Box 121A Weleetka, OK 74880
Adkins, II Gerrol D.
100% GJA Leasing CO,
Stockholders/partners -- Not Officers
P.O. Box 488 Weleetka, OK 74880
Gerrol Dean Adkins & Arbret June Adkins Family Trust (GDA/AJA)
Suc-Trustee Gerrol D Adkins Arbret June
Adkins Fam Trust
Trustee
523 W. Main Henryetta, OK 74437
Palmer, C.P.A. Reginald
100% RE eff 2/1/2016
Lessor Or Real Estate Owner
319 W. 9th Street Weleetka, OK 74880
GAJ Leasing Company, LLC
OP eff. 2/1/2016
Operating Entity
319 W. 9th Street Weleetka, OK 74880
Colonial Park Manor, LLC
Contracted Management Company eff
2/1/2016
Contracted Management
319 West 9th Street Weleetka, OK 74880
True North Healthcare Managment, LLC
Manager of GAJ Leasing CO, LLC eff
02/01/2016
Officers Who Do Not Hold Stock
319 West 9th St Weleetka, OK 74880
Adkins June
33% Colonial Park Manor & True North
Healthcare Management
Stockholders/partners -- Not Officers
319 West 9th Street Weleetka, OK 74880
The Charles Edward Simmons Revocable trust dated April 1 2015
Trustee of Charles Simmons Revocable
Trust
Officers Who Do Not Hold Stock
319 West 9th St. Weleetka, OK 74880
Simmons Charles
Beneficiary:Donna Simmons Rev Trust &
Charles Simmons Rev-Trust
Beneficiary
319 West 9th Street Weleetka, OK 74880
Simmons Kyle
Beneficiary Simmons Lucas
Page 40 of 265
Owner NameFacilities Owned
Beneficiary:Donna Simmons Rev Trust &
Charles Simmons Rev-Trust319 West 9th Street Weleetka, OK 74880
Beneficiary:Donna Simmons Rev Trust &
Charles Simmons Rev-Trust
Beneficiary
319 West 9th Street Weleetka, OK 74880
Simmons Nicholas
Beneficiary:Cynthia Denise Majors
Revocable Trust Dated 12-17-12
Beneficiary
319 West 9th Street Weleetka, OK 74880
Hayes Amber
Beneficiary:Cynthia Denise Majors
Revocable Trust Dated 12-17-12
Beneficiary
319 west 9th Street Weleetka, OK 74880
Hayes Benjamin
NH4901 918-825-53111320 Northeast 1st Place Pryor, OK 74362
Colonial Terrace Care Center
25% BGM Estate, LLC eff 9-16-16
Stockholders/partners -- Not Officers
P.O. Box 330 Muldrow, OK 74948
Tabor Angela
25% BGM Estate, LLC Eff 9-16-16
Stockholders/partners -- Not Officers
111522 S. 4740 Rd. Muldrow, OK 74948
Mitchell Robert Michael
25% BGM Estate, LLC Eff 9-16-16
Stockholders/partners -- Not Officers
412 S. Dogwood Sallisaw, OK 74955
Mitchell Marcinda
Operating Entity
PO Box 1107 Pryor, OK 74362
Colonial Terrace Care Center, L.L.C
12.5% OP, eff 04/22/13 25%BGM Estate,
LLC Eff 9-16-16
Stockholders/partners -- Not Officers
7240 Chase Oaks Blvd 121 Plano, TX 75025
Mitchell Kelly O.
25% member, effective 7/26/2013
Stockholders/partners -- Not Officers
P.O. Box 1454 Sallisaw, OK 74955
Philip M. Green Revocable Trust
25% member, eff. 10-26-12
Stockholders/partners -- Not Officers
P.O. Box 1090 Sallisaw, OK 74955
Gilbert F. Green Trust
Philip M. Green Revocable Trust eff.
7-26-13
Trustee
P.O. Box 1090 Sallisaw, OK 74955
Green Philip M.
Gilbert F. Green Trust eff. 7-26-13
Trustee
P.O. Box 1090 Sallisaw, OK 74955
Green Gilbert F.
37.50% OP eff 9-16-16
Stockholders/partners -- Not Officers
,
BGM Estate, LLC
Manager of OP Eff 10/26/2016
Officers Who Do Not Hold Stock
1320 NE. 1st Place Pryor, OK 74362
Cree Robert
NH0911 405-263-4658643 West Texas Okarche, OK 73762
Columbian Hall
Page 41 of 265
Owner NameFacilities Owned
100% Eff 10/31/11
Operating Entity
6th And Texas Okarche, OK 73762
Center Of Family Love
President eff 06/01/12
Officers Who Do Not Hold Stock
11701 N. Hasting Ave Yukon, OK 73099
Allen Ed
Treasurer, eff 06/01/12
Officers Who Do Not Hold Stock
P.O. Box 21000 Oklahoma City, ok 73156
Krittenbrink Jerry
Vice President, eff 06/01/12
Officers Who Do Not Hold Stock
2516 Somerset PL Oklahoma City, OK 73116
Cooper Steve
Executive Director
Officers Who Do Not Hold Stock
6404 Commodore Ln Oklahoma City, OK 73162
Espinoza Debbie
NH6805 918-489-2299503 South Main Street Gore, OK 74435
Community Health Care Of Gore
Lessor Or Real Estate Owner
Highway 100 Gore, OK 74435
Community Health Care Of Gore, Inc.
100% RE/OP eff.06-30-08
Stockholders/partners Who Are Officers
P.O. Box 638 Gore, OK 74435
Montgomery Schuyler
Operating Entity
P.O. Box 638 Gore, OK 74435
Gore Health Services, L.L.C.
NH2701 580-594-22921153 Cherokee Street Wakita, OK 73771
Community Health Center
Operating Entity
500 Cherokee Street Wakita, OK 73771
James Dennis Medical Foundation
Chairman of the Board
Officers Who Do Not Hold Stock
3007Barn Swallow Enid, OK 73703
Rapp L.D.
Vice Chairman
Officers Who Do Not Hold Stock
PO Box 395 Wakita, OK 73771
Green Feller
Board member eff 07/29/11
Officers Who Do Not Hold Stock
PO Box 114 Medford, OK
Smith Rev. Bob
Board member eff 07/29/11
Officers Who Do Not Hold Stock
30149 County Rd 830 Wakita, OK 73771
Jones Alvin
Board Member eff.07/24/2012
Officers Who Do Not Hold Stock
78701 Kiowa Rd Manchester, OK 73758
Feist Peggy
Board Member eff. 10/15/13
Officers Who Do Not Hold Stock
1254 Caddo St Wakita, OK 73771
Burgess Kirk
Page 42 of 265
Owner NameFacilities Owned
Board Member eff. 10/03/16
Officers Who Do Not Hold Stock
80574 MC Clain Rd Manchester, Ok 73758
Lanie Randy
NH7501 580-832-33711400 North College Cordell, OK 73632
Cordell Christian Home
Operating Entity
1400 N. College Cordell, OK 73632
Cordell Christian Home, Cordell, Oklahoma
Director
Officers Who Do Not Hold Stock
P.O. Box 670 Sentinel, OK 73664
Mayfield Bruce
President eff 07/18/2012
Officers Who Do Not Hold Stock
RR 1, Box 124-1 Dill City, OK 73641
Piercey Jimmy
Vice Pres eff 5/2/11
Officers Who Do Not Hold Stock
706 N. Lee St. Cordell, OK 73632
Corbett Jack
Sec/Treas eff 4/5/11
Officers Who Do Not Hold Stock
521 Frisco Clinton, OK 73601
Carpenter Penny
Director
Officers Who Do Not Hold Stock
112 E. 3rd St. Cordell, OK 73632
Doran Patty
Director
Officers Who Do Not Hold Stock
22455 E 1080 Rd Clinton, OK 73601
Martin Phyllis
Director eff 04/01/2014
Officers Who Do Not Hold Stock
1412 Park Ave Clinton, OK 73601
Moore Anthony
NH7502 580-343-2295106 West Adams Corn, OK 73024
Corn Heritage Village and Rehab
Lessor Or Real Estate Owner
106 W. Adams Corn, OK 73024
Corn ** The Mennonite Brethren Church of Corn, Oklahoma
Member eff 10-23-13
Officers Who Do Not Hold Stock
308 W. Main Corn, OK 73024
Loewen Neal
Chairman
Officers Who Do Not Hold Stock
Rt. 1, Box 76A Corn, OK 73024
Bartel Darrel
member
Officers Who Do Not Hold Stock
Rt 1 Box 31 Corn, OK 73024
Flaming Steve
eff. 07-01-09
Operating Entity
106 West Adams Corn, OK 73024
Corn Heritage Village of Corn Incorporated
Secretary eff. Oct 23-2013
Officers Who Do Not Hold Stock
Rt. 4 Box 54 Weatherford, OK 73096
Bartel Howard
Page 43 of 265
Owner NameFacilities Owned
Vice Chair eff 10-13-2016
Officers Who Do Not Hold Stock
510 N Oklahoma Corn, OK 73024
Wichert Jerome
NH2002 580-772-3993801 North Washington Weatherford, OK 73096
Corn Heritage Village and Rehab of Weatherford
Lessor Or Real Estate Owner
106 W. Adams Corn, OK 73024
Corn ** The Mennonite Brethren Church of Corn, Oklahoma
Chairman thru 07/1/11-member
Officers Who Do Not Hold Stock
308 W. Main Corn, OK 73024
Loewen Neal
Member
Officers Who Do Not Hold Stock
Rt. 1, Box 76A Corn, OK 73024
Bartel Darrel
member
Officers Who Do Not Hold Stock
Rt 1 Box 31 Corn, OK 73024
Flaming Steve
eff. 07-01-09
Operating Entity
801 North Washington Weatherford, OK 73096
Corn Heritage Village of Weatherford Incorporated
Board Mem eff 07/1/11
Officers Who Do Not Hold Stock
,
Gossen Bryan
Secretary eff-10-23-2013
Officers Who Do Not Hold Stock
Rt. 4 Box 54 Weatherford, OK 73096
Bartel Howard
NH6904 580-255-46001904 North Highway 81 Duncan, OK 73533
Country Club Care
Sec./Treas. RE/OP
Officers Who Do Not Hold Stock
7520 Hidden Creek Drive Duncan, OK 73533
Gregston Jack L.
25% RE
Stockholders/partners -- Not Officers
904 Whisenant Duncan, OK 73533
Akers Carla
25% VP RE
Stockholders/partners Who Are Officers
1603 Timbercreek Dr. Duncan, OK 73533
Gregston Jeff L.
Operating Entity
1904 North 81 Highway Duncan, OK 73533
Kanakuk, Inc.
25% RE
Stockholders/partners -- Not Officers
2414 Mallard Duncan, OK 73533
Gregston Jerry L.
25%RE 100%/OP President
Stockholders/partners Who Are Officers
1209 N. 13 Duncan, OK 73533
Gregston J. Lynn
Lessor Or Real Estate Owner
1904 North 81 Highway Duncan, OK 73533
Gregstons Inc.
Page 44 of 265
Owner NameFacilities Owned
NH5601 918-267-3362306 East 7th Street Beggs, OK 74421
Country Lane
100% OP/RE
Stockholders/partners -- Not Officers
PO Box 990 Edmond, OK 73013
Diakonos Group, LLC
100% of Diakonos Group, LLC
Stockholders/partners -- Not Officers
PO Box 990 Edmond, OK 73013
Pilgrim Scott
eff 9-1-04
Operating Entity
306 East 7th Beggs, OK 74421
Servant Living Center Holding Co. Servant Living Center - Beggs, LLC
Lessor Or Real Estate Owner
129 West 1st B Edmond, OK 73003
Servant Living Center Holding Company-Beggs, LLC
NH5615 918/267-3362303 East 7th Street Beggs, OK 74421
Country Lane Cottage #1
100% OP/RE
Stockholders/partners -- Not Officers
PO Box 990 Edmond, OK 73013
Diakonos Group, LLC
99% MagMemt Diakonos
Stockholders/partners -- Not Officers
PO Box 990 Edmond, OK 73013
Pilgrim Scott
Operating Entity
306 East 7th Beggs, OK 74421
Servant Living Center Holding Co. Servant Living Center - Beggs, LLC
Lessor Or Real Estate Owner
129 West 1st B Edmond, OK 73003
Servant Living Center Holding Company-Beggs, LLC
NH5616 918/267-3362301 East 7th Street Beggs, OK 74421
Country Lane Cottage #2
100% OP/RE
Stockholders/partners -- Not Officers
PO Box 990 Edmond, OK 73013
Diakonos Group, LLC
99% ManagMemt Diakonos
Stockholders/partners -- Not Officers
PO Box 990 Edmond, OK 73013
Pilgrim Scott
Operating Entity
306 East 7th Beggs, OK 74421
Servant Living Center Holding Co. Servant Living Center - Beggs, LLC
Lessor Or Real Estate Owner
129 West 1st B Edmond, OK 73003
Servant Living Center Holding Company-Beggs, LLC
Page 45 of 265
Owner NameFacilities Owned
NH5617 918/267-3362302 East 7th Street Beggs, OK 74421
Country Lane Cottage #3
100% OP/RE
Stockholders/partners -- Not Officers
PO Box 990 Edmond, OK 73013
Diakonos Group, LLC
99% ManagMemt Diakonos
Stockholders/partners -- Not Officers
PO Box 990 Edmond, OK 73013
Pilgrim Scott
Operating Entity
306 East 7th Beggs, OK 74421
Servant Living Center Holding Co. Servant Living Center - Beggs, LLC
Lessor Or Real Estate Owner
129 West 1st B Edmond, OK 73003
Servant Living Center Holding Company-Beggs, LLC
NH5618 918/267-3362304 East 7th Street Beggs, OK 74421
Country Lane Cottage #4
100% OP/RE
Stockholders/partners -- Not Officers
PO Box 990 Edmond, OK 73013
Diakonos Group, LLC
99% ManagMent Diakonos
Stockholders/partners -- Not Officers
PO Box 990 Edmond, OK 73013
Pilgrim Scott
Operating Entity
306 East 7th Beggs, OK 74421
Servant Living Center Holding Co. Servant Living Center - Beggs, LLC
Lessor Or Real Estate Owner
129 West 1st B Edmond, OK 73003
Servant Living Center Holding Company-Beggs, LLC
NH5619 918-267-3362511 N. Chippewa Beggs, OK 74421
Country Lane Cottage #5
100% OP/RE eff 1/10/17
Stockholders/partners -- Not Officers
PO Box 990 Edmond, OK 73013
Diakonos Group, LLC
99% Diakonos Group LLC eff 1/10/17
Stockholders/partners Who Are Officers
PO Box 990 Edmond, OK 73013
Pilgrim Scott
eff. 1/10/17
Operating Entity
306 East 7th Beggs, OK 74421
Servant Living Center Holding Co. Servant Living Center - Beggs, LLC
eff. 1/10/17
Lessor Or Real Estate Owner
129 West 1st B Edmond, OK 73003
Servant Living Center Holding Company-Beggs, LLC
1% Diakonos eff 1/10/17
Stockholders/partners -- Not Officers
P.O. Box 990 Edmond, OK 73083
Servant Holding Corporation
Page 46 of 265
Owner NameFacilities Owned
NH5409 918-650-9393Route 1, Box 2 (Highway 75) Weleetka, OK 74880
Country Place
amended corp. name (fkaProdetik, Inc.)
eff 02-05-08
Operating Entity
P.O. Box 217 Weleetka, OK 74880
The Reach Corporation
Non-Profit Board President of The Reach
Corproation 1-8-08
Officers Who Do Not Hold Stock
P.O. Box 790 Uniontown, KY 42461
Welsh Richard
Non-Profit Board VP of The Reach
Corporation 1-8-08
Officers Who Do Not Hold Stock
PO Box 790 UnionTown, KY 42461
Bailey M. Geoffry
Non-Profit Board Sec/Treas of The Reach
Corporation
Officers Who Do Not Hold Stock
PO Box 790 Uniontown, KY 42461
Pyle William "Bill"
authorized agent for The Reach
Corporation
Officers Who Do Not Hold Stock
1201 West Trudgeon Place Henryetta, OK 74437
Bentley Roy
eff. 8-15-07
Lessor Or Real Estate Owner
P.O. Box 409 Sturgis, KY 42459
Maricopa Properties, LLC
100% of RE
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Maricopa Partners, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Rock River, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
MMB, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Lovenest, LLC
30.959% of Rock River, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gary
16.025% of Rock River, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Lisa
32.88% of MMB, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Tim
17.455% of MMB, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Vicki
29.421% of Lovenest, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Robert
13.957% of Lovenest, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Laura
53.016% of Rock River, LLC - 4
children w/13.254% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
4 Irrevocable Trusts
Page 47 of 265
Owner NameFacilities Owned
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O.Box 409 Sturgis, KY 42459
Ervin Mallory
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Jade
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Luke
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gabe
49.665% of MMB, LLC- 5 children
w/9.933% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
3 Irrevocable Trusts
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Max
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box Sturgis, KY 42459
Linenger Jessica
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mitch
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Linenger Jennifer
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Brock
56.623% of Lovenest, LLC - 7 children
w/8.089% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
7 Irrevocable Trusts
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Thea
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugris, KY 42459
Ervin Issac
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugis, KY 42459
Ervin Samuel
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Elijah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Saul
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Micah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mathias
Page 48 of 265
Owner NameFacilities Owned
NH5102 918-463-5143Highway 64 East Warner, OK 74469
Countryside Estates
50% of the Inc.
Stockholders/partners Who Are Officers
P.O. Box 1083 Warner, OK 74469
Rogers Scott
100% RE/OP
Stockholders/partners -- Not Officers
Hwy 64 East Warner, OK 74469
Countryside Estates Inc.
25% of the Inc.
Stockholders/partners -- Not Officers
P.O. Box 749 Warner, OK 74469
Rogers Justin Todd
Lessor Or Real Estate Owner
Highway 64 East Warner, OK 74489
SDE Holdings, LLC
Operating Entity
Highway 64 East Warner, OK 74489
Countryside Health Services, LLC
25 % of Inc
Stockholders/partners -- Not Officers
P.O. Box 749 Warner, OK 74469
Three Oaks Rogers John Eric
NH7301 918-486-216630049 East 151st Street South Coweta, OK 74429
Coweta Manor Nursing Home
eff. 03-17-06
Lessor Or Real Estate Owner
30049 E 151 St South Coweta, OK 74429
Hilldale Nursing Facility, Inc.
100% OP/RE eff 05/23/11
Stockholders/partners -- Not Officers
PO Box 9 Sallisaw, OK 74955
Martin Eddie
20% treasury stock in OP/RE thru
05/23/11
Court Appointed Receiver
703 E. South Street Coweta, OK 74429
FNII, L.L.C.
FNII, LLC
Managing Member
,
Shankle Stacey
Eff 05/23/11
Operating Entity
30049 E 151 St South Coweta, OK 74429
CHRE, LLC
NH5407 918-650-9393104 East 6th Street Weleetka, OK 74880
Creek Place
amended corp. name (fkaProdetik, Inc.)
eff 02-05-08
Operating Entity
P.O. Box 217 Weleetka, OK 74880
The Reach Corporation
Non-Profit Board President of The Reach
Corporation 1-8-08
Officers Who Do Not Hold Stock
P.O. Box 790 Uniontown, KY 42461
Welsh Richard
Page 49 of 265
Owner NameFacilities Owned
Non-Profit Board VP of The Reach
Corporation 1-8-08
Officers Who Do Not Hold Stock
PO Box 790 UnionTown, KY 42461
Bailey M. Geoffry
Non-Profit Board Sec/Treas of The Reach
Corporation
Officers Who Do Not Hold Stock
PO Box 790 Uniontown, KY 42461
Pyle William "Bill"
authorized agent for The Reach
Corporation
Officers Who Do Not Hold Stock
1201 West Trudgeon Place Henryetta, OK 74437
Bentley Roy
eff. 8-15-07
Lessor Or Real Estate Owner
P.O. Box 409 Sturgis, KY 42459
Maricopa Properties, LLC
100% of RE
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Maricopa Partners, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Rock River, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
MMB, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Lovenest, LLC
30.959% of Rock River, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gary
16.025% of Rock River, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Lisa
32.88% of MMB, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Tim
17.455% of MMB, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Vicki
29.421% of Lovenest, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Robert
13.957% of Lovenest, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Laura
53.016% of Rock River, LLC - 4 children
w/13.254% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
4 Irrevocable Trusts
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O.Box 409 Sturgis, KY 42459
Ervin Mallory
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Jade
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Luke
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gabe
Stockholders/partners -- Not Officers 3 Irrevocable Trusts
Page 50 of 265
Owner NameFacilities Owned
49.665% of MMB, LLC - 5 children
w/9.933% eachP.O. Box 409 Sturgis, KY 42459
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Max
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box Sturgis, KY 42459
Linenger Jessica
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mitch
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Linenger Jennifer
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Brock
56.623% of Lovenest, LLC - 7 children
w/8.089% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
7 Irrevocable Trusts
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Thea
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugris, KY 42459
Ervin Issac
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugis, KY 42459
Ervin Samuel
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Elijah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Saul
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Micah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mathias
NH4202 405-969-2698208 East Sanderson Street Crescent, OK 73028
Crescent Care Center
Operating Entity
110 W. Muskogee Sulphur, OK 73086
Crescent Manor, Inc.
100% & Managing Member of
Interhealth, LLC eff 02/17/2017
Stockholders/partners -- Not Officers
9 Professional Drive Bella Vista, AR 72715
Montgomery Bradford
95% Trinkik Holdings, LLC eff 7/1/2016
Stockholders/partners -- Not Officers
P.O. Box 130 Newport, AR 72112
Niksefat Saeed Sy
5% Trinkik Holdings, LLC eff 7/1/2016
Stockholders/partners -- Not Officers
P.O. Box 130 Newport, AR 72112
Niksefat Sharona
Page 51 of 265
Owner NameFacilities Owned
100% Real Estate eff 07/01/2016
Lessor Or Real Estate Owner
P.O. Box 130 Newport, AR 72112
Trinik Holdings, LLC
Receiver CJ-2016-3346 Crescent Manor,
Inc eff 1/25/17
Court Appointed Receiver
419886 East 1080 Road Checotah, OK 74426
Cockrell Travis
Contracted Management Co. Eff
02-17-2017
Contracted Management
9 Professional Drive Bella Vista, AR 72715
Interhealth, LLC
NH5614 918-650-9393405 West 17th Street Okmulgee, OK 74447
Cross Place
amended corp. name (fkaProdetik, Inc.)
eff 02-05-08
Operating Entity
P.O. Box 217 Weleetka, OK 74880
The Reach Corporation
Non-Profit Board President of The Reach
Corproation 1-8-08
Officers Who Do Not Hold Stock
P.O. Box 790 Uniontown, KY 42461
Welsh Richard
Non-Profit Board VP of The Reach
Corporation 1-8-08
Officers Who Do Not Hold Stock
PO Box 790 UnionTown, KY 42461
Bailey M. Geoffry
Non-Profit Board Sec/Treas of The Reach
Corporation
Stockholders/partners -- Not Officers
PO Box 790 Uniontown, KY 42461
Pyle William "Bill"
authorized agent for The Reach
Corporation
Officers Who Do Not Hold Stock
1201 West Trudgeon Place Henryetta, OK 74437
Bentley Roy
eff. 8-15-07
Lessor Or Real Estate Owner
P.O. Box 409 Sturgis, KY 42459
Maricopa Properties, LLC
100% of RE
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Maricopa Partners, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Rock River, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
MMB, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Lovenest, LLC
30.959% of Rock River, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gary
16.025% of Rock River, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Lisa
32.88% of MMB, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Tim
17.455% of MMB, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Vicki
Page 52 of 265
Owner NameFacilities Owned
29.421% of Lovenest, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Robert
13.957% of Lovenest, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Laura
53.016% of Rock River, LLC - 4 children
w/13.254% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
4 Irrevocable Trusts
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O.Box 409 Sturgis, KY 42459
Ervin Mallory
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Jade
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Luke
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gabe
49.665% of MMB, LLC - 5 children
w/9.933% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
3 Irrevocable Trusts
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Max
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box Sturgis, KY 42459
Linenger Jessica
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mitch
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Linenger Jennifer
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Brock
56.623% of Lovenest, LLC - 7 children
w/8.089% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
7 Irrevocable Trusts
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Thea
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugris, KY 42459
Ervin Issac
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugis, KY 42459
Ervin Samuel
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Elijah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Saul
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Micah
Page 53 of 265
Owner NameFacilities Owned
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mathias
NH3212 405-452-3271204 East 1st Street Wetumka, OK 74883
Cypress Place Living Center, LLC
Trustee Family Trust & Pres. Pioneer
NHHC Inc. eff12/31/12
Stockholders/partners Who Are Officers
P.O. Box 488 Weleetka, OK 74880
Adkins Gerrol Dean
Trustee Family Trust & Sec. Pioneer
NHHC, Inc. eff 12/31/12
Stockholders/partners Who Are Officers
P.O. Box 488 Weleetka, OK 74880
Adkins Arbret June
Lessor Or Real Estate Owner
P.O. Box 488 Wetumka, OK 74880
Pioneer Nursing Home Of Hughes County, Inc.
Beneficiary eff.12/31/12319 West 9th St. Weleetka, OK 74880
Majors Cynthia
Beneficiary eff.12/31/12319 West 9th St Weleetka, OK 74880
Simmons Donna Renee
Beneficiary eff.12/31/12Rt. 1, Box 121A Weleetka, OK 74880
Adkins, II Gerrol D.
52% RE eff 12/31/12
Stockholders/partners -- Not Officers
P.O. Box 488 Weleetka, OK 74880
Gerrol Dean Adkins & Arbret June Adkins Family Trust (GDA/AJA)
eff. 1-1-07
Operating Entity
204 East First Street Wetumka, OK 74883
Cypress Place Living Center, LLC
100% manag.member of OP
Stockholders/partners -- Not Officers
204 East First Street Wetumka, OK 74883
Cypress Place Revocable Business Trust
16% RE eff 12/31/12
Stockholders/partners -- Not Officers
Rt 1 Box 121A Weleetka, OK 74880
Gerrol Dean Adkins II Irrevocable Trust dated 12/28/12
16% RE eff 12/31/12
Stockholders/partners -- Not Officers
Rt 1 Box 121A Weleekta, OK 74880
Cynthia Denise Majors Irrevocable Trust dated 12/28/12
16% RE eff 12/31/12
Stockholders/partners -- Not Officers
Rt 1 Box 121A Weleetka, OK 74880
Donna Renee Simmons Irrevocable Trust dated 12/28/12
Trustee eff 12/31/12
Trustee
523 W. Main Henryetta, OK 74437
Palmer, C.P.A. Reginald
NH7001 580-338-31861401 North Lelia Guymon, OK 73942
Dr. W F & Mada Dunaway Manor
Operating Entity
1401 N. Lelia Guymon, Ok 73942
The Dr. W.F. and Mada Dunaway Manor Nursing Home Of Guymon, Inc.
Page 54 of 265
Owner NameFacilities Owned
President, eff 09/22/15
Officers Who Do Not Hold Stock
219 NW 4th Street Guymon, OK 73942
Brown Phillip
Member, eff 09/22/15
Officers Who Do Not Hold Stock
PO Box 772 Hooker, OK 73945
Hofferber Kevin
Member, eff 09/22/15
Officers Who Do Not Hold Stock
6068 Sunset Drive Guymon, OK 73942
Parkhurst Mike
Member, eff 09/22/15
Officers Who Do Not Hold Stock
108 NE 22nd Guymon, OK 73942
Peterson Donna
Member, eff 09/22/15
Officers Who Do Not Hold Stock
124 N Academy Guymon, OK 73942
Urias Carlos
Member, eff 09/22/15
Officers Who Do Not Hold Stock
Rt 1 Box 25A Texhoma, OK 73949
Skelton Jane
Member, eff 09/22/15
Officers Who Do Not Hold Stock
RR! Box 6 Hardesty, OK 73944
Stump Kathy
NH1901 918-352-3249Pine & Bristow Drumright, OK 74030
Drumright Nursing Home
Successor Trustee & Beneficiary -WBT
eff 5/24/12
Trustee
P.O. Box 2230 Waldron, AR 72958
Watts Fred
9.61494% ONH, LTd
Contracted Management
210 E. Choctaw, P.O. Box 429 Sallisaw, OK 74955-0429
Oklahoma Nursing Homes, Ltd. (ONH,Ltd.)
8.314% OP & ONH,Ltd/ 8.4112% RE/
9.401287% ONH, Inc eff 5/24/12
Stockholders/partners -- Not Officers
P.O. Box 40 Sallisaw, OK 74955
Cheek Barnie J.
8.314% OP & ONH,Ltd./8.4112% RE eff
5/24/12
Stockholders/partners -- Not Officers
3520 East 110th Place Tulsa, OK 74137
Sandra Cheek Farmer Trust (SCFT)
5.834% OP&ONH,Ltd/5.9190% mgr
RE/6.597394% & Sec ONH,Inc.
Stockholders/partners Who Are Officers
4814 S. 164th East Ave. Tulsa, OK 74134
Haskins Lloyd
5.192%OP&ONH,Ltd/5.2626%RE/12.53
5047%ONH,Inc/TrusteeWBTeff 52412
Stockholders/partners -- Not Officers
51 green acre village #51 Sallisaw, OK 74955
Watts Cleo
Trustee for JKBRT
Trustee
Rt. 2 Box 339 Idabel, OK 74745
Bivin Steve
5.893% OP & ONH,Ltd / 5.9746% RE eff
5/24/12
Stockholders/partners -- Not Officers
51 Green Acre Village Sallisaw, OK 74955
Watts Beneficiaries Trust (WBT)
14.022%OP&ONH,Ltd/14.2078%RE/21.
936335% & VP ONH,Inc Eff 5/24/12
Stockholders/partners Who Are Officers
Box 856 Miami, OK 74355
Tubbs Steven
5.376% OP & ONH,Ltd / 5.4406% RE eff
5/24/12
Stockholders/partners -- Not Officers
3910 Cherry Forest Drive Houston, TX 77088
Tubbs, Jr. Stanley I.
Page 55 of 265
Owner NameFacilities Owned
5.542% OP&ONH,Ltd/ 5.6186% RE/
6.267525% ONH,Inc eff 5/24/12
Stockholders/partners -- Not Officers
416 Fairway Dr. Athens, TX 75751
Estep Pat
2.771% OP & ONH,Ltd / 2.8037% RE eff
5/24/12 Trustee (JKBRT)
Stockholders/partners -- Not Officers
1500 West Elm Stroud, OK 74079
Julie Kay Bivin Revocable Trust (JKBRT)
5.135% OP & ONH,Ltd/ RE 5.2207% eff
5/24/12
Stockholders/partners -- Not Officers
6708 South 256th East Avenue Broken Arrow, OK 74014
Caroyln D. Leaverton Revocable Trust
2.771% OP & ONH,Ltd/ 2.8037% RE eff
5/24/12
Stockholders/partners -- Not Officers
PO Box 370 Adair, OK 74330
Dr. William R. VanDeLinder Trust (DWVT)
2.771% OP & ONH,Ltd/ 2.8037% RE eff
5/24/12
Stockholders/partners -- Not Officers
3808 NW Marquess Drive Bentonville, AR 72712
Lynn M. Yowell Trust
9.7298% eff 05/24/12
Lessor Or Real Estate Owner
210 East Choctaw Sallisaw, OK 74955
Midwest Nursing Homes, LLC (MNHLLC)
2.771% Mgmt. / 2.8038% RE
Stockholders/partners -- Not Officers
2802 West Country Club Drive Oklahoma City, OK 73116
Richard Armstrong Trust (RAT)
9.61494% eff 05/24/2012
Operating Entity
PO Box 400 Sallisaw, OK 74955
Drumright Nursing Home, LLC
1.219% OP & Ltd.Gen eral Partner ONH,
Ltd. Mgr eff 05/24/12
Stockholders/partners -- Not Officers
P.O. Box 400 Sallisaw, OK 74955
Oklahoma Nursing Homes, Inc. General Partner (ONH,Inc)
9.401287% ONH Inc.&2.771% ONH,Ltd
eff 5/24/12 Ben. RAT&RGAT
Stockholders/partners -- Not Officers
2802 W. Country Club Dr. Oklahoma City, OK 73116
Armstrong Richard James
Trustee-SCFT/9.401287% ONH,Inc.
5/24/12
Stockholders/partners -- Not Officers
3520 East 110th Place Tulsa, OK 74137
Farmer Sandra
1.28306% OP&ONH,Ltd/ 1.3156%
RE/9.401287%ONH,Inc. eff11/21/16
Stockholders/partners -- Not Officers
20852 South Shannon Drive Claremore, OK 74017
Wilson James G.
2.079% OP & ONH,Ltd / 2.1028% RE eff
5/24/12
Stockholders/partners -- Not Officers
P.O. Box 173 Gore, OK 74435
Ferguson Debra M.
5.556%
OP&ONH,Ltd/5.5630%RE/5.657265%&
Treas ONH,Inc.eff 5/24/12
Stockholders/partners -- Not Officers
607 Mayo Street Sallisaw, OK 74955
McGrew Justin
2.771% OP & ONH,Ltd/ 2.8038% RE
Stockholders/partners -- Not Officers
HCR 68 Box 1260 Vian, OK 74962
Armstrong Sally
9.401287% & Pres.ONH,Inc.eff
5/24/12/Trustee DWVT
Stockholders/partners Who Are Officers
PO Box 370 Adair, OK 74330
VanDeLinder Dr. William R.
.70095% RE/0.69275%
OP&ONHLtd/Ben. HAVT
Stockholders/partners -- Not Officers
1405 E. Seattle St. Broken Arrow, OK 74012
Heath Armstrong VanDeLinder Trust (HAVT)
RE 0.70095% & 0.69275% OP & Mgmt
Ben. MMMVT eff 05/24/12
Stockholders/partners -- Not Officers
2812 West 114th Street Jenks, OK 74037
Meredith Margaret Marie VanDeLinder Trust (MMMVT)
Page 56 of 265
Owner NameFacilities Owned
0.69275%OP&ONHLtd/.70095%RE Eff.
05/24/12
Stockholders/partners -- Not Officers
8 Dinton Circle Bella Vista, AR 72714
Nicolas Edmund VanDeLinder Trust (NEVT)
0.69275% OP&OHNLtd/.70095% RE
Eff:05/24/12
Stockholders/partners -- Not Officers
2116 Whitney Lane McKinney, TX 75070
William Glen VanDelinder Trust (WGVT)
Julie Kay Bivin Revocable Trust
Trustee
1500 West Elm Stroud, OK 74079
Bivin Julie K.
2.771% OP &
Stockholders/partners -- Not Officers
2802 W. Country Club Dr. Oklahoma City, OK 73116
Richard Glen Armstrong Trust (RGAT)
Trustee-Carolyn D. Leaverton Rev. Trust
eff 05/24/12
Trustee
6708 South 256th East Ave Broken Bow, OK 74014
Leaverton Carolyn
Trustee -Carolyn D. Leaverton Rev. Trust
eff 05/24/12
Trustee
6708 South 256th East Ave Broken Arrow, OK 74014
Leaverton Ronald
Succ.Trustee & Benf-Carolyn D.
Leaverton Rev. Trust eff 05/24/12
Beneficiary
6708 South 256th East Ave Broken Arrow, OK 74014
Johnson Karen Diane
Succ.Trustee & Benf-Carolyn D.
Leaverton Rev. Trust eff 05/24/12
Beneficiary
6708 South 256th East Ave Broken Arrow, OK 74014
Fine Michael B.
Successor Trustee & Beneficiary -WBT
eff 5/24/12
Trustee
51 Green Acre Village Sallisaw, OK 74955
Byers Karen
Successor Trustee & Beneficiary - WBT
eff 5/24/12
Trustee
51 Green Acre Village Sallisaw, OK 74955
Rhodes Sharon
Beneficiary - Watts Beneficiaries Trust
eff 5/24/12
Trustee
51 Green Acre Village Sallisaw, OK 74955
Rhodes Grant
Beneficiary - Watts Beneficiaries Trust eff
5/24/12
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Miles Sydney
Beneficiary - Watts Beneficiaries Trust
eff 5/24/12
Trustee
51 Green Acre Village Sallisaw, OK 74955
Cameron Amber
Successor Trustee - Sandra Cheek Farmer
Trust eff 5/24/12
Trustee
3520 east 110th Place Tulsa, OK 74137
Farmer Frederick Sinclair
Beneficiary - Sandra Cheek Farmer Trust
eff 5/24/12
Beneficiary
3520 East 110th Place Tulsa, OK 74137
Farmer Cassandra C.
Beneficiary - SCFT eff 5/24/12
Beneficiary
3520 East 110th Place Tulsa, OK 74137
Farmer Alexandra C.
Trustee - WGVT, MMMVT ef11-27-13
Trustee
2812 West 114th St. south Jenks, ok 74037
Leutz William K.
Richard Armstrong Trust & Richard Glen
Armstrong Trust
Trustee
c/o Ben Bryers, 2802 W. Country Club DR. Oklahoma City, ok 73116
Heritage Trust Co.,
Lynn M. Yowell Trust eff- 11/27/2013
Trustee
3808 NW Marquess Drive Bentonville, AR 72712
Yowell Lynn
Page 57 of 265
Owner NameFacilities Owned
Lynn M. Yowell Trust eff- 11/27/2013 end
2014
Trustee
3808 NW Marquess Drive Bentonville,, AR 72712
Yowell Ron
Ben. MMMVT
Beneficiary
2812 West 114th Street South Jenks, OK 74037
VanDeLinder Meredith Margaret Marie
Ben. JKBRT
Beneficiary
1500 West Elm Stroud, OK 74079
Bivin Jeremy
Ben. JKBRT
Beneficiary
1500 West Elm Stroud, OK 74049
Bivin Ryan
Ben. RAT & RGAT 05/24/12
Beneficiary
2802 W. Country Club Dr. Oklahoma, OK 73116
Heritage Trust Company Armstrong Carol
NH5113 918-682-31913500 Haskell Boulevard Muskogee, OK 74403
Eastgate Village Retirement Center
60% BHCP GP JV 2015, LLC, 7/1/16
Stockholders/partners -- Not Officers
1633 North Campbell Avenue Chicago, IL 60647
Birchwood Health Care Properties, LLC
Manager & 100% Mbr, Birchwood HCP
LLC& OK4 Manager, LLC 7/1/16
Stockholders/partners Who Are Officers
1633 North Campbell Avenue Chicago, IL 60647
Dole Isaac
Manager 7/1/16
Manager
415 US Hwy377 S 200 Argyle, TX 76226
Transition Health Services-OK, LLC
100% Lessor (Real Estate) & Lessee (OP)
7/1/16
Stockholders/partners -- Not Officers
1633 N. Campbell Ave Chicago, IL 60647
OK4 SNF HoldCo, LLC
100% OK4 SNF HoldCo, LLC, 7/1/16
Stockholders/partners -- Not Officers
1633 N. Campbell Ave Chicago, IL 60647
OK4 HH/H Master HoldCo, LLC
75%-100% OK4 HH/H Master HoldCo,
LLC 7/1/16
Stockholders/partners -- Not Officers
1633 N. Campbell Ave Chicago, IL 60647
BHCP OK4 HH/H JV, LLC
5% BHCP OK4 HH/H JV, LLC 7/1/16
Stockholders/partners -- Not Officers
1633 N. Campbell Ave Chicago, IL 60647
BHCP OK4 HH/H Sponsor, LLC
95% BHCP OK4 HH/H JV, LLC,7/1/16
Stockholders/partners -- Not Officers
1633 N. Campbell Ave Chicago, IL 60647
BHCP OK4 HH/H Investors, LLC
Will own greater percent BHCP OK4
HH/H Sponsor,LLC 7/1/16
Stockholders/partners -- Not Officers
1633 N. Campbell Ave Chicago, IL 60647
BHCP GP JV 2015, LLC
Mgr-Applicant,Lessor, OK4 SNF
HoldCo,LLC,OK4HH/H Master 7/1/16
Manager
1633 N. Campbell Ave Chicago, IL 60647
OK4 Manager, LLC
0-25% OK4 HH/H Master HoldCo, LLC,
7/1/16
Stockholders/partners -- Not Officers
415 US Hwy 377 S 200 Argyle, TX 76226
SBS of OK, LLC
33.33% Member & Manager SBSof
OK,LLC&THS-OK,LLC,7/1/16
Stockholders/partners Who Are Officers
415 US Hwy 377 S 200 Argyle, TX 76226
Bates Josh
Page 58 of 265
Owner NameFacilities Owned
33.33% Member & Manager SBSof
OK,LLC&THS-OK,LLC,7/1/16
Stockholders/partners Who Are Officers
415 US Hwy 377 S 200 Argyle, TX 76226
Shelton Chana
33.33% Member & Manager SBSof
OK,LLC&THS-OK,LLC,7/1/16
Stockholders/partners Who Are Officers
415 US Hwy 377 S 200 Argyle, TX 76226
Sims Debra
7/1/16
Lessor Or Real Estate Owner
1633 N. Campbell Ave Chicago, IL 60647
OK4 Eastgate RealCo, LLC
Eff 1/7/16
Operating Entity
1633 N. Campbell Ave Chicago, IL 60647
OK4 Eastgate OpCo, LLC
NH5802 918-675-44556th & Highway 69 Commerce, OK 74339
Eastwood Manor
Beneficiary and Trustee Watts Benf Trust
Trustee
P.O. Box 2230 Waldron, AR 72958
Watts Fred
9.61494% Oklahoma Nursing Home, Ltd,
Manager
Contracted Management
210 E. Choctaw, P.O. Box 429 Sallisaw, OK 74955-0429
Oklahoma Nursing Homes, Ltd. (ONH,Ltd.)
8.314% OP & Mgr./ 8.4112% RE/
9.401287% Okla. Nurs. Homes, Inc.
Stockholders/partners -- Not Officers
P.O. Box 40 Sallisaw, OK 74955
Cheek Barnie J.
8.314% OP & Mgmt. / 8.4112% RE
Stockholders/partners -- Not Officers
3520 East 110th Place Tulsa, OK 74137
Sandra Cheek Farmer Trust (SCFT)
5.834% OP & Mgmt/5.9190% mgr
RE/6.597394% & Sec. Okl. NH,Inc.
Stockholders/partners Who Are Officers
4814 S. 164th East Ave. Tulsa, OK 74134
Haskins Lloyd
5.192% OP & Mgmt /5.2626%
RE/12.535047% ONHInc./Trustee WBT
Trustee
51 green acre village #51 Sallisaw, OK 74955
Watts Cleo
Success Trustee of JKBRT 05/24/12
Trustee
Rt. 2 Box 339 Idabel, OK 74745
Bivin Steve
5.893% OP & Mgmt. / 5.9746% RE
Stockholders/partners -- Not Officers
51 Green Acre Village Sallisaw, OK 74955
Watts Beneficiaries Trust (WBT)
14.022% OP Mgt/ 14.2078% RE/
21.936335% &VP ONH, Inceff 10/26/10
Stockholders/partners -- Not Officers
Box 856 Miami, OK 74355
Tubbs Steven
5.376% OP & Mgmt./5.4406% RE
Stockholders/partners -- Not Officers
3910 Cherry Forest Drive Houston, TX 77088
Tubbs, Jr. Stanley I.
5.542% OP & Mgr./ 5.6186%
RE/6.267525% Okla Nurs Homes, Inc.
Stockholders/partners -- Not Officers
416 Fairway Dr. Athens, TX 75751
Estep Pat
2.771% OP & ONH,Ltd / 2.8037% RE eff
5/24/12
Stockholders/partners -- Not Officers
1500 West Elm Stroud, OK 74079
Julie Kay Bivin Revocable Trust (JKBRT)
Stockholders/partners -- Not Officers Caroyln D. Leaverton Revocable Trust
Page 59 of 265
Owner NameFacilities Owned
5.135% OP/Mgt/5.2207% RE eff
05/27/116708 South 256th East Avenue Broken Arrow, OK 74014
2.771% OP & Mgmt./ 2.8037% RE
Stockholders/partners -- Not Officers
PO Box 370 Adair, OK 74330
Dr. William R. VanDeLinder Trust (DWVT)
RE 2.8037%/2.771%OP & Mgmt
Stockholders/partners -- Not Officers
3808 NW Marquess Drive Bentonville, AR 72712
Lynn M. Yowell Trust
8.7298 eff 05/24/12
Lessor Or Real Estate Owner
210 East Choctaw Sallisaw, OK 74955
Midwest Nursing Homes, LLC (MNHLLC)
2.771% Mgmt. / 2.8038% RE
Stockholders/partners -- Not Officers
2802 West Country Club Drive Oklahoma City, OK 73116
Richard Armstrong Trust (RAT)
9.61494% eff 04/25/2016
Operating Entity
PO Box 400 Sallisaw, OK 74955
Eastwood Manor, LLC
1.219% mgr OP & Mgmt.
Stockholders/partners -- Not Officers
P.O. Box 400 Sallisaw, OK 74955
Oklahoma Nursing Homes, Inc. General Partner (ONH,Inc)
9.401287% Oklahoma Nursing Homes,
Inc; Ben. of RA Trust & RGAT
Stockholders/partners -- Not Officers
2802 W. Country Club Dr. Oklahoma City, OK 73116
Armstrong Richard James
Trustee - SCFT/9401287%ONH, Inc
05/24/12
Stockholders/partners -- Not Officers
3520 East 110th Place Tulsa, OK 74137
Farmer Sandra
1.283% OP&Mgmt./ 1.3156%
RE/9.401287%
Ok.Nurs.Hms,Inc.eff5/24/12
Stockholders/partners Who Are Officers
20852 South Shannon Drive Claremore, OK 74017
Wilson James G.
2.079% OP & Mgmt. / 2.1028% RE
Stockholders/partners -- Not Officers
P.O. Box 173 Gore, OK 74435
Ferguson Debra M.
5.556%OP &
Mgmt./5.5630%RE/5.657065% & Treas.
ONH, Inc.
Stockholders/partners -- Not Officers
607 Mayo Street Sallisaw, OK 74955
McGrew Justin
2.7710% OP ONH, Ltd/2.8038% RE
Stockholders/partners -- Not Officers
HCR 68 Box 1260 Vian, OK 74962
Armstrong Sally
9.401287% & Pres.ONH,Inc.eff 5/24/12;
Trustee of DWRVT
Stockholders/partners Who Are Officers
PO Box 370 Adair, OK 74330
VanDeLinder Dr. William R.
.70095%RE/ 0.69275% OP & Mgmt
Stockholders/partners -- Not Officers
1405 E. Seattle St. Broken Arrow, OK 74012
Heath Armstrong VanDeLinder Trust (HAVT)
RE 0.70095% & 0.69275% OP & Mgmt
Stockholders/partners -- Not Officers
2812 West 114th Street Jenks, OK 74037
Meredith Margaret Marie VanDeLinder Trust (MMMVT)
.070095%RE/.69275%OP&MGMT
Stockholders/partners -- Not Officers
8 Dinton Circle Bella Vista, AR 72714
Nicolas Edmund VanDeLinder Trust (NEVT)
0.70095% RE/0.69275% OP & Mgmt
Stockholders/partners -- Not Officers
2116 Whitney Lane McKinney, TX 75070
William Glen VanDelinder Trust (WGVT)
Trustee of JKBRT/
Trustee
1500 West Elm Stroud, OK 74079
Bivin Julie K.
Page 60 of 265
Owner NameFacilities Owned
2.771% OP
Stockholders/partners -- Not Officers
2802 W. Country Club Dr. Oklahoma City, OK 73116
Richard Glen Armstrong Trust (RGAT)
Trustee-Carolyn D. Leaverton Rev. Trust
eff 05/24/12
Trustee
6708 South 256th East Ave Broken Bow, OK 74014
Leaverton Carolyn
Trustee - Carolyn D. Leverton Rev. Trust
eff. 05/14/12
Trustee
6708 South 256th East Ave Broken Arrow, OK 74014
Leaverton Ronald
Suc. Trustee/Beneficiary CDLRT
Trustee
6708 South 256th East Ave Broken Arrow, OK 74014
Johnson Karen Diane
Suc. Trustee/Beneficiary of CDLRT
Trustee
6708 South 256th East Ave Broken Arrow, OK 74014
Fine Michael B.
Beneficiary and Trustee Watts Benf Trust
Trustee
51 Green Acre Village Sallisaw, OK 74955
Byers Karen
Beneficiary and Trustee Watts Benf Trust
Trustee
51 Green Acre Village Sallisaw, OK 74955
Rhodes Sharon
Beneficiary Watts Benf Trust
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Rhodes Grant
Beneficiary Watts Benf Trust
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Miles Sydney
Beneficiary Watts Benf Trust
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Byers Jack
Beneficiary Watts Benf Trust
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Cameron Amber
Successor Trustee of SCFT 05/12
Trustee
3520 east 110th Place Tulsa, OK 74137
Farmer Frederick Sinclair
Beneficiary of SCFT
Beneficiary
3520 East 110th Place Tulsa, OK 74137
Farmer Cassandra C.
Beneficary of SCFT
Beneficiary
3520 East 110th Place Tulsa, OK 74137
Farmer Alexandra C.
Trustee of MMMV & WGV Trust
Trustee
2812 West 114th St. south Jenks, ok 74037
Leutz William K.
Trustee of RA Trust & RGAT 5/24/12
Trustee
c/o Ben Bryers, 2802 W. Country Club DR. Oklahoma City, ok 73116
Heritage Trust Co.,
Trustee of LMYT
Trustee
3808 NW Marquess Drive Bentonville, AR 72712
Yowell Lynn
Trustee of LMYT
Trustee
3808 NW Marquess Drive Bentonville,, AR 72712
Yowell Ron
Trustee/Ben of HAVT
Trustee
1405 E. Seattle St. Broken Arrow, OK 74012
VanDelinder Heath Armstrong
Beneficiary of MMMVT
Beneficiary
2812 West 114th Street South Jenks, OK 74037
VanDeLinder Meredith Margaret Marie
Page 61 of 265
Owner NameFacilities Owned
Trustee & Ben NEVT; Ben. of Dr WRVT
Trustee
8 Dinton Circle Bella Vista, AR 71714
VanDelinder Nicolas Edmund
Trustee & Ben of WGVT & Ben
DWRVT
Trustee
6260 Dark Forest Drive McKinney, TX 75070
VanDelinder William Glen
Beneficiary of JKBRT
Beneficiary
1500 West Elm Stroud, OK 74079
Bivin Jeremy
Beneficiary of JKBRT
Beneficiary
1500 West Elm Stroud, OK 74049
Bivin Ryan
Benf. RATrust * RGAT
Beneficiary
2802 W. Country Club Dr. Oklahoma, OK 73116
Heritage Trust Company Armstrong Carol
Beneficiary of LMYT
Beneficiary
3808 NW Marquess Drive Bentonville, AR 74017
Lamp Jo Ann
Beneficiary of LMYT
Beneficiary
3808 NW Marquess Drive Bentonville, ar 74017
Austin Jennifer
Successor Trustee DWRVT 05/12
Trustee
,
VanDeLinder Patricia Rene
NH5543 405-216-33351100 East 9th Street Edmond, OK 73034
Edmond Health and Rehabilitation
51% of Edmond Health & Rehab, LLC,
(OP) eff 7/31/2012 Man. Mem.
Stockholders/partners Who Are Officers
PO Box 1831 Ocean Springs, MS 39566
fax 601-510-9727 Daves, Jr. William E. (Billy)
49% Member OP Edmond Health &
Rehab, LLC eff 7/31/12
Stockholders/partners -- Not Officers
PO Box 17888 Hattiesburg Hattiesburg, MS 39404
Johnson Christopher W.
100% RE eff 01/10/11
Lessor Or Real Estate Owner
1422 Clarkview Road Baltimore, MD 21209
CHFG Edmond, LLC
President of THI of Oklahoma at
Edmond, LLC eff 01/10/2011
Officers Who Do Not Hold Stock
930 Ridgebrook Rd Sparks, MD 21152
THI of Oklahoma at Edmond, LLC Costello Kenneth
100% of CHFG Edmond, LLC (RE) eff
01/10/11
Stockholders/partners -- Not Officers
1422 Clarkview Road Baltimore, MD 21209
CHFG/HPCG Real Estate I, LLC
36.45% of CHFG/HPCG Real Estate I,
LLC (RE) eff 01/10/11
Stockholders/partners -- Not Officers
1422 Clarkview Road Baltimore, MD 21209
Capital Hospital Finance Group, LLC
8.36% of CHFG/HPCG Real Estate I,
LLC (RE) eff 01/10/2011
Stockholders/partners -- Not Officers
C/O Glen R. Dwyer 1422 Clarkview Road Baltimore, MD 21209
Dwyer Ann Patricia
45.15% of CHFG/HPCG Real Estate I,
LLC (RE) eff 01/10/11
Stockholders/partners -- Not Officers
101 LaRue France, 500 Lafayette, LA 740508
AMG Realty I, LLC
33.33% of AMG Realty I LLC eff
01/10/2011
Stockholders/partners -- Not Officers
101 La Rue France 500 Lafayette, LA 70508
Howard Timothy
Page 62 of 265
Owner NameFacilities Owned
33.33% of AMG Realty I LLC eff
01/10/2011
Stockholders/partners -- Not Officers
101 La Rue France 500 Lafayette, LA 70508
Rantz, IV August J.
33.33% of AMG Realty I LLC eff
01/10/2011
Stockholders/partners -- Not Officers
101 La Rue France 500 Lafayette, LA 70508
Rantz, III August J.
100% of Capital Hospital Finance Group,
LLC eff 7/31/12
Stockholders/partners Who Are Officers
C/O Glen R. Dwyer, 1422 Clarkview Road Baltimore, MD 21209
Dwyer John
OP eff 7/31/2012
Operating Entity
1100 E 9th Street Edmond, OK 73034
Edmond Health & Rehabilitation, LLC
NH5508 405-942-388439 East 33rd Street Edmond, OK 73013
Edmond Health Care Center
33.33% GenPtnr & 31.07% Ltd Ptnr
ECM,LP/ Pres. GMGP,Inc. & R&M N
Stockholders/partners -- Not Officers
P.O. Box 977 Guthrie, OK 73044
Machtolff Gregory E.
31.33%G Ptnr & 37.02% Ltd Ptnr ECM,
LP/ Sec/Tres GMGP, Inc.
Stockholders/partners -- Not Officers
P.O. Box 977 Guthrie, OK 73044
Machtolff III George H.
Lessor Or Real Estate Owner
P.O. Box 977 Guthrie, OK 73044
R and M Nursing Homes, Inc.
Pres.100% OP
Stockholders/partners Who Are Officers
3714 N. Portland Oklahoma City, OK 73112
Crane Judy M.
5.95% Ltd Ptnr ECM, LP
Stockholders/partners -- Not Officers
221 East Cleveland Guthrie, OK 73044
Machtolff Marty
Operating Entity
3714 N. Portland Okla. City, OK 73112
Young and Crane, Inc.
100% RE
Stockholders/partners -- Not Officers
P.O. Box 977 Guthrie, OK 73044
ECM, LP
33.33% Gen Ptnr & 24.96% Ltd Ptnr
ECM, LP/ VP GMGP,Inc.
Stockholders/partners -- Not Officers
P.O. Box 977 Guthrie, OK 73044
Earleen C. Machtolff Irrevocable Trust
1%gen.partn. ECM, LP
Stockholders/partners -- Not Officers
PO Box 977 Guthrie, OK 73044
GMGP, INC.
NH5549 405-424-22731530 Northeast Grand Blvd Oklahoma City, OK
73117
Edwards Redeemer Health & Rehab
100% ER Prty Hdgs LLC eff.12/5/12
Managing Member
3050 Peachtree Rd 355 Atlanta, GA 30305
Brogdon Christopher
Page 63 of 265
Owner NameFacilities Owned
eff.12/05/12
Lessor Or Real Estate Owner
1145 Hembree Road Roswell, GA 30076
Edwards Redeemer Property Holdings, LLC
Contracted Management
4704 Hixson Pike 102 Hixson, TN 37343
New Beginnings Care, LLC
Eff. 10/11/2013
Operating Entity
850 Shades Creek Parkway 200 Hixson, AL 35209
Edwards Redeemer Healthcare & Rehab, LLC
25% OP Managing Member, 50% New
Beg Care, LLC Eff 10/11/2013
Stockholders/partners Who Are Officers
4704 Hixon Pike Hixon, TN 37343
Jones Deborah J.
25% OP Managing Member, 50% New
Beg Care, LLC Eff 10/11/2013
Stockholders/partners Who Are Officers
4704 Hixon Pike Hixon, TN 37343
Tolbert Trent
50% OP Eff. 10/11/2013
Stockholders/partners -- Not Officers
1900 winston Rd. 100 Knoxiville, TN 37919
EBT Healthcare Partners, LLC
33.3% EBT Healthcare Partners, LLC
Eff. 10/11/2013
Stockholders/partners -- Not Officers
5347 Bent River Rd Knoxville, TN 37919
Preston Charles
33.3% EBT Healthcare Partners, LLC
Eff. 10/11/2013
Stockholders/partners -- Not Officers
1633 Wembley Hills Knoxville, TN 37922
Thomas William M.
33.4% EBT Healthcare Partners, LLC
Eff. 10/11/2013
Stockholders/partners -- Not Officers
7211 Sherwood Dr. Knoxville, TN 37919
Sims Edward B.
NH0904 405-262-33232100 Townsend Drive El Reno, OK 73036
El Reno Post-Acute Rehabilitation Center
50% OP/RE;100% BG Mgt., Inc.; 99%
GD2 Inv., LP EFF 10/2/2014
Stockholders/partners Who Are Officers
19143 Chestermere Circle Edmond, OK 73012
Guymon Gregory L
50% OP/RE EFF 10/2/2014
Stockholders/partners Who Are Officers
22122 East 63rd Street Broken Arrow, OK 74014
Huxall Garrett
1% GD2 Inv., LP; 1% Health Care
Properties of Oklahoma, L.L.C.
Stockholders/partners -- Not Officers
19413 Chestermere Circle Edmond, OK 73012
BG Management, Inc.
1% Cat Daddy Inv, LP;1% Health Care
Properties of Oklahoma, L.LC
Stockholders/partners -- Not Officers
22122 East 63rd Street Broken Arrow, OK 74014
GRH Managment, Inc.
49% Health Care Properties of Oklahoma,
L.L.C.
Stockholders/partners -- Not Officers
19413 Chestermere Circle Edmond, OK 73012
GD2 Invstments, LP
49% Health Care Properties of Oklahoma,
L.L.C.
Stockholders/partners -- Not Officers
22122 E. 63rd Street Broken Arrow, OK 74014
Cat Daddy Investments, LP
100% RE EFF 10/2/2014
Lessor Or Real Estate Owner
PO Box 140338 Broken Arrow, OK 74014
Health Care Properties of Oklahoma, L.L.C.
Page 64 of 265
Owner NameFacilities Owned
EFF 10/2/2014
Operating Entity
2100 Townsend Drive El Reno, OK 73036
El Reno Health Care, LLC
NH0503 580-225-2811301 North Garrett Elk City, OK 73644
Elk City Nursing and Rehabilitation Center
75% Man Mbr ECNH, LLC 1-8-15 &
99% Pres. FWHC, Inc. eff 09/01/12
Stockholders/partners Who Are Officers
3434 S.E. Kentucky Place Bartlesville, OK 74006
Brown Jim
eff. 07-31-09
Operating Entity
3434 Southeast Kentucky Place Bartlesville, OK 74006
Elk City Nursing Home, L.L.C. (ECNH)
25% Elk 421, LLC eff. 1/8/15
Stockholders/partners Who Are Officers
3805 Creek Bank Rd Edmond, OK 73003
Elk 421, LLC
25% Elk City Nursing Home, LLC eff.
01/08/15
Stockholders/partners -- Not Officers
3805 Creek Bank Rd Edmond, OK
David Braly Rev Trust & Maria Trapp Braly Rev. Trust (co-trustee
NH6902 580-475-0750811 West Elk Duncan, OK 73533
Elk Crossing
70% OP eff 02/02/12
Stockholders/partners -- Not Officers
1603 Timbercreek Dr. Duncan, OK 73533
Gregston Jeff L.
25% OP eff 02/02/12
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Don Greiner Trustee Kenneth D.Greiner III Revocable Trust, Don Greiner
Benef/Trustee
100% RE eff 12/09/11
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Okc, OK 73108
Don Greiner Trust
Eff 02/02/12
Operating Entity
700 Palm St Duncan, OK 73108
JLG Healthcare, LLC
Eff 12/09/11
Lessor Or Real Estate Owner
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
JLG Real Estate, LLC
5% OP eff 02/02/12
Stockholders/partners -- Not Officers
2120 Elk 4 Duncan, ok 73533
Miller Douglas Che
NH1003 580-223-33031811 9th Street Northwest Ardmore, OK 73401
Elmbrook Home
Operating Entity
,
Elmbrook Home Inc.
Page 65 of 265
Owner NameFacilities Owned
65% OP, Pres. eff. 08/01/12
Stockholders/partners Who Are Officers
1908 12th Ave N.W. E Ardmore, OK 73401
Coble Tom C.
35% OP, V.Pres./Sec/Treas. eff. 08/01/12
Stockholders/partners Who Are Officers
1908 12th Ave NW Ardmore, OK 73401
Jackson Don N.
100% OP
Stockholders/partners -- Not Officers
1908 12th Avenue, N W E Ardmore, OK 73401
Elmbrook Properties, Inc.
NH6701 405-257-6621300 South Seminole Wewoka, OK 74884
Elmwood Manor Nursing Home
100% manag.memb
Stockholders/partners Who Are Officers
PO Box 2 Holdenville, OK 74848
Humphreys Doug
Operating Entity
P.O. Box 2 Holdenville, OK 74848
Elmwood Manor Nursing Home L.L.C.
NH5512 405-737-66012900 Parklawn Drive Midwest City, OK 73110
Emerald Care Center Midwest
VP OP Eff 12-5-2016 end 3/16/17
Officers Who Do Not Hold Stock
333 N Summit St Toledo, OH 43604
Hoops Kathryn Sue
18.75% OP member/manager 5% RE
mgr. eff 3/17/17
Stockholders/partners -- Not Officers
22 Sherri Ln Spring Valley, NY 10977
Gamzeh David
18.75% OP member/manager 5% RE
mgr. eff 3/17/17
Stockholders/partners -- Not Officers
791 Flanders Dr. Valley Stream, NY 11581
Glatzer Akiva
18.75% OP member 50% RE mgr. eff
3/17/17
Stockholders/partners -- Not Officers
34 Lord Ave. Lawrence, NY 11559
Lahasky Ephraim
16.875% OP member 20% RE eff 3/17/17
Stockholders/partners -- Not Officers
748 Hillcrest Place Valley Stream, NY 11581
Chafetz Yisreol
16.875% OP member 20% RE eff 3/17/17
Stockholders/partners -- Not Officers
585 Flanders Dr. Valley Stream, NY 11581
Walden Jacob
5% OP member eff 3/17/17
Stockholders/partners -- Not Officers
2116 New York Ave. Brooklyn, NY 11210
Farkovits Josh
5% OP member eff 3/17/17
Stockholders/partners -- Not Officers
1111 Marcus Ave. 107 Lake Success, NY 11042
ChickieStrong Midwest City LLC
33.33% ChickieStrong MWC, LLC
member eff 3/17/17
Stockholders/partners -- Not Officers
1111 Marcus Ave. 107 Lake Success, NY 11042
Carone Frank
Stockholders/partners -- Not Officers Fensterman Jordan
Page 66 of 265
Owner NameFacilities Owned
33.33% ChickieStrong MWC, LLC
member/mgr eff 3/17/171111 Marcus Ave. 107 Lake Success, NY 11042
33.33% ChickieStrong MWC, LLC
member eff 3/17/17
Stockholders/partners -- Not Officers
1111 Marcus Ave. 107 Lake Success, NY 11402
Fensterman Lori
eff 3/17/17
Operating Entity
791 Flanders Drive Valley Stream, NY 11581
Garden Manor Rehab and Nursing of Midwest City LLC
eff 3/17/17
Lessor Or Real Estate Owner
791 Flanders Drive Valley Stream, NY 11581
Garden Manor of Midwest City Real Estate LLC
NH5514 405-632-77715600 South Walker Oklahoma City, OK 73109
Emerald Care Center Southwest
eff 3/17/17
Operating Entity
791 Flanders Drive Valley Stream, NY 11581
Garden Manor Rehab and Nursing of Southwest LLC
18.75% OP member/manager 5% RE
mgr. eff 3/17/17
Stockholders/partners -- Not Officers
22 Sherri Ln Spring Valley, NY 10977
Gamzeh David
18.75% OP member/manager 5% RE
mgr. eff 3/17/17
Stockholders/partners -- Not Officers
791 Flanders Dr. Valley Stream, NY 11581
Glatzer Akiva
18.75% OP member 50% RE mgr. eff
3/17/17
Officers Who Do Not Hold Stock
34 Lord Ave. Lawrence, NY 11559
Lahasky Ephraim
16.875% OP member 20% RE eff 3/17/17
Stockholders/partners -- Not Officers
748 Hillcrest Place Valley Stream, NY 11581
Chafetz Yisreol
16.875% OP member 20% RE eff 3/17/17
Stockholders/partners -- Not Officers
585 Flanders Dr. Valley Stream, NY 11581
Walden Jacob
5% OP member eff 3/17/17
Stockholders/partners -- Not Officers
2116 New York Ave. Brooklyn, NY 11210
Farkovits Josh
5% OP member eff 3/17/17
Stockholders/partners -- Not Officers
1111 Marcus Ave. 107 Lake Success, NY 11042
ChickieStrong Midwest City LLC
33.33% ChickieStrong MWC, LLC
member eff 3/17/17
Officers Who Do Not Hold Stock
1111 Marcus Ave. 107 Lake Success, NY 11042
Carone Frank
33.33% ChickieStrong MWC, LLC
member/mgr eff 3/17/17
Officers Who Do Not Hold Stock
1111 Marcus Ave. 107 Lake Success, NY 11042
Fensterman Jordan
33.33% ChickieStrong MWC, LLC
member eff 3/17/17
Stockholders/partners -- Not Officers
1111 Marcus Ave. 107 Lake Success, NY 11402
Fensterman Lori
eff 3/17/17
Lessor Or Real Estate Owner
22 Sherri Ln Spring Valley, NY 10977
Garden Manor of Southwest Real Estate LLC
Page 67 of 265
Owner NameFacilities Owned
NH7210 918-628-09322425 South Memorial Tulsa, OK 74129
Emerald Care Center Tulsa
18.75% OP member/manager 5% RE
mgr. eff 3/17/17
Stockholders/partners -- Not Officers
22 Sherri Ln Spring Valley, NY 10977
Gamzeh David
18.75% OP member/manager 5% RE
mgr. eff 3/17/17
Stockholders/partners -- Not Officers
791 Flanders Dr. Valley Stream, NY 11581
Glatzer Akiva
18.75% OP member 50% RE mgr. eff
3/17/17
Stockholders/partners -- Not Officers
34 Lord Ave. Lawrence, NY 11559
Lahasky Ephraim
16.875% OP member 20% RE eff 3/17/17
Stockholders/partners -- Not Officers
748 Hillcrest Place Valley Stream, NY 11581
Chafetz Yisreol
16.875% OP member 20% RE eff 3/17/17
Stockholders/partners -- Not Officers
585 Flanders Dr. Valley Stream, NY 11581
Walden Jacob
5% OP member eff 3/17/17
Stockholders/partners -- Not Officers
2116 New York Ave. Brooklyn, NY 11210
Farkovits Josh
5% OP member eff 3/17/17
Stockholders/partners -- Not Officers
1111 Marcus Ave. 107 Lake Success, NY 11042
ChickieStrong Midwest City LLC
33.33% ChickieStrong MWC, LLC
member eff 3/17/17
Stockholders/partners -- Not Officers
1111 Marcus Ave. 107 Lake Success, NY 11042
Carone Frank
33.33% ChickieStrong MWC, LLC
member/mgr eff 3/17/17
Stockholders/partners -- Not Officers
1111 Marcus Ave. 107 Lake Success, NY 11042
Fensterman Jordan
33.33% ChickieStrong MWC, LLC
member eff 3/17/17
Stockholders/partners -- Not Officers
1111 Marcus Ave. 107 Lake Success, NY 11402
Fensterman Lori
eff 3/17/17
Operating Entity
791 Flanders Drive Valley Stream, NY 11581
Garden Manor Rehab and Nursing of Tulsa LLC
eff 3/17/17
Lessor Or Real Estate Owner
791 Flanders Valley Stream, NY 11581
Garden Manor of Tulsa Real Estate LLC
NH3302 580-477-11331515 Canterbury Blvd Altus, OK 73521
English Village Manor
Eff 3/1/17
Operating Entity
22260 Highway 62B Snyder, OK 73566
WCR Enterprises, Inc.
50 % Shareholder, Director, Pres & Treas
eff 3/1/17
Stockholders/partners Who Are Officers
22260 Highway 62B Snyder, OK 73566
Ayers Michael
50% Shareholder & Director eff 3/1/17
Stockholders/partners Who Are Officers
22260 Highway 62B Snyder, OK 73566
Ayers David
Page 68 of 265
Owner NameFacilities Owned
Director, V.P & Secretary eff 3/1/17
Officers Who Do Not Hold Stock
22260 Highway 62B Snyder, OK 73566
Ayers Jake
Director, eff 3/1/17
Officers Who Do Not Hold Stock
22260 Highway 62B Snyder, OK 73566
Ayers Allison
NH2410 580-237-1973410 North 30th Street Enid, OK 73701
Enid Senior Care
100% OP/RE eff 07/28/11
Stockholders/partners -- Not Officers
593 Atlanta Street Roswell, GA 30075
Brogdon Connie
Manager Senior NH, LLC and 100%
Marsh Pointe Management, LLC
Stockholders/partners -- Not Officers
3050 Peachtree Rd 355 Atlanta, GA 30305
Brogdon Christopher
OP /RE Eff 07/28/11
Operating Entity
593 Atlanta Street Roswell, GA 30075
Senior NH, LLC
Eff. 1/14/14
Contracted Management
Two Buckhead Plaza, 3050 Peachtree Road NW 355 Atlanta, GA 30305
Marsh Pointe Managment, LLC
NH4603 918-689-32111033 Hospital Road Eufaula, OK 74432
Eufaula Manor Nursing and Rehabilitation Center
100% RE/OP
Stockholders/partners Who Are Officers
415 Rogers Avenue Ft. Smith, AK 72902
Morton Michael
Lessor Or Real Estate Owner
107 Mckinley Eufaula, OK 74432
Eufaula Manor, Inc.
Operating Entity
1033 Hospital Road Eufaula, OK 74432
Eufaula Care Center, Inc.
NH5702 918-642-3234282 County Road 6300 Fairfax, OK 74637
Fairfax Manor
Beneficiary &Trustee Watts Benf Trust
Trustee
P.O. Box 2230 Waldron, AR 72958
Watts Fred
9.61494% Oklahoma Nursing Home, Ltd,
Manager
Contracted Management
210 E. Choctaw, P.O. Box 429 Sallisaw, OK 74955-0429
Oklahoma Nursing Homes, Ltd. (ONH,Ltd.)
8.314% OP & Mgmt/ 8.4112% RE/
9.401287% ONH, INC. eff 05/24/12
Stockholders/partners -- Not Officers
P.O. Box 40 Sallisaw, OK 74955
Cheek Barnie J.
Page 69 of 265
Owner NameFacilities Owned
8.314% OP & Mgmt/ 8.4112% RE
Stockholders/partners -- Not Officers
3520 East 110th Place Tulsa, OK 74137
Sandra Cheek Farmer Trust (SCFT)
5.834% OP&
Mgmt/5.9190%RE/6.597394% & Sec eff
05/24/12
Stockholders/partners Who Are Officers
4814 S. 164th East Ave. Tulsa, OK 74134
Haskins Lloyd
12.535047%ONHInc/5.192%OP/ Mgt
5.2626%RE&Trustee Watts Ben Trust
Stockholders/partners -- Not Officers
51 green acre village #51 Sallisaw, OK 74955
Watts Cleo
5.893% OP & Mgmt/ 5.9746% RE
Stockholders/partners -- Not Officers
51 Green Acre Village Sallisaw, OK 74955
Watts Beneficiaries Trust (WBT)
14.022% OP Mgt/ 14.2078% RE/
21.936335% &VP ONH,INC eff 05/24/12
Stockholders/partners Who Are Officers
Box 856 Miami, OK 74355
Tubbs Steven
5.376% OP & Mgmt. / 5.4406% RE
Stockholders/partners -- Not Officers
3910 Cherry Forest Drive Houston, TX 77088
Tubbs, Jr. Stanley I.
5.542% OP & Mgmt/5.6186% RE/
6.267525% ONH, Inc eff 05/24/12
Stockholders/partners -- Not Officers
416 Fairway Dr. Athens, TX 75751
Estep Pat
2.771% OP & ONH,Ltd / 2.8037% RE eff
5/24/12
Stockholders/partners -- Not Officers
1500 West Elm Stroud, OK 74079
Julie Kay Bivin Revocable Trust (JKBRT)
5.135% OP & MGMT/RE 5.2207% eff
05/27/11
Stockholders/partners -- Not Officers
6708 South 256th East Avenue Broken Arrow, OK 74014
Caroyln D. Leaverton Revocable Trust
2.771% OP & ONH,Ltd/ 2.8037% RE eff
5/24/12
Stockholders/partners -- Not Officers
PO Box 370 Adair, OK 74330
Dr. William R. VanDeLinder Trust (DWVT)
2.771% OP & Mgmt. / 2.8037% RE
Stockholders/partners -- Not Officers
3808 NW Marquess Drive Bentonville, AR 72712
Lynn M. Yowell Trust
9.7298RE eff 05/24/12
Lessor Or Real Estate Owner
210 East Choctaw Sallisaw, OK 74955
Midwest Nursing Homes, LLC (MNHLLC)
2.771% Mgmt. / 2.8038% RE
Stockholders/partners -- Not Officers
2802 West Country Club Drive Oklahoma City, OK 73116
Richard Armstrong Trust (RAT)
9.61494% OP eff 05/24/12
Operating Entity
PO Box 400 Fairfax, OK 74955
Fairfax Manor, LLC
1.219% OP / Manager eff 05/24/12
Contracted Management
P.O. Box 400 Sallisaw, OK 74955
Oklahoma Nursing Homes, Inc. General Partner (ONH,Inc)
9.401287% Mngt. eff 05/24/12 Ben of RA
Trust & RGA Trust
Stockholders/partners -- Not Officers
2802 W. Country Club Dr. Oklahoma City, OK 73116
Armstrong Richard James
9.401287% ONH, eff 08/02/12 & Trustee
SCFT
Stockholders/partners -- Not Officers
3520 East 110th Place Tulsa, OK 74137
Farmer Sandra
1.283% OP&Mgmt./ 1.3156%
RE/9.401287%
Ok.Nurs.Hms,Inc.eff5/24/12
Stockholders/partners -- Not Officers
20852 South Shannon Drive Claremore, OK 74017
Wilson James G.
Page 70 of 265
Owner NameFacilities Owned
2.079% OP&Mgt; 2.1028% RE; Eff. 5/12
Stockholders/partners -- Not Officers
P.O. Box 173 Gore, OK 74435
Ferguson Debra M.
5.556% OP Mgm/5.5630% RE/
5.657065% &Treas ONH, Inc eff
05/24/12
Stockholders/partners Who Are Officers
607 Mayo Street Sallisaw, OK 74955
McGrew Justin
2.771% OP & ONH,Ltd/ 2.8038% RE
Stockholders/partners -- Not Officers
HCR 68 Box 1260 Vian, OK 74962
Armstrong Sally
9.401287% & Pres. eff 05/24/12; Trustee
of DWRVT
Stockholders/partners Who Are Officers
PO Box 370 Adair, OK 74330
VanDeLinder Dr. William R.
.70095% RE/0.69275% OP & Mgmt
Stockholders/partners -- Not Officers
1405 E. Seattle St. Broken Arrow, OK 74012
Heath Armstrong VanDeLinder Trust (HAVT)
RE 0.70095% & 0.69275% OP & MGMT
Stockholders/partners -- Not Officers
2812 West 114th Street Jenks, OK 74037
Meredith Margaret Marie VanDeLinder Trust (MMMVT)
RE 0.70095% & 0.69275% OP & Mgmt
Stockholders/partners -- Not Officers
8 Dinton Circle Bella Vista, AR 72714
Nicolas Edmund VanDeLinder Trust (NEVT)
0.70095% RE/0.69275% OP & Mgmt
Stockholders/partners -- Not Officers
2116 Whitney Lane McKinney, TX 75070
William Glen VanDelinder Trust (WGVT)
Trustee of JKBRT
Trustee
1500 West Elm Stroud, OK 74079
Bivin Julie K.
2.77100% OP
Stockholders/partners -- Not Officers
2802 W. Country Club Dr. Oklahoma City, OK 73116
Richard Glen Armstrong Trust (RGAT)
Trustee-Carolyn D. Leaverton Rev. Trust
eff 04/24/2014
Trustee
6708 South 256th East Ave Broken Bow, OK 74014
Leaverton Carolyn
Trustee-Carolyn D. Leaverton Rev. Trust
eff 04/24/2014
Trustee
6708 South 256th East Ave Broken Arrow, OK 74014
Leaverton Ronald
Trustee and Ben. Carolyn D. Leaverton
Rev. Trust eff 4/24/2014
Trustee
6708 South 256th East Ave Broken Arrow, OK 74014
Johnson Karen Diane
Trustee & Ben.Carolyn D. Leaverton Rev.
Trust eff 4/24/2014
Trustee
6708 South 256th East Ave Broken Arrow, OK 74014
Fine Michael B.
Beneficiary and Trustee Watts Benf Trust
Trustee
51 Green Acre Village Sallisaw, OK 74955
Byers Karen
Beneficiary and Trustee Watts Benf Trust
Trustee
51 Green Acre Village Sallisaw, OK 74955
Rhodes Sharon
Watts Beneficiaries Trust
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Rhodes Grant
Beneficiary of Watts Beneficiaries Trust
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Miles Sydney
Beneficiary of Watts Beneficiaries Trust
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Byers Jack
Page 71 of 265
Owner NameFacilities Owned
Beneficiary of Watts Beneficiaries Trust
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Cameron Amber
Successor Trustee - Sandra Cheek Farmer
Trust eff 4-24-14
Trustee
3520 east 110th Place Tulsa, OK 74137
Farmer Frederick Sinclair
Sandra Cheek Farmer Trust eff 4/24/14
Beneficiary
3520 East 110th Place Tulsa, OK 74137
Farmer Cassandra C.
Sandra Cheek Farmer Trust eff 4/24/14
Beneficiary
3520 East 110th Place Tulsa, OK 74137
Farmer Alexandra C.
Trustee of the MMMV Trust, WGVT
Trustee
2812 West 114th St. south Jenks, ok 74037
Leutz William K.
Trustee of RA Trust & RGAT
Trustee
c/o Ben Bryers, 2802 W. Country Club DR. Oklahoma City, ok 73116
Heritage Trust Co.,
Trustee LMYT
Trustee
3808 NW Marquess Drive Bentonville, AR 72712
Yowell Lynn
Trustee of LMYT
Trustee
3808 NW Marquess Drive Bentonville,, AR 72712
Yowell Ron
Trustee and Beneficiary of the HAVT
Trustee
1405 E. Seattle St. Broken Arrow, OK 74012
VanDelinder Heath Armstrong
Beneficiary of the MMMVTrust
Beneficiary
2812 West 114th Street South Jenks, OK 74037
VanDeLinder Meredith Margaret Marie
Trustee & Ben NEVT; Ben. of Dr WRVT
Trustee
8 Dinton Circle Bella Vista, AR 71714
VanDelinder Nicolas Edmund
Trustee and Beneficiary of the WGVT,
Ben. of Dr. WRVT
Stockholders/partners -- Not Officers
6260 Dark Forest Drive McKinney, TX 75070
VanDelinder William Glen
Beneficiary Julie Kay Biven Revocable
Trust
Beneficiary
1500 West Elm Stroud, OK 74079
Bivin Jeremy
Beneficiary Julie Kay Biven Revocable
Trust
Beneficiary
1500 West Elm Stroud, OK 74049
Bivin Ryan
Beneficiary of RA RGA Trust
Beneficiary
2802 W. Country Club Dr. Oklahoma, OK 73116
Heritage Trust Company Armstrong Carol
Beneficiary of LMYT
Beneficiary
3808 NW Marquess Drive Bentonville, AR 74017
Lamp Jo Ann
Beneficiary of LMYT
Beneficiary
3808 NW Marquess Drive Bentonville, ar 74017
Austin Jennifer
NH4701 580-227-3783605 East State Road Fairview, OK 73737
Fairview Fellowship Home For Senior Citizens, Inc
Page 72 of 265
Owner NameFacilities Owned
Operating Entity
605 East State Road Fairview, OK 73737
The Fairview Fellowship Home For Senior Citizens, Inc.
Treasurer
Officers Who Do Not Hold Stock
906 Cheyenne Drive Fairview, OK 73737
Ewald Brad
V. Chairman, eff. 07/11/2012
Officers Who Do Not Hold Stock
802 Highland Fairview, OK 73737
Kliewer Clay
Vice Chairman
Officers Who Do Not Hold Stock
P.O. Box 157 Ringwood, Ok 73768
Nichols Oma Gay
Secretary, eff 07/11/2012
Officers Who Do Not Hold Stock
109 Woodcreek Fairview, OK 73737
Bartel Brenda
Board Member
Officers Who Do Not Hold Stock
115 Woodcreek Fairview, OK 73737
Ewbank Vicki
Board Member
Officers Who Do Not Hold Stock
NW of City Isabella, OK 73747
Levings Jason
Board Member
Officers Who Do Not Hold Stock
Rt. 1, Box 127 Ringwood, OK 73737
Wahl Monica
Board Member
Officers Who Do Not Hold Stock
910 N. Jefferson Ave. Fairview, OK 73737
Koehn Jerry
Board Member
Officers Who Do Not Hold Stock
Rt #1 Box 190A Fairview, OK 73737
Willits Ann
NH5803 918-676-368512 East Conner Fairland, OK 74343
Family Care Center of Fairland
Eff 01/01/12
Lessor Or Real Estate Owner
4773 FM 933 N Whitney, TX 76692
TG Operations, LLC
Mnger RE
Officers Who Do Not Hold Stock
4773 FM 933 N Whitney, TX 76692
Ward P. Diane
Mnger RE
Officers Who Do Not Hold Stock
4773 FM 933 N Whitney, TX 76692
Ward Michael L.
50% RE eff 09/2016
Member
4773 FM 933 N Whitnay, TX 76692
MIDI Family, LTD
Eff 01/01/12
Operating Entity
5430 West 640 Rd Chouteau, OK 74337
Awenasa Management, LLC
100% OP, Manging Member eff
01/01/12; 50% Mem. RE 9/2016
Stockholders/partners Who Are Officers
5430 West 640 Rd Chouteau, OK 74337
Mahurin Teresa
Page 73 of 265
Owner NameFacilities Owned
NH4802 580-564-2216701 Highway 32 Kingston, OK 73439
Family Care Center of Kingston
50%, MngMem. OP/RE eff. 10-4-12
Stockholders/partners Who Are Officers
3548 Wellsite Drive Norman, OK 73069
Scearce Audra
50%, MngMem. OP/RE eff. 10-4-12
Stockholders/partners Who Are Officers
3548 Wellsite Drive Norman, OK 73069
Scearce Joe
eff. 10-4-12
Operating Entity
3548 Wellsite Drive Norman, OK 73069
FCC of Kingston LLC
eff. 10-4-12
Lessor Or Real Estate Owner
3548 Wellsite Drive Norman, OK 73069
EHC Holdings LLC
NH4209 405-282-81662102 W. Warner Guthrie, OK 73044
Fayes Place
100% of Op Entity and Real Estate Entity
Stockholders/partners -- Not Officers
PO Box 990 Edmond, OK 73013
Diakonos Group, LLC
99% Diakonos Group, LLC
Stockholders/partners -- Not Officers
PO Box 990 Edmond, OK 73013
Pilgrim Scott
EFF 09-01-2015
Operating Entity
P.O. Box 990 Edmond, OK 73083
Guthrie Cottages, LLC
EFF 09-01-2015
Lessor Or Real Estate Owner
P.O Box 990 Edmond, OK 73083
Guthrie Holding, LLC
1% of Diakonos Group, LLC
Stockholders/partners -- Not Officers
P.O. Box 990 Edmond, OK 73083
Servant Living Center Holding Company
NH3702 405-375-31571415 South Main Street Kingfisher, OK 73750
First Shamrock Care Center
Beneficiary of Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Green Trust Philip Riley
25% BGM Estate, LLC eff 9-27-16
Stockholders/partners -- Not Officers
P.O. Box 330 Muldrow, OK 74948
Tabor Angela
25% BGM Estate, LLC eff 9-27-16
Stockholders/partners -- Not Officers
111522 S. 4740 Rd. Muldrow, OK 74948
Mitchell Robert Michael
25% BGM Estate eff 9-27-16
Stockholders/partners -- Not Officers
412 S. Dogwood Sallisaw, OK 74955
Mitchell Marcinda
12.5% OP, eff 5/2/14 25% BGM Estate,
LLC eff 9-27-16
Stockholders/partners -- Not Officers
7240 Chase Oaks Blvd 121 Plano, TX 75025
Mitchell Kelly O.
Page 74 of 265
Owner NameFacilities Owned
UPL Mgr. eff. 6/30/2017
Contracted Management
201 N. Elm, Suite A Sallisaw, OK 74955
Shamrock Care Centers, L.L.C.
Beneficiary of Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Green Reba
Beneficiary of Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Ellis, fka Seay Tiffany Renee
Beneficiary of Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Thurman Bronson Owen
Beneficiary of Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, Ok 74955
Tiffany Ellis, fka Seay Trust
Beneficiary of Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Thurman Trust, Gilbert F. Green, Trustee Bronson
Beneficiary of Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Michelle Green Lori
25% OP
Stockholders/partners -- Not Officers
P.O. Box 1454 Sallisaw, OK 74955
Philip M. Green Revocable Trust
25% OP
Stockholders/partners -- Not Officers
P.O. Box 1090 Sallisaw, OK 74955
Gilbert F. Green Trust
Trustee Philip M Green Revocable Trust
Trustee
P.O. Box 1090 Sallisaw, OK 74955
Green Philip M.
Trustee of Philip M. Green Revocable
TrustBeneficiary of Gilbert
Trustee
P.O. Box 1090 Sallisaw, OK 74955
Green Philip M.
Trustee of Gilbert F. Green Trust
Trustee
P.O. Box 1090 Sallisaw, OK 74955
Green Gilbert F.
Trustee of Gilbert F Green Trust
Trustee
P.O. Box 1090 Sallisaw, OK 74955
Green Gilbert F.
Beneficiary of Philip M. Green Revocable
Trust
Beneficiary
P.O. box 1090 Sallisaw, OK 74955
Stewart Lori Green
Beneficiary of Philip M. Green Revocable
Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Green Philip R.
37.50% OP eff 9-16-16
Stockholders/partners -- Not Officers
,
BGM Estate, LLC
Manager EFF 3/14/16
Officers Who Do Not Hold Stock
905 Beall Rd Kingfisher, OK 73750
Kopacka Brendan
UPL Owner eff. 6/30/2017
Operating Entity
100 W. Paul Avenue Pauls Valley, OK 73075
City of Pauls Valley
Page 75 of 265
Owner NameFacilities Owned
NH7244 918-254-50004300 West Houston Broken Arrow, OK 74012
Forest Hills Care and Rehabilitation Center
100% RE Eff 11/15/2010
(Assignor-06/01/13)
Lessor Or Real Estate Owner
18831 Von Karman Ave. 400 Irvine, CA 92612
Sabra Forest Hills, LLC
100% of Sabra Forest Hills, LLC
Stockholders/partners -- Not Officers
18831 Von Karman Ave. 400 Irvine, CA 92612
Sabra Health Care Holdings II, LLC
100% Sabra Health Care Holding II, LLC
Stockholders/partners -- Not Officers
18831 Von Karman Ave. 400 Irvine, CA 92612
Sabra Health Care Holding I, LLC
100% of Sabra Health Care I, LLC
Stockholders/partners -- Not Officers
18831 Von Karman Ave 400 Irvine, CA 92612
Sabra Health Care Limited Partnership
1% Limited Partner of Sabra Health Care
Limited Partnership
Stockholders/partners -- Not Officers
18831 Von Karman Ave 400 Irvine, CA 92612
Sabra Health Care, LLC
99% General Paertner of Sabra Health
Care Limited Partnership
Stockholders/partners -- Not Officers
18831 Von Karman Ave. 400 Irvine, CA 92612
Sabra Health Care REIT, Inc.
Contracted Management eff 11-13-2017
Contracted Management
2 City Place Drive 200 St. Louis, MO 63141
Midwest Geriatric Management, LLC
7% Forest Hills HC Managing Member,
50% Midwest Geriatric Manage
Stockholders/partners Who Are Officers
14447 Chellington Ct. 430 Chesterfield, MO 63017
Bienstock Judah
50% Managing Member OP, eff 06/01/13
Stockholders/partners -- Not Officers
8 Primrose Dr. Lakewood, NJ 08701
Jeremias Baruch
10% of Forest Hills Health Care, LLC eff
11/11/2017
Stockholders/partners Who Are Officers
1111 Marcus Ave 107 Lake Success, NY 11042
Fensterman Howard
37% of Forest Hills Health Care, LLC eff
11/11/2017
Stockholders/partners -- Not Officers
1111 Marcus Ave. 107 Lake Success, NY 11042
Landa Benjamin
Eff 06/01/2013
Operating Entity
477 North Lindergh Blvd 310 St. Louis, MO 63141
314-812-2550 Forest Hills Health Care, LLC
Eff. 06/01/2013 (Assignee)
Lessor Or Real Estate Owner
2 City Place 200 St. Louis, MO 63141
Emerald Senior Care, LLC
13% of Forest Hill Heatlh Care, LLC eff
11/11/2017
Stockholders/partners -- Not Officers
59 Causeway Lawrence, NY 11559
Taub Miriam
33% of Forest Hills HC, 50% MGM and
Trustee of Nationwide Trust
Stockholders/partners -- Not Officers
8 Primrose Drive Lakewood, NJ 08701
Oklahoma Acquisitions, LLC
15.15% of Oklahoma Acquisitions eff
11-2016 no members have 5%
Stockholders/partners -- Not Officers
445 Central Ave 304 Cedarhurst, NY 11516
MACB Resources, LLC
Page 76 of 265
Owner NameFacilities Owned
NH7401 918-534-33551410 N. Choctaw St. Dewey, OK 74029
Forrest Manor Nursing Center
Lessor Or Real Estate Owner
1802 N.E. Loop 410 #111 San Antonil, TX 78217
Cotter James F.
100% OP
Stockholders/partners -- Not Officers
105 Washington Pauls Valley, OK 73075
McCaskill Don
Operating Entity
PO Box 280 Dewey, OK 74029
Dewbar Management, L.L.C.
NH5103 918-478-2456205 East Poplar Fort Gibson, OK 74434
Fort Gibson Nursing Home
60% BHCP GP JV 2015, LLC, 7/1/16
Stockholders/partners -- Not Officers
1633 North Campbell Avenue Chicago, IL 60647
Birchwood Health Care Properties, LLC
Manager & 100% Mbr, Birchwood HCP
LLC& OK4 Manager, LLC 7/1/16
Stockholders/partners Who Are Officers
1633 North Campbell Avenue Chicago, IL 60647
Dole Isaac
7/1//16
Lessor Or Real Estate Owner
1633 N. Campbell Ave Chicago, IL 60647
OK4 Ft. Gibson RealCo, LLC
Manager 7/1/16
Manager
415 US Hwy377 S 200 Argyle, TX 76226
Transition Health Services-OK, LLC
100% Lessor (Real Estate) & Lessee (OP)
7/1/16
Stockholders/partners -- Not Officers
1633 N. Campbell Ave Chicago, IL 60647
OK4 SNF HoldCo, LLC
100% OK4 SNF HoldCo, LLC, 7/1/16
Stockholders/partners -- Not Officers
1633 N. Campbell Ave Chicago, IL 60647
OK4 HH/H Master HoldCo, LLC
75%-100% OK4 HH/H Master HoldCo,
LLC 7/1/16
Stockholders/partners -- Not Officers
1633 N. Campbell Ave Chicago, IL 60647
BHCP OK4 HH/H JV, LLC
5% BHCP OK4 HH/H JV, LLC 7/1/16
Stockholders/partners -- Not Officers
1633 N. Campbell Ave Chicago, IL 60647
BHCP OK4 HH/H Sponsor, LLC
95% BHCP OK4 HH/H JV, LLC,7/1/16
Stockholders/partners -- Not Officers
1633 N. Campbell Ave Chicago, IL 60647
BHCP OK4 HH/H Investors, LLC
Will own greater percent BHCP OK4
HH/H Sponsor,LLC 7/1/16
Stockholders/partners -- Not Officers
1633 N. Campbell Ave Chicago, IL 60647
BHCP GP JV 2015, LLC
Mgr-Applicant,Lessor, OK4 SNF
HoldCo,LLC,OK4HH/H Master 7/1/16
Manager
1633 N. Campbell Ave Chicago, IL 60647
OK4 Manager, LLC
0-25% OK4 HH/H Master HoldCo, LLC,
7/1/16
Stockholders/partners -- Not Officers
415 US Hwy 377 S 200 Argyle, TX 76226
SBS of OK, LLC
Stockholders/partners Who Are Officers Bates Josh
Page 77 of 265
Owner NameFacilities Owned
33.33% Member & Manager SBSof
OK,LLC&THS-OK,LLC,7/1/16415 US Hwy 377 S 200 Argyle, TX 76226
33.33% Member & Manager SBSof
OK,LLC&THS-OK,LLC,7/1/16
Stockholders/partners Who Are Officers
415 US Hwy 377 S 200 Argyle, TX 76226
Shelton Chana
33.33% Member & Manager SBSof
OK,LLC&THS-OK,LLC,7/1/16
Stockholders/partners Who Are Officers
415 US Hwy 377 S 200 Argyle, TX 76226
Sims Debra
Eff 7/1/16
Operating Entity
1633 N. Campbell Ave Chicago, IL 60647
OK4 Ft. Gibson OpCo, LLC
NH5603 918-652-7021107 East Barclay Henryetta, OK 74437
Fountain View Manor, Inc
Operating Entity
107 E. Barclay Henryetta, OK 74437
Fountain View Manor, Inc.
24.50% Sec./Treas.
Stockholders/partners -- Not Officers
8702 Quebec Tulsa, OK 74137
Thomas A. Connery Trust
16.5% Pres
Stockholders/partners Who Are Officers
P.O. Box 179 Henryetta, OK 74437
Kramer Sylvia
16.5%
Stockholders/partners -- Not Officers
5013 S. Ross Oklahoma City, OK 73119
Molet John
Trustee of Thomas A. Connery Trust and
sec/treasurer
Trustee
8702 S. Quebec Ave. Tulsa, OK 74137
Connery Patricia
Trustee Deborah Barnes Trust Eff
Jan-14-2014
Trustee
2660 S. Boston Ave. Tulsa, OK 74114
Barnes Deborah
Trustee Deborah Barnes Trust Eff
Jan-14-2014
Trustee
2660 S. Boston Ave. Tulsa, OK 74114
Barnes Deborah
Vice President Eff Jan-14-2014
Officers Who Do Not Hold Stock
2660 S. Boston Ave. Tulsa, OK 74114
Barnes Ron
1.5%
Stockholders/partners -- Not Officers
111 E. Jefferson Henryetta, OK 74437
Clason Jennifer
24.50% VP eff.07-10-09
Stockholders/partners Who Are Officers
2660 S. Boston Ave. Tulsa, OK 74114
Deborah Barnes Trust
16.5% (spouse of Patrick Molet) Eff
02/14/2017
Stockholders/partners -- Not Officers
1071 Hickory Dr. Choctaw, OK 73020
Molet Ann
NH0704 580-924-53001212 Four Seasons Drive Durant, OK 74701
Four Seasons Rehabilitation & Care
Page 78 of 265
Owner NameFacilities Owned
Chairman of Senior Care Group, Inc. eff.
10/28/10
Officer
1240 Marbella Plaza Drive #12 Tampa, FL 33619
Vaughan David R.
eff. 11-01-06
Operating Entity
1240 Marbella Drive Tampa, FL 33619
SCG Durant Four Seasons, LLC
eff. 11-01-06
Lessor Or Real Estate Owner
1115 Marbella Plaza Drive Tampa, FL 33619
Investors in Real and Personal Property, Tenants in Common
eff. 11-01-06
Contracted Management
1240 Marbella Plaza Drive Tampa, FL 33619
SCG Red River Management, LLC
1.71% RE
Stockholders/partners -- Not Officers
1240Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Christy, LLC
2.29% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Fridrich, LLC
2.86% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Drobeck, LLC
1.21% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Correia, LLC
4.11% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Klatt, LLC
1.37% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Mealer, LLC
2.86% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Fish, LLC
3.43% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Page, LLC
2.29% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Stalker, LLC
3.43% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Pendleton, LLC
2.51% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Brauburger, LLC
1.71% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Mathews-Bingham, LLC
1.14% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - DeMane, LLC
1.14% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Crowley, LLC
2.11% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - May, LLC
4.57% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Young, LLC
Page 79 of 265
Owner NameFacilities Owned
2.29% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Robert Yeh, LLC
2.29% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Albert Yeh, LLC
5.39% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Levenson, LLC
2.86% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Wallace, LLC
3.75% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Evelyn Wallace, LLC
5.91% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Stangl, LLC
6.72% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Shull, LLC
1.14% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Restivo, LLC
2.29% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - McIntosh, LLC
2.29% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Essayli, LLC
3.43% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Hall, LLC
11.43% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Alexander, LLC
2.29% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Hijazi, LLC
1.26% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Wang, LLC
0.29% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Howard, LLC
1.0% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Roberts, LLC
1.71% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Sandra Shaner, LLC
4.92% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Kelley, LLC
100% OP/RE/Mnger
Managing Member
1240 Marbella Plaza Drive Tampa, FL 33619
Senior Care Group, Inc.
Board Memboer of Senior Care Group,
Inc.
Officers Who Do Not Hold Stock
1240 Marbella Plaza Drive Tampa, FL 33619
Fridrich, Sr. Gerald D.
Page 80 of 265
Owner NameFacilities Owned
Board Memboer of Senior Care Group,
Inc.
Officers Who Do Not Hold Stock
1240 Marbella Plaza Drive Tampa, FL 33619
Surtees Robert E.
Sole Managing Member Moran
Consulting Group, LLC
Officers Who Do Not Hold Stock
2547 Mason Oaks Drive Valrico, FL 33596
Moran Francis D.
Manager for TIC Owners (real estate) eff
1-01-08
Lessor Or Real Estate Owner
2547 Mason Oaks Drive Vairico, FL 33596
Moran Consulting Group, LLC
Board Mem/Senior Care Group, Inc. eff.
10-28-10
Officers Who Do Not Hold Stock
1240 Marbella Plaza Drive Tampa, FL 33619
Swart Louis
Pres, SCG eff 04/21/2017
Officer
1240 Marbella Plaza Drive Tampa, FL 33619
Vaughan Michelle
CFO of SCG eff 04/21/2017
CFO
1240 Marbella Plaza Drvie Tampa, FL 33619
Barnhart Amy
COO for SCG eff 04/21/2017
Officer
1240 Marbella Plaza Drive Tampa, FL 33619
Brinkerhoff Brian
NH5417 918-650-93931342 East Columbia Street Okemah, OK 74859
Freedom Place
amended corp. name (fkaProdetik, Inc.)
eff 02-05-08
Operating Entity
P.O. Box 217 Weleetka, OK 74880
The Reach Corporation
Non-Profit Board President of The Reach
Corporation
Officers Who Do Not Hold Stock
P.O. Box 790 Uniontown, KY 42461
Welsh Richard
Non-Profit Board VP of The Reach
Corporation
Officers Who Do Not Hold Stock
PO Box 790 UnionTown, KY 42461
Bailey M. Geoffry
Non-Profit Board Sec/Treas. of Prodetik,
Inc.
Officers Who Do Not Hold Stock
PO Box 790 Uniontown, KY 42461
Pyle William "Bill"
authorized agent for The Reach
Corporation
Officers Who Do Not Hold Stock
1201 West Trudgeon Place Henryetta, OK 74437
Bentley Roy
100% RE
Lessor Or Real Estate Owner
P.O. Box 409 Sturgis, KY 42459
Maricopa Properties, LLC
100% Maricopa Properties, LLC eff
11-7-2008
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Maricopa Partners, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Rock River, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
MMB, LLC
Page 81 of 265
Owner NameFacilities Owned
33.33% of Maricopa Partners, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Lovenest, LLC
4 irrevocable trusts
Trustee
P.O. Box 409 Sturgis, KY 42459
Ervin Gary
4 irrevocable trusts
Trustee
P.O. Box 409 Sturgis, KY 42459
Ervin Lisa
32.88% of MMB,LLC and trustee 3
irrevocable trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Tim
17.455% of MMB, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Vicki
29.421% of Lovenest, LLC & Trustee 7
irrevocable trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Robert
13.957% of Lovenest, LLC & Trustee
7irrevocable trusts
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Laura
53.016% of Rock River, LLC - 4 children
w/13.254% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
4 Irrevocable Trusts
25% of 4 Irrevocable Trusts
Beneficiary
P.O.Box 409 Sturgis, KY 42459
Ervin Mallory
25% of 4 Irrevocable Trusts
Beneficiary
P.O. Box 409 Sturgis, KY 42459
Ervin Jade
25% of 4 Irrevocable Trusts
Beneficiary
P.O. Box 409 Sturgis, KY 42459
Ervin Luke
25% of 4 Irrevocable Trusts
Beneficiary
P.O. Box 409 Sturgis, KY 42459
Ervin Gabe
49.665% of MMB, LLC - 5 children
w/9.933% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
3 Irrevocable Trusts
20% of 3 Irrevocable Trusts
Beneficiary
P.O. Box 409 Sturgis, KY 42459
Ervin Max
20% of 3 Irrevocable Trusts
Beneficiary
P.O. Box Sturgis, KY 42459
Linenger Jessica
20% of 3 Irrevocable Trusts
Beneficiary
P.O. Box 409 Sturgis, KY 42459
Ervin Mitch
20% of 3 Irrevocable Trusts
Beneficiary
P.O. Box 409 Sturgis, KY 42459
Linenger Jennifer
20% of 3 Irrevocable Trusts
Beneficiary
P.O. Box 409 Sturgis, KY 42459
Ervin Brock
56.623% of Lovenest, LLC - 7 children
w/8.089% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
7 Irrevocable Trusts
Page 82 of 265
Owner NameFacilities Owned
14.286% of 7 Irrevocable Trusts
Beneficiary
P.O. Box 409 Sturgis, KY 42459
Ervin Thea
14.286% of 7 Irrevocable Trusts
Beneficiary
P.O. Box 409 Stugris, KY 42459
Ervin Issac
14.286% of 7 Irrevocable Trusts
Beneficiary
P.O. Box 409 Stugis, KY 42459
Ervin Samuel
14.286% of 7 Irrevocable Trusts
Beneficiary
P.O. Box 409 Sturgis, KY 42459
Ervin Elijah
14.286% of 7 Irrevocable Trusts
Beneficiary
P.O. Box 409 Sturgis, KY 42459
Ervin Saul
14.286% of 7 Irrevocable Trusts
Beneficiary
P.O. Box 409 Sturgis, KY 42459
Ervin Micah
14.286% of 7 Irrevocable Trusts
Beneficiary
P.O. Box 409 Sturgis, KY 42459
Ervin Mathias
3 irrevocable trusts
Trustee
P.O Box 409 Sturgis, KY 42459
Ervin Vicky
NH2405 580-234-25261404 N. Garland Road Enid, OK 73703
Garland Road Nursing & Rehab Center
Trustee of Denver McCormick Revocable
Trust
Trustee
9813 S. Penn OKC, OK 73159
McCormick Denver
Trustee Linda McCormick Revocable
Trust
Trustee
9813 S. Penn OKC, OK 73159
McCormick Linda
Trustee of Arlena Dunbar Revocable
Trust
Trustee
5413 NW 107th Street Oklahoma City, OK 73162
Dunbar Arlena
trustee of the Don Nevard Rev Trust
Trustee
4800 N. Lincoln OKC, OK 73105
Nevard Donald
100% of RE
Lessor Or Real Estate Owner
9813 South Penn Oklahoma City, OK 73159
HPM of Enid, LLC
29.167% RE Eff. 02/03/2014/
Stockholders/partners -- Not Officers
9813 S. Penn Oklahoma City, OK 73159
Denver McCormick Revocable Trust
29..167% RE Eff. 02/03/2014
Stockholders/partners -- Not Officers
9813 S. Penn Oklahoma City, OK 73159
Linda McCormick Revocable Trust
29.167% RE Eff. 02/03/2014
Stockholders/partners -- Not Officers
5413 N.W. 107th Okla. City, OK 73162
Arlena Dunbar Revocable Trust
12.5% of HPM of Enid, LLC
Stockholders/partners -- Not Officers
5 S.W. 9th Okla. City, OK
Donald Nevard, Revocable Trust
Page 83 of 265
Owner NameFacilities Owned
Beneficiary of Don Nevard Revocable
Trust
Beneficiary
4800 N. Lincoln Blvd. Okla. City, OK 73105
Nevard Debra
Beneficiary of Don Nevard Revocable
Trust
Beneficiary
4800 N. Lincoln Blvd. Okla. City, OK 73105
Nevard Lisa
Beneficary of Don Nevard Revocable
Trust
Beneficiary
4800 N. Lincoln Blvd. Okla. City, OK 73105
Nevard Michael
Beneficiary of Linda & Denver
McCormicks Revocable Trusts
Beneficiary
4108 Opus Ct. Flower Mound, TX 75022
Pennington Amy
Beneficiary of Linda & Denver
McCormicks Revocable Trusts
Beneficiary
2433 Glenoak Dr. Norman, OK 73071
Petrone Alison
Beneficiary of Linda & Denver
McCormicks Revocable Trusts
Beneficiary
8594 D East 133 Holdenville, OK 74850
Jones Joshua
Beneficiary of Linda & Denver
McCormicks Revocable Trusts
Beneficiary
8594 D East 133 Holdenville, OK 74850
Jones Tanner
Beneficiary of Arlena Dunbar Revocable
Trust
Beneficiary
5413 NW 107th Okla. City, OK 73159
Dunbar William
Beneficiary of Arlena Dunbar Revocable
Trust
Beneficiary
12204 N. Kimberlyn Rd. Okla. City, OK 73162
Dunbar Teresa
Subcontracted Manager Eff 6/30/2017
Contracted Management
1500 Waters Ridge Drive 200 Lewisville, TX 75057
Stonegate Senior Living, LLC
Beneficiary of Arlena Dunbar Revocable
Trust
Beneficiary
3913 Spyglass Road Okla. City, OK 73167
Nard Charlotte
UPL Owner eff. 6/30/2017
Operating Entity
100 W. Paul Avenue Pauls Valley, OK 73075
City of Pauls Valley
UPL Manager Eff 6/30/2017
Contracted Management
,
Garland Road Nursing & Rehab Center
NH7252 918-258-39001401 East College Broken Arrow, OK 74012
Gatesway Foundation III
Operating Entity
1217 E. College Broken Arrow, OK 74012
Gatesway Foundation, Inc.
President
Officers Who Do Not Hold Stock
1844 North 106th East Avenue Owasso, OK 74116
Pacula Jim
Vice President
Officers Who Do Not Hold Stock
6111 E. Skelly Drive 506 Tulsa, OK 74135
Tulsa Community College Artis Dr. Fredrick
Page 84 of 265
Owner NameFacilities Owned
Treasurer
Officers Who Do Not Hold Stock
2720 N Hemlock CT C Broken Arrow, OK 74012
Parrish David
Secretary
Officers Who Do Not Hold Stock
510 S. Rockford Tulsa, OK 74120
Ruggles Debbie
CEO Eff Dec 2015
Officers Who Do Not Hold Stock
1217 E College Broken Arrow, OK 74012
Morton Gloria
NH7212 918-258-39001217 East College Broken Arrow, OK 74012
Gatesway Foundation, Inc.
Operating Entity
1217 E. College Broken Arrow, OK 74012
Gatesway Foundation, Inc.
President, eff - 6/25/14
Officers Who Do Not Hold Stock
1844 North 106th East Avenue Owasso, OK 74116
Pacula Jim
Vice President eff - 6/25/14
Officers Who Do Not Hold Stock
6111 E. Skelly Drive 506 Tulsa, OK 74135
Tulsa Community College Artis Dr. Fredrick
Treasuer eff - 6/25/14
Officers Who Do Not Hold Stock
2720 N Hemlock CT C Broken Arrow, OK 74012
Parrish David
Secretary eff - 6/25/14
Officers Who Do Not Hold Stock
510 S. Rockford Tulsa, OK 74120
Ruggles Debbie
CEO Eff Dec 2015
Officers Who Do Not Hold Stock
1217 E College Broken Arrow, OK 74012
Morton Gloria
NH7236 918-258-39001217 East College Broken Arrow, OK 74012
Gatesway Foundation, Inc. II
Operating Entity
1217 E. College Broken Arrow, OK 74012
Gatesway Foundation, Inc.
Treasurer, eff. 06/25/2012
Officers Who Do Not Hold Stock
4705 S. 129th E. Ave. Tulsa, OK 74134
Warkentin Kent E.
Secretary, eff. 06/25/2012
Officers Who Do Not Hold Stock
1717 S. Boulder Ave. 900 Tulsa, OK 74119
Whiting Ralston Sharolyn
President,eff. 06/25/2012
Officers Who Do Not Hold Stock
1502 E College Broken Arrow, OK 74012
Cook Joe
Vice President, eff. 06/25/2012
Officers Who Do Not Hold Stock
1844 North 106th East Avenue Owasso, OK 74116
Pacula Jim
CEO Eff Dec 2015
Officers Who Do Not Hold Stock
1217 E College Broken Arrow, OK 74012
Morton Gloria
Page 85 of 265
Owner NameFacilities Owned
NH7257 918-258-39001301 East College Broken Arrow, OK 74012
Gatesway Foundation, Inc. IV
Operating Entity
1217 E. College Broken Arrow, OK 74012
Gatesway Foundation, Inc.
Treasurer
Officers Who Do Not Hold Stock
4705 S. 129th E. Ave. Tulsa, OK 74134
Warkentin Kent E.
Secretary, eff. 06/27/2012
Officers Who Do Not Hold Stock
1717 S. Boulder Ave. 900 Tulsa, OK 74119
Whiting Ralston Sharolyn
President, ef.06/27/2012
Officers Who Do Not Hold Stock
1502 E College Broken Arrow, OK 74012
Cook Joe
Vice Pres. eff. 06/27/2012
Officers Who Do Not Hold Stock
1844 North 106th East Avenue Owasso, OK 74116
Pacula Jim
CEO Eff Dec 2015
Officers Who Do Not Hold Stock
1217 E College Broken Arrow, OK 74012
Morton Gloria
NH7258 91828914591313 East College Broken Arrow, OK 74012
Gatesway Foundation, Inc. V
Operating Entity
1217 E. College Broken Arrow, OK 74012
Gatesway Foundation, Inc.
Treasurer
Officers Who Do Not Hold Stock
4705 S. 129th E. Ave. Tulsa, OK 74134
Warkentin Kent E.
Secretary, eff. 06/27/2012
Officers Who Do Not Hold Stock
1717 S. Boulder Ave. 900 Tulsa, OK 74119
Whiting Ralston Sharolyn
President, eff. 06/27/2012
Officers Who Do Not Hold Stock
1502 E College Broken Arrow, OK 74012
Cook Joe
Vice Pres. eff. 06/27/2012
Officers Who Do Not Hold Stock
1844 North 106th East Avenue Owasso, OK 74116
Pacula Jim
NH0602 405-884-5440720 North Galena Geary, OK 73040
Geary Community Nursing Home
effective 3/19/2014
Operating Entity
2416 N. Portland Ave. OKC, OK 73112
First Choice Home Medical, Inc.
51% Pres / Treasurer eff 3/19/2014
Stockholders/partners Who Are Officers
1908 Brook Court Edmond, OK 73003
Maldonado Cruz A.
Page 86 of 265
Owner NameFacilities Owned
49% V. Pres / Sec eff. 3/19/2014
Stockholders/partners Who Are Officers
1804 E. Cavanaugh Elreno, OK 73036
Myers Vicki Dean Russell
NH7233 918-291-42301700 East 141st Street Glenpool, OK 74033
Glennwood Healthcare
Mangaer of Amity Care, LLC &
ReGlenpool, LLC eff 9/16/2015
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Greiner Don
Mangers of Amity Care, LLC &
ReGlenpool, LLC eff. 9/16/2015
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Dimond Mike
management company eff 9/16/2015
Contracted Management
4350 Will Rogers Parkway 300 Okc, OK 73108
Amity Care, L.L.C.
99% OP & 78% Amity Care eff
9/16/2015
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Don Greiner Trustee Kenneth D.Greiner III Revocable Trust, Don Greiner
Benef/Trustee
22% Amity Care, LLC eff.9/16/2015
ben/trustee Don Greiner Tr
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Okc, OK 73108
Don Greiner Trust
58% ReGlenpool, LLC eff 9/16/2015
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Clarity Properties, LLC
52% of Renew - Mike Dimond,Trustee eff
9/16/2015
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Stalwort Trust
eff. 9/16 /2015
Operating Entity
4530 Will Rogers Park Way 300 OKC, OK 73108
Glenpool Operations, LLC
eff 9/16/2015
Lessor Or Real Estate Owner
4530 Will Rogers Park Way OKC, OK 73108
ReGlenpool, LLC
42% ReGlenpool, LLC eff 9/16/2015
Stockholders/partners -- Not Officers
4530 Will Rogers Park Way 300 OKC, OK 73108
Renew Properties, LLC
100% Clarity Properties 48% Renew
Prop. eff 9/16/2015
Stockholders/partners -- Not Officers
4530 Will Rogers Parkway 300 OKC, OK 73108
Don Greiner Family Trust, Don Greiner Trustee
NH4203 405-282-6285419 East Oklahoma Guthrie, OK 73044
Golden Age Nursing Home of Guthrie, LLC
7% Mbr HMLC, LLC
Stockholders/partners -- Not Officers
P.O. Box 1095 Guthrie, OK 73044
Golden Age Nursing Home Of Guthrie, Inc.(GAN)
15% mbr HMLC, LLC
Stockholders/partners -- Not Officers
Box 1095 Guthrie, OK 73044
Chappell Mary Lou
Page 87 of 265
Owner NameFacilities Owned
3% Mbr HMLC, LLC eff 3/4/16
Stockholders/partners -- Not Officers
P.O. Box 1095 Guthrie, OK 73044
Perry Green Valley Nursing Home, Inc.(PGV)
3% Mbr HMLC, LLC eff 04/18/2012
Stockholders/partners -- Not Officers
PO Box 1095 Guthrie, OK 73044
Stilwell Nursing Home, Inc.(SNH)
Chappell 2012 Succession Tr
Beneficiary
P.O. Box 1095 Guthrie, OK 73044
Chappell Jeff
RE
Lessor Or Real Estate Owner
P.O. Box 1095 Guthrie, OK 73044
H&M Family Property, LLC
27% RE, eff 3/4/16
Stockholders/partners -- Not Officers
P.O. Box 1095 Guthrie, OK 73044
Oklahoma All Risk, LLC
Manager of HMLC,LLC, OP & RE
Manager
P.O. Box 1095 Guthrie, OK 73044
Hastings Tandie
Operating Entity
P.O. Box 1095 Guthrie, OK 73044
Golden Age Nursing Home of Guthrie, LLC
34% RE eff 03/04/16
Stockholders/partners -- Not Officers
P.O. Box 1095 Guthrie, OK 73044
Bennie & Leo, LLC
100% Mbr OP & 39% RE
Stockholders/partners -- Not Officers
PO Box 1095 Guthrie, OK 73044
HMLC, LLC
Manager, HMLC, LLC; Trustee Chappell
2012 Succession Trust
Trustee
PO Box 1095 Guthrie, OK 73044
Chappell Hollie "Joe"
72% Mbr HMLC, LLC, eff 3/4/16
Stockholders/partners -- Not Officers
P.O. Box 1095 Guthrie, OK 73044
Chappell 2012 Succession Trust dated 1/3/2012
Chappell 2012 Succession Tr
Beneficiary
,
Chappell Jon D.
Chappell 2012 Succession Tr
Beneficiary
,
Crockett Mary Janice
NH2408 580-24926005801 North Oakwood Road Enid, OK 73703
Golden Oaks Senior Living
eff 6-1-03
Lessor Or Real Estate Owner
,
holland whitney
17.33 % ORV Vice Pres, and Bene
Wesley Kroeker Revocable Trust
Stockholders/partners Who Are Officers
5801 N. Oakwood Enid, OK 73703
Lillie Annette
17.33% ORV & Trustee Wesley Kroeker
Revoable Trust & Treasurer
Stockholders/partners Who Are Officers
5801 N. Oakwood Enid, OK 73703
Kroeker Bryan
Receiver CJ-2012-64-01 Eff 5/01/2012
Operating Entity
5801 North Oakwood Road Enid, OK 73703
Hardin Investments, LLC - Receiver CJ-2012-64-01
Page 88 of 265
Owner NameFacilities Owned
President
Officers Who Do Not Hold Stock
5801 N.Oakwood Rd. Enid, OK 73703
Lillie Gary
Lessor Or Real Estate Owner
5801 N. Oakwood Enid, OK 73703
Oakwood Retirement Village, Inc. (ORV, Inc)
49% ORV
Stockholders/partners -- Not Officers
6622 N. Oakwood Rd. Enid, OK 73703
Wesley Kroeler Revocable Trust
Secretary
Officers Who Do Not Hold Stock
5613 Oakwood Rd. Enid, OK 73703
Lillie Kyle
16.33% ORV
Stockholders/partners -- Not Officers
7362 Lane Park Drive Dallas, TX 75225
Kroeker Charlotte
NH5518 405-789-72427000 Northwest 32nd Street Bethany, OK 73008
Grace Living Center-Bethany
President/Manag.Member of
OP/RE/Manager
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Greiner Don
Lessor Or Real Estate Owner
4415 Highline Blvd. Oklahoma City, OK 73108
Bethlinwood, L. L. C.
Contracted Management
4350 Will Rogers Parkway 300 Okc, OK 73108
Amity Care, L.L.C.
78% OP & Amity Care, LLC eff.
10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Don Greiner Trustee Kenneth D.Greiner III Revocable Trust, Don Greiner
Benef/Trustee
22% OP & Amity Care, LLC
Beneficiary/Trustee of Don Greiner Tr
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Okc, OK 73108
Don Greiner Trust
Secretary
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Okc, OK 73108
Diamond Mike
Operating Entity
4350 Will Rogers Parkway 300 OKC, OK 73108
Putnam City Convalescent Center, L.L.C.
NH5554 405-636-0626940 Southwest 84th Street Oklahoma City, OK 73139
Grace Living Center-Brookwood
President/Manag.Member of
OP/RE/Manager
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Greiner Don
Lessor Or Real Estate Owner
2200 NW 50th 126 Oklahoma City, OK 73112
Azaleabrook, L. L. C.
Contracted Management
4350 Will Rogers Parkway 300 Okc, OK 73108
Amity Care, L.L.C.
Page 89 of 265
Owner NameFacilities Owned
78% OP & Amity Care, LLC eff.
10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Don Greiner Trustee Kenneth D.Greiner III Revocable Trust, Don Greiner
Benef/Trustee
22% OP & Amity Care, LLC
eff.10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Okc, OK 73108
Don Greiner Trust
Secretary
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Okc, OK 73108
Diamond Mike
Operating Entity
4350 Will Rogers 300 OKC, OK 73108
Brookwood Nursing Center, L.L.C.
NH3001 580-735-2415111 Walnut Drive Buffalo, OK 73834
Grace Living Center-Buffalo
President/Manag.Member of
OP/RE/Manager
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Greiner Don
Lessor
Lessor Or Real Estate Owner
2200 NW 50th 126 Oklahoma City, OK 73112
Rebuffalo, L.L.C.
Contracted Management
4350 Will Rogers Parkway 300 Okc, OK 73108
Amity Care, L.L.C.
78% OP & Amity Care, LLC eff.
10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Don Greiner Trustee Kenneth D.Greiner III Revocable Trust, Don Greiner
Benef/Trustee
22% OP & Amity Care, LLC eff.10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Okc, OK 73108
Don Greiner Trust
Secretary
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Okc, OK 73108
Diamond Mike
Operating Entity
4350 Will Rogers Parkway 300 OKC, OK 73108
Western Nursing Home, L.L.C.
NH2603 405-224-64562300 Iowa Avenue Chickasha, OK 73023
Grace Living Center-Chickasha
President/Manag.Member of
OP/RE/Manager
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Greiner Don
Lessor Or Real Estate Owner
2200 N.W. 50th 126 Oklahoma City, OK 73112
Stillgrady, L. L. C.
Contracted Management
4350 Will Rogers Parkway 300 Okc, OK 73108
Amity Care, L.L.C.
Page 90 of 265
Owner NameFacilities Owned
78% OP & Amity Care, LLC eff.
10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Don Greiner Trustee Kenneth D.Greiner III Revocable Trust, Don Greiner
Benef/Trustee
22% OP & Amity Care, LLC eff.10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Okc, OK 73108
Don Greiner Trust
Secretary
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Okc, OK 73108
Diamond Mike
Operating Entity
4350 Will Rogers Parkway 300 OKC, OK 73108
Convalescent Center of Grady County, L.L.C.
Lessor Or Real Estate Owner
4350 Will Rogers Parkway 300 Okla. City, OK 73108
Rechickasha, L.L.C.
NH2001 580-323-11102400 West Modelle Clinton, OK 73601
Grace Living Center-Clinton
President/Manag.Member of
OP/RE/MGT/ bene/trustee Don Greiner
Tr
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Greiner Don
UPL Manager, eff 6/30/17
Manager
P.O. Box 270120 Oklahoma City, OK 73137
Clinton Nursing Center, L.L.C.
Lessor Or Real Estate Owner
2200 NW 50th 126 Oklahoma City, OK 73112
Herclin, L. L. C.
Manager-UPL eff 6/30/17
Managing Member
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Dimond Mike
Contracted Management
4350 Will Rogers Parkway 300 Okc, OK 73108
Amity Care, L.L.C.
78% OP & Amity Care, LLC eff.
10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Don Greiner Trustee Kenneth D.Greiner III Revocable Trust, Don Greiner
Benef/Trustee
22% OP & Amity Care, LLC eff.
10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Okc, OK 73108
Don Greiner Trust
Chairman/Mayor, City of Pauls Valley, eff
6/30/17
Officers Who Do Not Hold Stock
PO Box 778 Pauls Valley, OK 73075
Alfred Gary
V-Chair/V-Mayor City of Pauls Valley,
eff 6/30/17
Officers Who Do Not Hold Stock
PO Box 778 Pauls Valley, OK 73075
Rushing Jocelyn
Member, City of Pauls Valley, eff 6/30/17
Member
PO Box 778 Pauls Valley, OK 73075
Grimmett Patrick
Member, City of Pauls Valley, eff 6/30/17
Member
PO Box 778 Pauls Valley, Ok 73075
Parrish Michael
Member, City of Pauls Valley, eff 6/30/17
Member
PO Box 778 Pauls Valley, OK 73075
Montgomery Shirley
Page 91 of 265
Owner NameFacilities Owned
UPL Owner eff. 6/30/2017
Operating Entity
100 W. Paul Avenue Pauls Valley, OK 73075
City of Pauls Valley
NH5510 405-677-3349400 South Scott Street Del City, OK 73115
Grace Living Center-Del City
Lessor
Lessor Or Real Estate Owner
3301 Glenn Valley Drive Midwest City, OK 73110
C H And C Company
President/Manag.Member of
OP/RE/Manager
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Greiner Don
Secretary, ended 6/29/17; Manager-UPL
eff 6/30/17
Managing Member
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Dimond Mike
Contracted Management
4350 Will Rogers Parkway 300 Okc, OK 73108
Amity Care, L.L.C.
78% OP & Amity Care, LLC eff.
10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Don Greiner Trustee Kenneth D.Greiner III Revocable Trust, Don Greiner
Benef/Trustee
22% OP & Amity Care, LLC
eff.10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Okc, OK 73108
Don Greiner Trust
UPL Manager eff 6/30/17
Manager
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Del City Nursing Center, L.L.C.
Receiver RE Eff 8/14/09
Court Appointed Receiver
119 N. Robinson 400 Oklahoma City, OK 73102
David R. Payne, Receiver, d/b/a Receiver Care LLC
Chairman/Mayor, City of Pauls Valley, eff
6/30/17
Officers Who Do Not Hold Stock
PO Box 778 Pauls Valley, OK 73075
Alfred Gary
V-Chair/V-Mayor City of Pauls Valley,
eff 6/30/17
Officers Who Do Not Hold Stock
PO Box 778 Pauls Valley, OK 73075
Rushing Jocelyn
Member, City of Pauls Valley, eff 6/30/17
Member
PO Box 778 Pauls Valley, OK 73075
Grimmett Patrick
Member, City of Pauls Valley, eff 6/30/17
Member
PO Box 778 Pauls Valley, Ok 73075
Parrish Michael
Member, City of Pauls Valley, eff 6/30/17
Member
PO Box 778 Pauls Valley, OK 73075
Montgomery Shirley
UPL Owner eff. 6/30/2017
Operating Entity
100 W. Paul Avenue Pauls Valley, OK 73075
City of Pauls Valley
Page 92 of 265
Owner NameFacilities Owned
NH5536 405-341-14332520 South Rankin Edmond, OK 73013
Grace Living Center-Edmond
President/Manag.Member of
OP/RE/Manager
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Greiner Don
Lessor Or Real Estate Owner
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Timwest, L. L. C.
Contracted Management
4350 Will Rogers Parkway 300 Okc, OK 73108
Amity Care, L.L.C.
78% OP & Amity Care, LLC eff.
10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Don Greiner Trustee Kenneth D.Greiner III Revocable Trust, Don Greiner
Benef/Trustee
22% OP & Amity Care, LLC
eff.10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Okc, OK 73108
Don Greiner Trust
Secretary
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Okc, OK 73108
Diamond Mike
UPL Mgr. eff 6/30/2017
Contracted Management
4350 Will Rogers Parkway 300 Oklahoma, OK 73108
Timberlane Manor, L.L.C.
UPL Owner eff. 6/30/2017
Operating Entity
100 W. Paul Avenue Pauls Valley, OK 73075
City of Pauls Valley
NH0903 405-262-28331901 Parkview Drive El Reno, OK 73036
Grace Living Center-El Reno
78% OP & Amity Care, LLC eff.
10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Don Greiner Trustee Kenneth D.Greiner III Revocable Trust, Don Greiner
Benef/Trustee
22% OP & Amity Care, LLC eff.10-21-03
ben/trustee Don Greiner Tr
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Okc, OK 73108
Don Greiner Trust
Operating Entity
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
El Reno Nursing Center, L.L.C.
NH7202 918-299-8508711 North 5th Street Jenks, OK 74037
Grace Living Center-Jenks
President/Manag.Member of
OP/RE/Manager
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Greiner Don
Operating Entity
4415 Highline Boulevard Oklahoma City, OK 73108
Jenks Living Centers, L.L.C.
Page 93 of 265
Owner NameFacilities Owned
Lessor Or Real Estate Owner
4415 Highline Boulevard Oklahoma City, OK 73108
Highline L. L. C.
40% RE
Stockholders/partners -- Not Officers
4415 Highline Blvd. Oklahoma City, OK 73108
Captains Properties, L.L.C.
60% RE
Stockholders/partners -- Not Officers
P.O. Box 23017 Oklahoma City, OK 73123
Straight Path, L.L.C.
Secretary, op
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Dimond Mike
78% OP & Amity Care, LLC eff.
10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Don Greiner Trustee Kenneth D.Greiner III Revocable Trust, Don Greiner
Benef/Trustee
22% OP & Amity Care, LLC
eff.10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Okc, OK 73108
Don Greiner Trust
Employment Tax Entity
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Jenks Admin. LLC
NH2801 580-782-3346320 Carey Street Mangum, OK 73554
Grace Living Center-Mangum
Pres/Manag.Member of OP/RE/Manager
Trustee/ben. Don Greiner Trst
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Greiner Don
Contracted Management
4350 Will Rogers Parkway 300 Okc, OK 73108
Amity Care, L.L.C.
78% OP & Amity Care, LLC eff.
10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Don Greiner Trustee Kenneth D.Greiner III Revocable Trust, Don Greiner
Benef/Trustee
22% OP & Amity Care, LLC eff.10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Okc, OK 73108
Don Greiner Trust
Secretary
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Okc, OK 73108
Diamond Mike
UPL Mgr. eff. 6/30/2017
Contracted Management
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Mangum Nursing Center, L.L.C
Lessor Or Real Estate Owner
2200 NW 50th 126 Okla. City, OK 73112
Remangum, LLC
UPL Owner eff. 6/30/2017
Operating Entity
100 W. Paul Avenue Pauls Valley, OK 73075
City of Pauls Valley
NH1410 405-366-8800201 48th Avenue Southwest Norman, OK 73072
Grace Living Center-Norman
Page 94 of 265
Owner NameFacilities Owned
President/Manag.Member of
OP/RE/Manager
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Greiner Don
1% Corp Stock
Operating Entity
P.O. Box 270120 Oklahoma City, OK 73137
Security Health Care, L.L.C.
Lessor Or Real Estate Owner
151 N. Main 700 Wichita, KS 67202
Norman Properties, LLC
99% OP & 78% Amity Care, LLC eff.
10-21-03
Stockholders/partners Who Are Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Don Greiner Trustee Kenneth D.Greiner III Revocable Trust, Don Greiner
Benef/Trustee
Secretary
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Okc, OK 73108
Diamond Mike
Tax Entity
Employment Tax Entity
4350 Will Rogers 300 Oklahoma City, OK 73108
Norman Admin, LLC
NH5535 405-424-14491921 Northeast 21st Street Oklahoma City, OK 73111
Grace Living Center-Northeast O K C
President/Manag.Member of
OP/RE/Manager
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Greiner Don
Lessor Or Real Estate Owner
2200 N.W. 50th 126 Oklahoma City, OK 73112
Terrgar, L. L. C.
Secretary, ended 6/29/17; Manager-UPL
eff 6/30/17
Managing Member
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Dimond Mike
Contracted Management
4350 Will Rogers Parkway 300 Okc, OK 73108
Amity Care, L.L.C.
78% OP & Amity Care, LLC eff.
10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Don Greiner Trustee Kenneth D.Greiner III Revocable Trust, Don Greiner
Benef/Trustee
22% OP & Amity Care, LLC
eff.10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Okc, OK 73108
Don Greiner Trust
UPL Manager eff 6/30/17
Manager
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Terrace Gardens Nursing Center, L.L.C.
V-Chair/V-Mayor City of Pauls Valley,
eff 6/30/17
Officers Who Do Not Hold Stock
PO Box 778 Pauls Valley, OK 73075
Rushing Jocelyn
Member, City of Pauls Valley, eff 6/30/17
Member
PO Box 778 Pauls Valley, OK 73075
Grimmett Patrick
Member, City of Pauls Valley, eff 6/30/17
Member
PO Box 778 Pauls Valley, Ok 73075
Parrish Michael
Member, City of Pauls Valley, eff 6/30/17
Member
PO Box 778 Pauls Valley, OK 73075
Montgomery Shirley
Page 95 of 265
Owner NameFacilities Owned
UPL Owner eff. 6/30/2017
Operating Entity
100 W. Paul Avenue Pauls Valley, OK 73075
City of Pauls Valley
NH5511 405-943-83663233 Northwest 10th Street Oklahoma City, OK 73107
Grace Living Center-Northwest O K C
President/Manag.Member of
OP/RE/Manager
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Greiner Don
UPL Mgr. eff 6/30/2017
Contracted Management
4350 Will Rogers Parkway 300 Okc, OK 73108
Northwest, Incorporated
Contracted Management
4350 Will Rogers Parkway 300 Okc, OK 73108
Amity Care, L.L.C.
78% OP & Amity Care, LLC eff.
10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Don Greiner Trustee Kenneth D.Greiner III Revocable Trust, Don Greiner
Benef/Trustee
22% OP & Amity Care, LLC
eff.10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Okc, OK 73108
Don Greiner Trust
Secretary
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Okc, OK 73108
Diamond Mike
eff. 07-01-07
Lessor Or Real Estate Owner
4350 Will Rogers Parkway 300 Okla. City, OK 73108
Northwest 10th Real Estate, L.L.C.
Chairman/Mayor, City of Pauls Valley, eff
6/30/17
Officers Who Do Not Hold Stock
PO Box 778 Pauls Valley, OK 73075
Alfred Gary
UPL Owner eff. 6/30/2017
Operating Entity
100 W. Paul Avenue Pauls Valley, OK 73075
City of Pauls Valley
NH5538 405-681-53812400 Southwest 55th Street Oklahoma City, OK 73119
Grace Living Center-Southwest O K C
President/Manag.Member of
OP/RE/Manager
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Greiner Don
Lessor Or Real Estate Owner
2200 N.W. 50th 126 Oklahoma City, OK 73112
Capitolcreek, L.L.C.
Contracted Management
4350 Will Rogers Parkway 300 Okc, OK 73108
Amity Care, L.L.C.
78% OP & Amity Care, LLC eff.
10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Don Greiner Trustee Kenneth D.Greiner III Revocable Trust, Don Greiner
Benef/Trustee
Page 96 of 265
Owner NameFacilities Owned
22% OP & Amity Care, LLC
eff.10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Okc, OK 73108
Don Greiner Trust
Secretary
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Okc, OK 73108
Diamond Mike
UPL Mgr. eff. 6/30/2017
Contracted Management
4350 Will Rogers Parkway Oklahoma City, OK 73108
Capitol Hill Nursing Center, L.L.C
UPL Owner eff. 6/30/2017
Operating Entity
100 W. Paul Avenue Pauls Valley, OK 73075
City of Pauls Valley
NH6004 405-372-10001215 West 10th Street Stillwater, OK 74074
Grace Living Center-Stillwater
President/Manag.Member of
OP/RE/Manager
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Greiner Don
Lessor Or Real Estate Owner
2200 N.W. 50th 126 Oklahoma City, OK 73112
Stillgrady, L. L. C.
Contracted Management
4350 Will Rogers Parkway 300 Okc, OK 73108
Amity Care, L.L.C.
78% OP & Amity Care, LLC eff.
10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Don Greiner Trustee Kenneth D.Greiner III Revocable Trust, Don Greiner
Benef/Trustee
22% OP & Amity Care, LLC
eff.10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Okc, OK 73108
Don Greiner Trust
Secretary
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Okc, OK 73108
Diamond Mike
Operating Entity
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Stillwater Nursing Center, L.L.C.
NH1103 918-456-2573614 Cherry Street Tahlequah, OK 74464
Grace Living Center-Tahlequah East Shawnee
President/Manag.Member of
OP/RE/Manager
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Greiner Don
Contracted Management
4350 Will Rogers Parkway 300 Okc, OK 73108
Amity Care, L.L.C.
78% OP & Amity Care, LLC eff.
10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Don Greiner Trustee Kenneth D.Greiner III Revocable Trust, Don Greiner
Benef/Trustee
Page 97 of 265
Owner NameFacilities Owned
22% OP & Amity Care, LLC eff.10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Okc, OK 73108
Don Greiner Trust
Secretary
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Okc, OK 73108
Diamond Mike
Lessor Or Real Estate Owner
2200 N.W. 50th 126 OKC, OK 73112
Reeastshawnee, LLC
Operating Entity
4350 Will Rogers Parkway 300 OKC, OK
East Shawnee Nursing Center, L.L.C.
NH1101 918-456-61811201 North Vinita Avenue Tahlequah, OK 74464
Grace Living Center-Tahlequah University Northwest
President/Manag.Member of
OP/RE/Manager
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Greiner Don
President/Manag.Member of
OP/RE/Manager
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Greiner Don
President/Manag.Member of
OP/RE/Manager
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Greiner Don
Lessor Or Real Estate Owner
2200 N.E. 50th Oklahoma City, OK 73112
Cherhomes, L. L. C.
Contracted Management
4350 Will Rogers Parkway 300 Okc, OK 73108
Amity Care, L.L.C.
78% OP & Amity Care, LLC eff.
10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Don Greiner Trustee Kenneth D.Greiner III Revocable Trust, Don Greiner
Benef/Trustee
22% OP and Amity Care, LLC
eff.10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Okc, OK 73108
Don Greiner Trust
Secretary
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Okc, OK 73108
Diamond Mike
Operating Entity
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
University Northwest Nursing Center, L.L.C.
NH5501 405-427-54141913 Northeast 50th Street Oklahoma City, OK 73111
Grace Living Center-Wildewood
President/Manag.Member of
OP/RE/Manager
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Greiner Don
Page 98 of 265
Owner NameFacilities Owned
40% RE
Stockholders/partners Who Are Officers
4415 Highline Blvd. Oklahoma City, OK 73108
Captains Properties, L.L.C.
60% RE
Stockholders/partners Who Are Officers
P.O. Box 23017 Oklahoma City, OK 73123
Straight Path, L.L.C.
UPL Manager eff 6/30/2017
Manager
4415 Highline Blvd. Oklahoma City, OK 73108
Sooner Geriatrics, L.L.C.
Secretary, ended 6/29/17; Manager-UPL
eff 6/30/17
Managing Member
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Dimond Mike
Contracted Management
4350 Will Rogers Parkway 300 Okc, OK 73108
Amity Care, L.L.C.
78% OP & Amity Care, LLC eff.
10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Don Greiner Trustee Kenneth D.Greiner III Revocable Trust, Don Greiner
Benef/Trustee
22% OP & Amity Care, LLC
eff.10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Okc, OK 73108
Don Greiner Trust
Lessor Or Real Estate Owner
2200 NW 50th Street 126 Okla. City, OK 73112
33 Real Estate, L.L.C.
Chairman/Mayor, City of Pauls Valley, eff
6/30/17
Officers Who Do Not Hold Stock
PO Box 778 Pauls Valley, OK 73075
Alfred Gary
V-Chair/V-Mayor City of Pauls Valley,
eff 6/30/17
Officers Who Do Not Hold Stock
PO Box 778 Pauls Valley, OK 73075
Rushing Jocelyn
Member, City of Pauls Valley, eff 6/30/17
Member
PO Box 778 Pauls Valley, OK 73075
Grimmett Patrick
Member, City of Pauls Valley, eff 6/30/17
Member
PO Box 778 Pauls Valley, Ok 73075
Parrish Michael
Member, City of Pauls Valley, eff 6/30/17
Member
PO Box 778 Pauls Valley, OK 73075
Montgomery Shirley
UPL Owner eff. 6/30/2017
Operating Entity
100 W. Paul Avenue Pauls Valley, OK 73075
City of Pauls Valley
NH5541 405-478-0531505 East Wilshire Blvd Oklahoma City, OK 73105
Grace Living Center-Wilshire & Broadway
President/Manag.Member of
OP/RE/Manager
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Greiner Don
Lessor Or Real Estate Owner
2200 NW 50th 126 Oklahoma City, OK 73112
Wilwood, L.L.C.
Secretary, ended 6/29/17; Manager-UPL
eff 6/30/17
Managing Member
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Dimond Mike
Page 99 of 265
Owner NameFacilities Owned
Contracted Management
4350 Will Rogers Parkway 300 Okc, OK 73108
Amity Care, L.L.C.
78% OP & Amity Care, LLC eff.
10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Don Greiner Trustee Kenneth D.Greiner III Revocable Trust, Don Greiner
Benef/Trustee
22% OP & Amity Care, LLC
eff.10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Okc, OK 73108
Don Greiner Trust
UPL Manager eff 6/30/2017
Manager
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Wilshire Nursing Home, L.L.C.
Chairman/Mayor, City of Pauls Valley, eff
6/30/17
Officers Who Do Not Hold Stock
PO Box 778 Pauls Valley, OK 73075
Alfred Gary
V-Chair/V-Mayor City of Pauls Valley,
eff 6/30/17
Officers Who Do Not Hold Stock
PO Box 778 Pauls Valley, OK 73075
Rushing Jocelyn
Member, City of Pauls Valley, eff 6/30/17
Member
PO Box 778 Pauls Valley, OK 73075
Grimmett Patrick
Member, City of Pauls Valley, eff 6/30/17
Member
PO Box 778 Pauls Valley, Ok 73075
Parrish Michael
Member, City of Pauls Valley, eff 6/30/17
Member
PO Box 778 Pauls Valley, OK 73075
Montgomery Shirley
UPL Owner eff. 6/30/2017
Operating Entity
100 W. Paul Avenue Pauls Valley, OK 73075
City of Pauls Valley
NH7703 580-256-6448429 E Downs Avenue Woodward, OK 73801
Grace Living Center-Woodward
President/Manag.Member of
OP/RE/Manager
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Greiner Don
Lessor Or Real Estate Owner
2200 NW 50th 126 Oklahoma City, OK 73112
Wilwood, L.L.C.
Contracted Management
4350 Will Rogers Parkway 300 Okc, OK 73108
Amity Care, L.L.C.
78% OP & Amity Care, LLC eff.
10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Don Greiner Trustee Kenneth D.Greiner III Revocable Trust, Don Greiner
Benef/Trustee
22% OP & Amity Care, LLC
eff.10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Okc, OK 73108
Don Greiner Trust
Secretary
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Okc, OK 73108
Diamond Mike
Operating Entity
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Woodward Nursing Center, L.L.C.
Page 100 of 265
Owner NameFacilities Owned
NH7229 918-622-34306201 East 36th Street Tulsa, OK 74135
Gracewood Health & Rehab
50% Gracewood Manor, 100%
Gracewood Health eff 10/31/2015
Stockholders/partners Who Are Officers
9 Professional Drive Bella Vista, AR 72715
Montgomery Bradford
RE 100% eff 10/31/2015
Lessor Or Real Estate Owner
9 Professional Drive Bella Vista, AR 72715
Gracewood Manor, LLC
OP eff 10/31/2015
Operating Entity
9 Professional Drive Bella Vista, AR 72715
Gracewood Health & Rehab, LLC
50% of Gracewood Manor, LLC eff
10/31/2015
Stockholders/partners Who Are Officers
9 Professional Drive Bella Vista, AR 72715
Montgomery John
NH0905 405-350-23111110 South Cornwell Drive Yukon, OK 73099
Gran Grans Place
Pres. 24% RE eff 7/1/2010
Stockholders/partners Who Are Officers
P.O. Box 977 Guthrie, OK 73044
Machtolff Gregory E.
Lessor Or Real Estate Owner
P.O. Box 977 Guthrie, OK 73044
GHM ENTERPRISES, INC.
Sec/Treas RE 24%
Stockholders/partners Who Are Officers
P.O. Box 977 Guthrie, OK 73044
Machtolff III George H.
eff 5-22-02
Operating Entity
917 Travertine Circle Yukon, OK 73099
PPG, L.L.C.
50%OpEnt
Stockholders/partners -- Not Officers
917 Travertine Circle Yukon, OK 73099
Lusty David
50%OpEnt
Stockholders/partners -- Not Officers
917 Travertine Circle Yukon, OK 73099
Lusty Nell
RE 25% eff 7/1/2010
Stockholders/partners -- Not Officers
P.O. Box 977 Guthrie, OK
George Machtolff Trust
Vice Pres RE 27% eff 7/1/2010
Stockholders/partners Who Are Officers
P.O. Box 977 Guthrie, OK 73044
Earleen C. Machtolff Revocable Trust
NH2102 918-786-2276103 Har-Ber Road Grove, OK 74345
Grand Lake Villa
Page 101 of 265
Owner NameFacilities Owned
100% of Oak Lake, LLC
Stockholders/partners -- Not Officers
593 Atlanta Street Roswell, GA 30075
Brogdon Connie
Manager of Oak Lake, LLC eff 07/28/11
Officers Who Do Not Hold Stock
3050 Peachtree Rd 355 Atlanta, GA 30305
Brogdon Christopher
Operating Entity
593 Atlanta, GA 30075
Oak Lake, LLC
Eff. 3/1/2014
Contracted Management
Two Buckhead Plaza, 3050 Peachtree Road NW 355 Atlanta, GA 30305
Marsh Pointe Managment, LLC
NH7204 918-428-36003601 North Columbia Tulsa, OK 74110
Green Country Care Center
Pres 33.3%
Stockholders/partners Who Are Officers
P.O. Box 3669 Tulsa, OK 74101
Buford Stephen
V/pres 33.3%
Stockholders/partners Who Are Officers
P.O. Box 3669 Tulsa, OK 74101
Buford Sam
V/pres 33.3%
Stockholders/partners Who Are Officers
P.O. Box 3669 Tulsa, OK 74101
fka Buford Linsenmeyer Sharon B.
eff10-1-1998
Lessor Or Real Estate Owner
P.O. Box 3669 Tulsa, OK 74101
Green Country Care Center, Inc.
Operating Entity
1563 Riverside Drive Tulsa, OK 74119
Court Appointed Receiver, Larry Cain/Phoenix Healthcare, L.L.C.,
NH2404 580-233-01211119 East Owen K Garriott Road Enid, OK 73701
Greenbrier Nursing Home
Operating Entity
,
Greenbrier Nursing Home Number Two, Inc.
34% GBV Enterpries, Inc.
Stockholders/partners -- Not Officers
1902 Mockingbird Lane Enid, OK 73703
Hackett Steven C.
39% GBV Enterprieses, Inc.
Officers Who Do Not Hold Stock
915 Westwood Rd. Enid,, OK 73703
Long Lori D. Hackett
27% GBV Enterprises, Inc.
Stockholders/partners -- Not Officers
1601 Bedford Oklahoma City, OK 73116
Naifeh Dick Alison R. Hackett
100% of Greenbrier Nursing Home
Number, Two eff. 2/20/2011
Stockholders/partners -- Not Officers
1119 E. Owen K. Garriott Road Enid, OK 73701
GBV Enterprises, Inc.
Page 102 of 265
Owner NameFacilities Owned
NH6903 580-658-2319711 South Broadway Marlow, OK 73055
Gregston Nursing Home, Inc.
Operating Entity
711 South Broadway Marlow, OK 73055
Gregston Nursing Home, Inc.
100%
Stockholders/partners -- Not Officers
1603 Timbercreek Dr. Duncan, OK 73533
Gregston Jeff L.
Secretary/Treasurer
,
Gregston Stephanie L.
NH2106 918-786-32231503 West Har-Ber Road Grove, OK 74344
Grove Nursing Center
Pres 33.33%
Stockholders/partners Who Are Officers
P.O. Box 3669 Tulsa, OK 74101
Buford Stephen
33.33%
Stockholders/partners -- Not Officers
P.O. Box 3669 Tulsa, OK 74101
Buford Sam
33.34%
Stockholders/partners -- Not Officers
P.O. Box 3669 Tulsa, OK 74101
fka Buford Linsenmeyer Sharon B.
Lessor Or Real Estate Owner
P. O. Box 3669 Tulsa, OK 74101
Midwest Land And Investment Company
Operating Entity
1563 Riverside Drive Tulsa, OK 74119
Court Appointed Receiver, Larry Cain/Phoenix Healthcare, L.L.C.,
NH5415 918-650-9393203 North 6th Avenue Okemah, OK 74859
Guthrie Place
amended corp. name (fkaProdetik, Inc.)
eff 02-05-08
Operating Entity
P.O. Box 217 Weleetka, OK 74880
The Reach Corporation
Non-profit President The Reach Corp.
Eff 12/07
Officers Who Do Not Hold Stock
P.O. Box 790 Uniontown, KY 42461
Welsh Richard
Non-Profit Board VP of The Reach
Corporation 12/07
Officers Who Do Not Hold Stock
PO Box 790 UnionTown, KY 42461
Bailey M. Geoffry
Non-Profit Board Sec/Treas of The Reach
Corporation 12/07
Officers Who Do Not Hold Stock
PO Box 790 Uniontown, KY 42461
Pyle William "Bill"
authorized agent for The Reach Corp. Eff
12/07
Officers Who Do Not Hold Stock
1201 West Trudgeon Place Henryetta, OK 74437
Bentley Roy
Page 103 of 265
Owner NameFacilities Owned
100% RE
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Maricopa Partners, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Rock River, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
MMB, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Lovenest, LLC
30.959% of Rock River, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gary
32.88% of MMB, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Tim
17.455% MMB, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Vicki
29.421% of Lovenest, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Robert
13.957% of Lovenest, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Laura
53.016% of Rock River, LLC - 4 children
w/13.254% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
4 Irrevocable Trusts
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O.Box 409 Sturgis, KY 42459
Ervin Mallory
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Jade
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Luke
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gabe
49.665% of MMB, LLC - 5 children
w/9.933% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
3 Irrevocable Trusts
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Max
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box Sturgis, KY 42459
Linenger Jessica
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mitch
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Linenger Jennifer
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Brock
Page 104 of 265
Owner NameFacilities Owned
56.623% of Lovenest, LLC - 7 children
w/8.089% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
7 Irrevocable Trusts
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Thea
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugris, KY 42459
Ervin Issac
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugis, KY 42459
Ervin Samuel
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Elijah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Saul
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Micah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mathias
NH5551 405-454-62552400 Whites Meadow Drive Harrah, OK 73045
Harrah Nursing Center
100%Harrah Whites Meadows
Nursing&Marsh Pointe Man eff 09/19/14
Stockholders/partners Who Are Officers
3050 Peachtree Rd 355 Atlanta, GA 30305
Brogdon Christopher
eff 07/31/2013
Operating Entity
Two Buckhead Plaza, 3050 Peachtree Road NW 355 Atlanta, GA 30305
Harrah Whites Meadows Nursing, LLC
Lessor Or Real Estate Owner
Two Buckhead Plaza 3050 Atlanta, GA 30305
Harrah Property Holdings,LLC
Eff March 1, 2014
Contracted Management
Two Buckhead Plaza, 3050 Peachtree Road NW 355 Atlanta, GA 30305
Marsh Pointe Managment, LLC
NH5104 918-482-3310405 North Choctaw Haskell, OK 74436
Haskell Care Center
100% mng member
Stockholders/partners Who Are Officers
PO Box 2 Holdenville, OK 74848
Humphreys Doug
100% of opera
Stockholders/partners -- Not Officers
3218 North 372 Holdenville, OK 74848
Alpha Care Properties, L.L.C.
Operating Entity
PO Box 1319 Haskell, OK 74436
Haskell Care Center, L.L.C.
Page 105 of 265
Owner NameFacilities Owned
NH3102 918-967-33811402 Northwest 7th Street Stigler, OK 74462
Haskell County Nursing Center, Inc.
100%
Stockholders/partners Who Are Officers
P.O. Box 707 Sallisaw, OK 74955
Stites Edmund E.
Operating Entity
PO Box 707 Sallisaw, OK 74955
Haskell County Nursing Center, Inc.
NH5301 918-273-2002312 South Mississippi Nowata, OK 74048
Hays House
9.61494% Oklahoma Nursing Home, Ltd,
Manager Eff 4/25/2016
Contracted Management
210 E. Choctaw, P.O. Box 429 Sallisaw, OK 74955-0429
Oklahoma Nursing Homes, Ltd. (ONH,Ltd.)
2.121569% OP/ 2.14% RE
Stockholders/partners -- Not Officers
P.O. Box 435 Vian, OK 74962
Armstrong Estate, Sally Armstrong, Executor James
8.314% OP & Mgr./ 8.4112% RE/
9.0401287% Okla. Nurs. Homes, Inc.
Stockholders/partners -- Not Officers
P.O. Box 40 Sallisaw, OK 74955
Cheek Barnie J.
1.838339% OP/ 1.86% RE
Stockholders/partners -- Not Officers
10105 S. 77th East Place Tulsa, OK 74133
Masako Cheek Trust, Masako Cheek Trustee
8.314% OP & Mgmt. / 8.4112% RE
Stockholders/partners -- Not Officers
3520 East 110th Place Tulsa, OK 74137
Sandra Cheek Farmer Trust (SCFT)
5.834% OP&Mgnt/5.9190% mgr RE
&6.597394% Sec of Ok.Nrs.Hms,Inc.
Stockholders/partners Who Are Officers
4814 S. 164th East Ave. Tulsa, OK 74134
Haskins Lloyd
5.192% OP & Mgmt./5.9746%
RE/12.535047%
OkNrs.Hms,Inc.eff5/24/12
Stockholders/partners -- Not Officers
51 green acre village #51 Sallisaw, OK 74955
Watts Cleo
5.893% OP & Mgmt. / 5.9746% RE
Stockholders/partners -- Not Officers
51 Green Acre Village Sallisaw, OK 74955
Watts Beneficiaries Trust (WBT)
5.612090% OP/ 5.67% RE
Stockholders/partners -- Not Officers
20852 S. Shannon Dr. Claremore, OK 74017
William McKesson Wilson Sr. 1997 Trust
14.022% OP&Mgmt/14.2078%
RE21.936335% OkNrs.Hms,Inc.VP
Stockholders/partners Who Are Officers
Box 856 Miami, OK 74355
Tubbs Steven
5.376% OP & Mgmt. / 5.4406% RE
Stockholders/partners -- Not Officers
3910 Cherry Forest Drive Houston, TX 77088
Tubbs, Jr. Stanley I.
2.771% OP & Mgmt. / 2.8038% RE
Stockholders/partners -- Not Officers
P.O. Box 435 Vian, OK 74962
Armstrong-Leutz Joyce
Page 106 of 265
Owner NameFacilities Owned
5.542% OP & Mgr./ 5.6186%
RE/6.267525% Ok Nrs
Hms,Inc.eff5/24/12
Stockholders/partners -- Not Officers
416 Fairway Dr. Athens, TX 75751
Estep Pat
2.771% OP & Mgmt. / 2.8037% RE
Stockholders/partners -- Not Officers
1500 West Elm Stroud, OK 74079
Julie Kay Bivin Revocable Trust (JKBRT)
5.135% OP/MANAGEMENT/ RE
7.2207% EFF 05/24/2012
Stockholders/partners -- Not Officers
6708 South 256th East Avenue Broken Arrow, OK 74014
Caroyln D. Leaverton Revocable Trust
2.771% OP & Mgmt./ 2.8037% RE &
8.309038% Okla.Nurs.Homes,Inc.
Stockholders/partners -- Not Officers
PO Box 370 Adair, OK 74330
Dr. William R. VanDeLinder Trust (DWVT)
2.771% OP & Mgmt. / 2.8037% RE
Stockholders/partners -- Not Officers
3808 NW Marquess Drive Bentonville, AR 72712
Lynn M. Yowell Trust
9.7298% EFF 05/24/2012
Lessor Or Real Estate Owner
210 East Choctaw Sallisaw, OK 74955
Midwest Nursing Homes, LLC (MNHLLC)
2.771% OP & Mgmt. / 2.8038% RE
Stockholders/partners -- Not Officers
2802 West Country Club Drive Oklahoma City, OK 73116
Richard Armstrong Trust (RAT)
9.61494 OP & MGMT
Operating Entity
P.O. Box 400 Sallisaw, OK 74955
Hays House, LLC
1.219% mgr OP & Mgmt. EFF
05/24/2012
Stockholders/partners -- Not Officers
P.O. Box 400 Sallisaw, OK 74955
Oklahoma Nursing Homes, Inc. General Partner (ONH,Inc)
9.401287% Oklahoma Nursing Homes,
Inc. EFF 05/24/2012
Stockholders/partners -- Not Officers
2802 W. Country Club Dr. Oklahoma City, OK 73116
Armstrong Richard James
8.4112 RE &9.401287% Oklahoma
Nursing Homes, Inc.eff 4/25/2016
Stockholders/partners -- Not Officers
3520 East 110th Place Tulsa, OK 74137
Farmer Sandra
1.283% OP&Mgmt./ 1.3156%
RE/9.401287%
Ok.Nurs.Hms,Inc.eff5/24/12
Stockholders/partners -- Not Officers
20852 South Shannon Drive Claremore, OK 74017
Wilson James G.
2.1028%RE/2.07900%OP
Stockholders/partners -- Not Officers
P.O. Box 173 Gore, OK 74435
Ferguson Debra M.
5.5630%RE/5.55600%OP/5.657265% ok
nr hm,inc EFF 05/24/2012 Treas
Stockholders/partners Who Are Officers
607 Mayo Street Sallisaw, OK 74955
McGrew Justin
2.771% OP & Mgmt/ 2.8038% RE
Stockholders/partners -- Not Officers
HCR 68 Box 1260 Vian, OK 74962
Armstrong Sally
9.401287% Ok Nrs Hms,Inc.
EFF05/24/12 Pres Trustee DWRVL
Trust
Officers Who Do Not Hold Stock
PO Box 370 Adair, OK 74330
VanDeLinder Dr. William R.
.70095%RE/.69275%OP&MGMT
Stockholders/partners -- Not Officers
1405 E. Seattle St. Broken Arrow, OK 74012
Heath Armstrong VanDeLinder Trust (HAVT)
.70095%RE/.69275%OP&MGMT EFF
4/25/2016
Stockholders/partners -- Not Officers
2812 West 114th Street Jenks, OK 74037
Meredith Margaret Marie VanDeLinder Trust (MMMVT)
Page 107 of 265
Owner NameFacilities Owned
.070095%RE/.69275%OP&MGMT
Stockholders/partners -- Not Officers
8 Dinton Circle Bella Vista, AR 72714
Nicolas Edmund VanDeLinder Trust (NEVT)
.70095%RE/069275%OP&MGMT EFF
4/25/2016
Stockholders/partners -- Not Officers
2116 Whitney Lane McKinney, TX 75070
William Glen VanDelinder Trust (WGVT)
Julie Kay Bivin Revocable Trust
Trustee
1500 West Elm Stroud, OK 74079
Bivin Julie K.
2.77100%OP 2.8038 RE edd 4/25/2016
Stockholders/partners -- Not Officers
2802 W. Country Club Dr. Oklahoma City, OK 73116
Richard Glen Armstrong Trust (RGAT)
Succ.Trustee & Benf-Carolyn D.
Leaverton Rev. Trust eff 05/24/12
Beneficiary
6708 South 256th East Ave Broken Arrow, OK 74014
Johnson Karen Diane
Succ.Trustee & Benf-Carolyn D.
Leaverton Rev. Trust eff 05/24/12
Beneficiary
6708 South 256th East Ave Broken Arrow, OK 74014
Fine Michael B.
Successor Trustee & Beneficiary -WBT
eff 5/24/12
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Byers Karen
Beneficiary - SCFT eff 5/24/12
Beneficiary
3520 East 110th Place Tulsa, OK 74137
Farmer Cassandra C.
Beneficiary - SCFT eff 5/24/12
Beneficiary
3520 East 110th Place Tulsa, OK 74137
Farmer Alexandra C.
MMMV Trust
Beneficiary
2812 West 114th St. south Jenks, ok 74037
Leutz William K.
Dr. WIlliam R. VanDeLinder Trust
Trustee
P.O. Box 370 Adair, ok 74330
VanDeLinder Dr. William R.
Lynn M. Yowell Trust eff- 11/27/2013
Trustee
3808 NW Marquess Drive Bentonville, AR 72712
Yowell Lynn
Lynn M. Yowell Trust eff- 11/27/2013
Trustee
3808 NW Marquess Drive Bentonville,, AR 72712
Yowell Ron
Beneficiary MMMV Trust
Beneficiary
2812 West 114th Street South Jenks, OK 74037
VanDeLinder Meredith Margaret Marie
Trustee & Benef WGV Trust Beneficary
DWRV Trust
Trustee
6260 Dark Forest Drive McKinney, TX 75070
VanDelinder William Glen
Beneficiary Julie Kay Biven Revocable
Trust
Beneficiary
1500 West Elm Stroud, OK 74079
Bivin Jeremy
Beneficiary Julie Kay Biven Revocable
Trust
Beneficiary
1500 West Elm Stroud, OK 74049
Bivin Ryan
NH1802 918-256-87681200 West Canadian Vinita, OK 74301
Heartsworth Center for Nursing and Rehabilitation
Page 108 of 265
Owner NameFacilities Owned
100% Vinita Holdgs,LLC/Heartsworth
Senior Lvng, EFF 03/01/2013
Stockholders/partners -- Not Officers
P.O. Box 990 Edmond, OK 73083
LEP Holdings, LLC
99% LEP Holdings, LLC EFF 03/01/2013
Stockholders/partners -- Not Officers
P.O. Box 990 Edmond, OK 73083
Pilgrim Lee E.
1% of LEP Holdings,LLC/1% LEP
Holdgs, LLC EFF 03/01/2013
Stockholders/partners -- Not Officers
P.O. Box 990 Edmond, OK 73083
LEP Senior Properties, Inc.
Lessor Or Real Estate Owner
P.O. Box 990 Edmond, OK 73083
Vinita Holdings, LLC
OP EFF 03/01/2013
Operating Entity
P.O. Box 990 Edmond, OK 73083
Heartsworth Senior Living, LLC
NH4007 918-653-2472204 West First Street - Heavener, OK 74937
Heavener Manor ffka Vista Nursing Home
EFF 1-1-2015
Operating Entity
9 Professional Drvie Bella Vista, AR 72715
Heavener Manor, LLC
100% OP Managing Member
Stockholders/partners -- Not Officers
9 Professional Drive Bella Vista, AR 72715
Montgomery Bradford
NH4001 918-653-2464114 West 2nd Street Heavener, OK 74937
Heavener Nursing & Rehab
eff 3/31/2014
Operating Entity
9 Professional Drvie Bella Vista, AR 72715
Heavener Manor, LLC
100%
Stockholders/partners -- Not Officers
9 Professional Drive Bella Vista, AR 72715
Montgomery Bradford
NH3703 405-769-5535705 East 3rd Street Hennessey, OK 73742
Hennessey Manor Nursing Home
Operating Entity
110 West Muskogee Sulphur, OK 73086
Hennessey Manor Nursing Home, Inc.
100% & Managing Member of
Interhealth, LLC eff 02/17/2017
Stockholders/partners -- Not Officers
9 Professional Drive Bella Vista, AR 72715
Montgomery Bradford
95% Trinkik Holdings, LLC eff 7/1/2016
Stockholders/partners -- Not Officers
P.O. Box 130 Newport, AR 72112
Niksefat Saeed Sy
Page 109 of 265
Owner NameFacilities Owned
5% Trinkik Holdings, LLC eff 7/1/2016
Stockholders/partners -- Not Officers
P.O. Box 130 Newport, AR 72112
Niksefat Sharona
100% Real Estate eff 07/01/2016
Lessor Or Real Estate Owner
P.O. Box 130 Newport, AR 72112
Trinik Holdings, LLC
Receiver CJ-2016-3346 of OP eff
01/25/2017
Court Appointed Receiver
419886 East 1080 Road Checotah, OK 74426
Cockrell Travis
Contracted Management eff 02/17/2017
Contracted Management
9 Professional Drive Bella Vista, AR 72715
Interhealth, LLC
NH5602 918-652-8797212 North Antes Henryetta, OK 74437
Henryetta Community Skilled Healthcare & Rehab
Manager of RE EFF 6/1/2016
Officers Who Do Not Hold Stock
P.O. Box 488 Weleetka, OK 74880
Adkins Gerrol Dean
Manager of RE EFF 6/1/2016
Officers Who Do Not Hold Stock
P.O. Box 488 Weleetka, OK 74880
Adkins Arbret June
33% MG member of OP/ Management
Stockholders/partners Who Are Officers
Rt. 1, Box 105C Weleetka, OK 74880
Cynthia Denise Majors Revocable Trust
33% Mng member OP/Management
Stockholders/partners Who Are Officers
Rt. 1, Box 114 Weleetka, ok 74880
Donna Renee Simmons Revocable Trust
Manager of OP/Management
Officers Who Do Not Hold Stock
319 West 9th St. Weleetka, OK 74880
Majors Cynthia
Manager of OP/Management
Officers Who Do Not Hold Stock
319 West 9th St Weleetka, OK 74880
Simmons Donna Renee
100% sole member RE
Stockholders/partners -- Not Officers
P.O. Box 488 Weleetka, OK 74880
Gerrol Dean Adkins & Arbret June Adkins Family Trust (GDA/AJA)
1% of MNGR EFF 6/1/2016
Contracted Management
319 West 9th Street Weleetka, OK 74880
True North Healthcare Managment, LLC
EFF 6/1/2016
Lessor Or Real Estate Owner
319 West 9th St Weleetka, OK 74880
Adkins Holdings, LLC
1 % of OP EFF 6/1/2016
Operating Entity
319 West 9th St Weleetka, OK 74880
Henryetta Community Skilled Healthcare & Rehab, LLC
33% Managing Member OP/Managment
Stockholders/partners Who Are Officers
319 West 9th Street Weleetka, OK 74880
The Charles Edward Simmons Revocable trust dated April 1 2015
Manager of OP/Management
Officers Who Do Not Hold Stock
319 West 9th St. Weleetka, OK 74880
Simmons Charles
Page 110 of 265
Owner NameFacilities Owned
NH0502 580-928-2494Highway 152, Box 465 Sayre, OK 73662
Hensley Nursing Home
Lessor Or Real Estate Owner
,
Canadian State Bank
Operating Entity
1/4 M E of Chon 152 Sayre, OK 73533
Sayre Health Care, Inc.
50% Sec/Treas
Stockholders/partners Who Are Officers
2400 W. Camelback Duncan, OK 73553
Wilkins Tony
50% Pres
Stockholders/partners Who Are Officers
3434 S.E. Kentucky Place Bartlesville, OK 74006
Brown Jim
NH6105 918-423-2920411 North West Street McAlester, OK 74502
Heritage Hills Living & Rehabilitation Center
President of Heritage Hills NC & Trustee
of 1996 Rev Trust C Har
Officers Who Do Not Hold Stock
,
Charles F. Hardy, Iii, And Patricia J. Hardy
Operating Entity
411 N. West Street McAlester, ok 74502
Heritage Hills Nursing Center, Inc.
Lessor Or Real Estate Owner
5252 E. 11th Pl. Tulsa, OK 74137
Heritage Hills Nursing Properties LLC
51% OP/RE Charles F. Hardy III &
Patricia J. Hardy, Indep Co-Tru
Trustee
5252 E 114th Place Tulsa, Ok 74137
1996 Revocable Trust of Patricia J. Hardy
49% OP/RE VP/Sec
Stockholders/partners Who Are Officers
5252 East 114th Place Tulsa, OK 74137
1996 Revocable Trust of Charles F. Hardy III
NH5522 405-789-71033804 North Barr Oklahoma City, OK 73122
Heritage Manor
33.66% Lim Partner Eff 07/01/10
Lessor Or Real Estate Owner
1029 Mockingbird Lane Guthrie, OK 73044
Machtolff Earleen
31.67% Lim Partner, 33.3% press GMGP
Eff 07/01/10
Lessor Or Real Estate Owner
P.O. Box 977 Guthrie, OK 73044
Machtolff Gregory E.
6.91% Lim Partner; 33.3% Sec/Treas
GMGP Eff 070110
Lessor Or Real Estate Owner
P.O. Box 977 Guthrie, OK 73044
Machtolff III George H.
100% Op & President eff 06/07/2016
Stockholders/partners Who Are Officers
3714 N. Portland Oklahoma City, OK 73112
Crane Judy M.
Page 111 of 265
Owner NameFacilities Owned
LP eff 07/01/10
Lessor Or Real Estate Owner
221 East Cleveland Guthrie, OK 73044
Westview Living Centers, LP
1.00% Lim partner Eff 070110
Lessor Or Real Estate Owner
221 East Cleveland Guthrie, OK 73044
Machtolff Helen
1.00% Lim partner Eff 070110
Lessor Or Real Estate Owner
221 East Cleveland Guthrie, OK 73044
Machtolff Marty
Operating Entity
3714 N. Portland Oklahoma City, OK 73112
Crane Younge and Associates, Inc.
33.3% VicePress GMGP eff 070110
Lessor Or Real Estate Owner
P.O. Box 977 Guthrie, OK 73044
Earleen C. Machtolff Irrevocable Trust
NH5509 405-942-38846912 Northwest 23rd Street Bethany, OK 73008
Heritage Park
33.66% Lim partner Eff 070110
Lessor Or Real Estate Owner
1029 Mockingbird Lane Guthrie, OK 73044
Machtolff Earleen
31.67% Lim Partner; 33.3% Press GMGP
Eff 070110
Lessor Or Real Estate Owner
P.O. Box 977 Guthrie, OK 73044
Machtolff Gregory E.
31.67% Lim Partner; 33.3% Sec/Treas
GMGP Eff 070110
Lessor Or Real Estate Owner
P.O. Box 977 Guthrie, OK 73044
Machtolff III George H.
100%-President eff. 06/07/2016
Stockholders/partners Who Are Officers
3714 N. Portland Oklahoma City, OK 73112
Crane Judy M.
Lessor Or Real Estate Owner
221 East Cleveland Guthrie, OK 73044
Westview Living Centers, LP
1.00% Lim Partner Eff 070110
Lessor Or Real Estate Owner
221 East Cleveland Guthrie, OK 73044
Machtolff Helen
1.00% Lim Partner Eff 070110
Lessor Or Real Estate Owner
221 East Cleveland Guthrie, OK 73044
Machtolff Marty
Operating Entity
3714 North Porland Oklahoma City, Ok 73112
C and Y Management Company, Inc
33.3% VicePress GMGP Eff 070110
Lessor Or Real Estate Owner
P.O. Box 977 Guthrie, OK 73044
Earleen C. Machtolff Irrevocable Trust
NH7405 918-335-32221244 Woodland Loop Bartlesville, OK 74006
Heritage Villa Nursing Center
50% Arbor Springs of Oklahoma, LLC
Stockholders/partners -- Not Officers
8500 West 110th Street 510 Overland Park, KS 662010
Wurth David
Page 112 of 265
Owner NameFacilities Owned
50% Arbor Springs of Oklahoma, LLC
Stockholders/partners -- Not Officers
8500 West 110th Street 510 Overland Park, KS 66210
Wurth Charles
Real Estate Owner 05/01/2015
Lessor Or Real Estate Owner
1633 North Campbell Avenue Chicago, IL 60647
BHCP Heritage Villa Real Co, LLC
OP eff 05/01/2015
Operating Entity
1633 North Campbell Avenue Chicago, IL 60647
BHCP Heritage Villa OP Co, LLC
Contracted Management Company eff
05/01/2015
Contracted Management
8400 West 110th Street 230 Overland Park, KS 66210
Arbor Springs of Oklahoma, LLC
100% BHCP Heritage Villa Real Co &
BHCP Heritage Villa OP
Stockholders/partners -- Not Officers
1633 North Campbell Ave Chicago, IL 60647
BHCP Heritage Villa Hold Co, LLC
5% BHCP Heritage Villa Hold Co, LLC
Stockholders/partners -- Not Officers
1633 North Campbell Avenue Chicago, IL 60647
BHCP Heritage Villa Sponsor, LLC
Manager of BHCP Heritage Villa Hold
Co, LLC
Manager
1633 North Campbell Avenue Chicago, IL 60647
BHCP Heritage Villa Manager, LLC
95% BHCP Heritage Villa Hold Co, LLC
Stockholders/partners -- Not Officers
1633 North Campbell Avenue Chicago, IL 60647
BHCP Heritage Villa Investors, LLC
95% of BHCP Heritage Villa Sponsor,
LLC
Stockholders/partners -- Not Officers
1633 North Campbell Avenue Chicago, IL 60647
Birchwood Health Care Properties, LLC
5% BHCP Heritage Villa Sponsor, LLC
Stockholders/partners -- Not Officers
1633 North Campbell Avenue Chicago, IL 60647
Rothbart Jeff
100% Member/Manager Birchwood
Healthcare, LLC
Stockholders/partners -- Not Officers
1633 North Campbell Avenue Chicago, IL 60647
Dole Isaac
NH3205 405-786-2266801 Highway 48 North Holdenville, OK 74848
Heritage Village Nursing Home
Pres. of RE & Bene. & Trus of G D & A
J Adkins Fam Tr.
Trustee
P.O. Box 488 Weleetka, OK 74880
Adkins Gerrol Dean
Sec. of RE & Bene. Gerrol D Adkins and
Arbret J Adkins Fam Trust
Officers Who Do Not Hold Stock
P.O. Box 488 Weleetka, OK 74880
Adkins Arbret June
effective 7/1/87
Lessor Or Real Estate Owner
Rt. 1 Box 54 Holdenville, OK 74848
Holdenville Nursing Home Inc.
Beneficiary of Cynthia Denise Majors
Irrevocable Tr. eff12/31/12
Trustee
319 West 9th St. Weleetka, OK 74880
Majors Cynthia
Beneficiary of Donna Renee Simmons
Irrevocable Tr. eff 12/31/12
Trustee
319 West 9th St Weleetka, OK 74880
Simmons Donna Renee
Trustee Adkins, II Gerrol D.
Page 113 of 265
Owner NameFacilities Owned
Beneficiary Gerrol Dean Adkins II
Irrevocable Trust eff.12/31/12Rt. 1, Box 121A Weleetka, OK 74880
52%of RE eff 12/31/12
Stockholders/partners -- Not Officers
P.O. Box 488 Weleetka, OK 74880
Gerrol Dean Adkins & Arbret June Adkins Family Trust (GDA/AJA)
eff 1-1-07
Operating Entity
801 HWY 48 Holdenville, OK 74848
Heritage Village Nursing Center, LLC
100% OP manag.member
Stockholders/partners -- Not Officers
P.O. Box 488 Weleetka, OK 74880
Heritage Village Nursing Center Revocable Business Trust
16% RE eff 12/31/12
Stockholders/partners -- Not Officers
Rt 1 Box 121A Weleetka, OK 74880
Gerrol Dean Adkins II Irrevocable Trust dated 12/28/12
16% RE eff 12/31/12
Stockholders/partners -- Not Officers
Rt 1 Box 121A Weleekta, OK 74880
Cynthia Denise Majors Irrevocable Trust dated 12/28/12
16% RE eff 12/31/12
Stockholders/partners -- Not Officers
Rt 1 Box 121A Weleetka, OK 74880
Donna Renee Simmons Irrevocable Trust dated 12/28/12
CMajors Ir.Tr, Gerrol II and DSimmons
Ir.Tr GDA/AJA Fam Trust.
Trustee
523 W. Main Henryetta, OK 74437
Palmer, C.P.A. Reginald
NH5806 918-674-2233407 Whitebird Avenue Quapaw, OK 74363
Higher Call Nursing Center
President /Trus
Officers Who Do Not Hold Stock
P.O. Box 918 Miami, OK 74355
Chirillo Gordon
V-Pres/trus
Officers Who Do Not Hold Stock
P.O. Box 918 Miami, OK 74355
Wright Terry L.
eff 1-17-03
Operating Entity
P.O. Box 918 Miami, OK 74355
Higher Call Nursing Center, Inc.
Vice President/Treasurer 02/2014
Officers Who Do Not Hold Stock
P.O. Box 918 Miami, OK 74355
Harting-Henn Karen
NH5604 918-756-56111307 R D Miller Drive Okmulgee, OK 74447
Highland Park Health Care
Trustee Denver McCormick Revocale
Trust
Trustee
9813 S. Penn OKC, OK 73159
McCormick Denver
Trustee Denver McCormick Revocale
Trust
Trustee
9813 S. Penn OKC, OK 73159
McCormick Denver
Trustee Arlena Dunbar Revocable Trust
Trustee
5413 NW 107th Street Oklahoma City, OK 73162
Dunbar Arlena
Page 114 of 265
Owner NameFacilities Owned
Trustee Arlena Dunbar Revocable Trust
Trustee
5413 NW 107th Street Oklahoma City, OK 73162
Dunbar Arlena
Real Estate EFF 6/30/2017
Lessor Or Real Estate Owner
9813 South Penn Oklahoma City, OK 73159
Okmulgee Health Care, L.L.C.
33.4% RE
Stockholders/partners -- Not Officers
9813 S. Penn Oklahoma City, OK 73159
Denver McCormick Revocable Trust
33.3% RE
Stockholders/partners -- Not Officers
9813 S. Penn Oklahoma City, OK 73159
Linda McCormick Revocable Trust
33.3% RE
Stockholders/partners -- Not Officers
5413 N.W. 107th Okla. City, OK 73162
Arlena Dunbar Revocable Trust
Beneficiary of Linda & Denver
McCormicks Revocable Trusts
Beneficiary
4108 Opus Ct. Flower Mound, TX 75022
Pennington Amy
Beneficiary of Linda & Denver
McCormicks Revocable Trusts
Beneficiary
2433 Glenoak Dr. Norman, OK 73071
Petrone Alison
Beneficiary of Linda & Denver
McCormicks Revocable Trusts
Beneficiary
8594 D East 133 Holdenville, OK 74850
Jones Joshua
Beneficiary of Linda & Denver
McCormicks Revocable Trusts
Beneficiary
8594 D East 133 Holdenville, OK 74850
Jones Tanner
Beneficiary of Arlena Dunbar Revocable
Trust
Beneficiary
5413 NW 107th Okla. City, OK 73159
Dunbar William
Beneficiary of Arlena Dunbar Revocable
Trust
Beneficiary
5413 NW 107th Okla. City, OK 73159
Dunbar William
Beneficiary of Arlena Dunbar Revocable
Trust
Beneficiary
12204 N. Kimberlyn Rd. Okla. City, OK 73162
Dunbar Teresa
Subcontracted Manager Eff 6/30/2017
Contracted Management
1500 Waters Ridge Drive 200 Lewisville, TX 75057
Stonegate Senior Living, LLC
Beneficiary of Arlenea Dunbar Revocable
Trust
Beneficiary
3913 Spyglass Road Okla. City, OK 73167
Nard Charlotte
UPL Owner eff. 6/30/2017
Operating Entity
100 W. Paul Avenue Pauls Valley, OK 73075
City of Pauls Valley
UPL Manager Eff 6/30/2017
Contracted Management
,
HPM SNF Operations, LLC (HPM)
NH4502 580-286-5398808 Northwest M L King Avenue Idabel, OK 74745
Hill Nursing Home, Inc.
Operating Entity
808 N.W. 1st Street Idabel, OK 74745
Hill Nursing Home, Inc.
Page 115 of 265
Owner NameFacilities Owned
100% of Hill Nursing Home, Inc.
President Eff 2012
Stockholders/partners Who Are Officers
P.O. Box 687 Idabel, OK 74745
Hill G. Joy
50% (RE) Abbris Properties II, LLC eff
10/27/2016
Stockholders/partners -- Not Officers
P.O. Box 70 Hydro, OK 73048
Abbott Cody
NH3604 580-363-32441210 South 6th Street Blackwell, OK 74631
Hillcrest Manor
33.3% mem
Stockholders/partners Who Are Officers
PO Box 367 Billings, OK 74630
Hardin Kelly
50% RE mem. Eff. 04/03/2015
Stockholders/partners Who Are Officers
3216 Shiloh Creek Stillwater, OK 74074
Young Jeffrey
50% RE mem. Eff. 04/03/2015
Stockholders/partners Who Are Officers
46487 E. 1040 Rd. Sallisaw, OK 74955
Rhodes Johnathan Grant
Operating Entity
6116 s. MEMORIAL DR TULSA, OK 74133
Bedlam Properties, L.L.C.
Lessor Or Real Estate Owner
6116 S. Memorial Dr. Tulsa, Ok 74113
Black Diamond Investments, L.L.C.
CEO of OP eff. 03-23-10
Officers Who Do Not Hold Stock
9017 N. Yale Ave Sperry, OK 74073
Lietzke Mark
NH1402 405-794-24282120 North Broadway Moore, OK 73160
Hillcrest Nursing Center
100% of Gary Crest, LLC eff 01/11/2016
Stockholders/partners Who Are Officers
4921 Haley Lane Stillwater, OK 74074
Smart Gary
100% of BK Strategies Real Estate, LLC
Stockholders/partners -- Not Officers
131 North Broadway Ada, OK 74820
Reed Bart
100% Moore Hillcrest Real Estate, LLC
eff 01/11/2016
Stockholders/partners -- Not Officers
131 North Broadway Ada, OK 74820
BK Strategies Real Estate, LLC
100% RE eff 01/11/2015
Lessor Or Real Estate Owner
131 North Broadway Ada, OK 74820
Moore Hillcrest Real Estate, LLC
UPL Manager Eff 6/30/2017
Contracted Management
4921 Haley Lane Stillwater, OK 74074
Gary Crest, LLC
UPL Owner eff. 6/30/2017
Operating Entity
100 W. Paul Avenue Pauls Valley, OK 73075
City of Pauls Valley
Page 116 of 265
Owner NameFacilities Owned
NH3803 580-726-3381709 North Lowe Hobart, OK 73651
Hobart Nursing & Rehab
100% of Hobart Manor & Hobart Nursing
& Rehab eff 01/09/2015
Stockholders/partners -- Not Officers
9 Professional Drive Bella Vista, AR 72715
Montgomery Bradford
100% of the Real Estate eff 01/09/2015
Lessor Or Real Estate Owner
9 Professional Drive Bella Vista, AR 72715
Hobart Manor, LLC
OP eff 01/09/2015
Operating Entity
9 Professional Drive Bella Vista, AR 72715
Hobart Nursing & Rehab, LLC
NH1403 405-321-7932301 East Dale Norman, OK 73069
Holiday Heights Nursing Home
100% Real Estate eff 07/29/2016
Lessor Or Real Estate Owner
1413 North Crewford Norman, OK 73069
Simmons Real Estate, LLC
OP eff 07/29/2016
Operating Entity
1413 North Crawford Norman, OK 73069
Holiday Heights, LLC
100% Simmons RE & Holiday Heights
eff 10-31-2016
Stockholders/partners -- Not Officers
115 South Peters Ave 6 Norman, OK 73069
Estate of Bob Simmons, Personal Representative Zachary Simmons
Manager of Holiday Heights eff
12-28-2016
Officers Who Do Not Hold Stock
115 South Peters Ave 6 Norman, OK 73069
Simmons Zachary
NH1808 918-256-4958104 South Foreman Vinita, OK 74301
Home of Hope Foreman House
Director
Officers Who Do Not Hold Stock
6122 E. 107th St. Tulsa, OK 74137
Willis James A.
Operating Entity
900 Hope Avenue Vinita, OK 74301
Home Of Hope, Inc.
VP Operations
Officers Who Do Not Hold Stock
1005 West Canadian Vinita, OK 74301
Hartley Jot
Director
Officers Who Do Not Hold Stock
5924 Flagstaff Wichita, KS 67220
Harney Jerry
Treasurer
Officers Who Do Not Hold Stock
332 N. Scraper Vinita, OK 74301
Luginbuel Jack
VP P&D
Officers Who Do Not Hold Stock
319 E. Illinois Vinita, OK 74301
Patrick Dennis
Page 117 of 265
Owner NameFacilities Owned
VP P&D
Officers Who Do Not Hold Stock
319 E. Illinois Vinita, OK 74301
Patrick Dennis
Secretary
Officers Who Do Not Hold Stock
450500 Happy Hollow Dr. Afton, OK 74331
Cupp Gary
Director
Officers Who Do Not Hold Stock
106 Lakeview Drive Vinita, OK 74301
Dalquest Len
Director
Officers Who Do Not Hold Stock
100 N. Broadway 1500 Oklahoma City, OK 73102
Hager Don
Director
Officers Who Do Not Hold Stock
310 South Scraper Vinita, OK 74301
Hartley Robert(Bob)
President
Officers Who Do Not Hold Stock
PO Box 160 Langley, OK 74350
Sellers Jim
Director
Officers Who Do Not Hold Stock
3507 E. 66th Place Tulsa, OK 74136
Lynch Robert
Director
Officers Who Do Not Hold Stock
229 S. Smith St. Vinita, OK 74301
Montana Jo
Director eff 2014
Officers Who Do Not Hold Stock
20 East 5th St. 200 Tulsa, OK 74103
Frizzell Blaine
CEO eff 2014
Officers Who Do Not Hold Stock
3205 Par Ct Claremore, OK 74019
Home Of Home, Inc. Richardson Ralph
NH1807 918-256-7825420 North Brewer Vinita, OK 74301
Home of Hope Brewer House
Director eff 5-23-14
Officers Who Do Not Hold Stock
6122 E. 107th St. Tulsa, OK 74137
Willis James A.
Operating Entity
900 Hope Avenue Vinita, OK 74301
Home Of Hope, Inc.
VP Operations
Officers Who Do Not Hold Stock
1005 West Canadian Vinita, OK 74301
Hartley Jot
Director
Officers Who Do Not Hold Stock
5924 Flagstaff Wichita, KS 67220
Harney Jerry
treasurer
Officers Who Do Not Hold Stock
332 N. Scraper Vinita, OK 74301
Luginbuel Jack
VP P&D
Officers Who Do Not Hold Stock
319 E. Illinois Vinita, OK 74301
Patrick Dennis
Secretary
Officers Who Do Not Hold Stock
450500 Happy Hollow Dr. Afton, OK 74331
Cupp Gary
Page 118 of 265
Owner NameFacilities Owned
Director
Officers Who Do Not Hold Stock
106 Lakeview Drive Vinita, OK 74301
Dalquest Len
Director
Officers Who Do Not Hold Stock
100 N. Broadway 1500 Oklahoma City, OK 73102
Hager Don
Director
Officers Who Do Not Hold Stock
310 South Scraper Vinita, OK 74301
Hartley Robert(Bob)
President
Officers Who Do Not Hold Stock
PO Box 160 Langley, OK 74350
Sellers Jim
Director
Officers Who Do Not Hold Stock
3507 E. 66th Place Tulsa, OK 74136
Lynch Robert
Director
Officers Who Do Not Hold Stock
229 S. Smith St. Vinita, OK 74301
Montana Jo
Director eff 2014
Officers Who Do Not Hold Stock
20 East 5th St. 200 Tulsa, OK 74103
Frizzell Blaine
CEO 2014
Officers Who Do Not Hold Stock
3205 Par Ct Claremore, OK 74019
Home Of Home, Inc. Richardson Ralph
Director eff Sept 2015
Officers Who Do Not Hold Stock
2809 Summerfield Place Pryor, OK 74361
Brown Tim
Director Eff Sept 2015
Officers Who Do Not Hold Stock
37640 S. 4110 Rd. Big Cabin, OK 74322
Gibson Virginia
NH5809 918-540-07703125 East Street North Miami, OK 74354
Home of Hope Elmwood House
Director
Officers Who Do Not Hold Stock
6122 E. 107th St. Tulsa, OK 74137
Willis James A.
Operating Entity
900 Hope Avenue Vinita, OK 74301
Home Of Hope, Inc.
VP Operations
Officers Who Do Not Hold Stock
1005 West Canadian Vinita, OK 74301
Hartley Jot
Director
Officers Who Do Not Hold Stock
5924 Flagstaff Wichita, KS 67220
Harney Jerry
Treasurer Eff April 21 2014
Officers Who Do Not Hold Stock
332 N. Scraper Vinita, OK 74301
Luginbuel Jack
VP P&D Eff April 21 2014
Officers Who Do Not Hold Stock
319 E. Illinois Vinita, OK 74301
Patrick Dennis
Secretary
Officers Who Do Not Hold Stock
450500 Happy Hollow Dr. Afton, OK 74331
Cupp Gary
Page 119 of 265
Owner NameFacilities Owned
Director
Officers Who Do Not Hold Stock
106 Lakeview Drive Vinita, OK 74301
Dalquest Len
Director
Officers Who Do Not Hold Stock
100 N. Broadway 1500 Oklahoma City, OK 73102
Hager Don
Director
Officers Who Do Not Hold Stock
310 South Scraper Vinita, OK 74301
Hartley Robert(Bob)
President
Officers Who Do Not Hold Stock
PO Box 160 Langley, OK 74350
Sellers Jim
Director Eff April 21 2014
Officers Who Do Not Hold Stock
3507 E. 66th Place Tulsa, OK 74136
Lynch Robert
Director
Officers Who Do Not Hold Stock
229 S. Smith St. Vinita, OK 74301
Montana Jo
Director eff 2014
Officers Who Do Not Hold Stock
20 East 5th St. 200 Tulsa, OK 74103
Frizzell Blaine
CEO eff 2014
Officers Who Do Not Hold Stock
3205 Par Ct Claremore, OK 74019
Home Of Home, Inc. Richardson Ralph
Director eff Sept 2015
Officers Who Do Not Hold Stock
2809 Summerfield Place Pryor, OK 74361
Brown Tim
Director Eff Sept 2015
Officers Who Do Not Hold Stock
37640 S. 4110 Rd. Big Cabin, OK 74322
Gibson Virginia
NH1804 918-256-7825528 North Gunter Vinita, OK 74301
Home Of Hope Gunter House
Director end 12/07/2015
Officers Who Do Not Hold Stock
6122 E. 107th St. Tulsa, OK 74137
Willis James A.
Operating Entity
900 Hope Avenue Vinita, OK 74301
Home Of Hope, Inc.
VP operations
Officers Who Do Not Hold Stock
1005 West Canadian Vinita, OK 74301
Hartley Jot
Director
Officers Who Do Not Hold Stock
5924 Flagstaff Wichita, KS 67220
Harney Jerry
Treasurer
Officers Who Do Not Hold Stock
332 N. Scraper Vinita, OK 74301
Luginbuel Jack
VP P&D
Officers Who Do Not Hold Stock
319 E. Illinois Vinita, OK 74301
Patrick Dennis
Secretary
Officers Who Do Not Hold Stock
450500 Happy Hollow Dr. Afton, OK 74331
Cupp Gary
Page 120 of 265
Owner NameFacilities Owned
Director
Officers Who Do Not Hold Stock
106 Lakeview Drive Vinita, OK 74301
Dalquest Len
Director
Officers Who Do Not Hold Stock
100 N. Broadway 1500 Oklahoma City, OK 73102
Hager Don
Director 11/20/2013
Officers Who Do Not Hold Stock
310 South Scraper Vinita, OK 74301
Hartley Robert(Bob)
President
Officers Who Do Not Hold Stock
PO Box 160 Langley, OK 74350
Sellers Jim
President
Officers Who Do Not Hold Stock
PO Box 160 Langley, OK 74350
Sellers Jim
Director
Officers Who Do Not Hold Stock
3507 E. 66th Place Tulsa, OK 74136
Lynch Robert
Director eff 11/20/2013
Officers Who Do Not Hold Stock
229 S. Smith St. Vinita, OK 74301
Montana Jo
Director eff 2014
Officers Who Do Not Hold Stock
20 East 5th St. 200 Tulsa, OK 74103
Frizzell Blaine
CEO eff 2014
Officers Who Do Not Hold Stock
3205 Par Ct Claremore, OK 74019
Home Of Home, Inc. Richardson Ralph
Director eff Sept 2015
Officers Who Do Not Hold Stock
2809 Summerfield Place Pryor, OK 74361
Brown Tim
Director Eff Sept 2015
Officers Who Do Not Hold Stock
37640 S. 4110 Rd. Big Cabin, OK 74322
Gibson Virginia
NH5810 918-540-03001026 3rd Northwest Miami, OK 74354
Home of Hope K House
Director eff may 15, 2014
Officers Who Do Not Hold Stock
6122 E. 107th St. Tulsa, OK 74137
Willis James A.
Operating Entity
900 Hope Avenue Vinita, OK 74301
Home Of Hope, Inc.
VP Operations
Officers Who Do Not Hold Stock
1005 West Canadian Vinita, OK 74301
Hartley Jot
Director
Officers Who Do Not Hold Stock
5924 Flagstaff Wichita, KS 67220
Harney Jerry
Treasurer
Officers Who Do Not Hold Stock
332 N. Scraper Vinita, OK 74301
Luginbuel Jack
VP P&D
Officers Who Do Not Hold Stock
319 E. Illinois Vinita, OK 74301
Patrick Dennis
Page 121 of 265
Owner NameFacilities Owned
Secretary
Officers Who Do Not Hold Stock
450500 Happy Hollow Dr. Afton, OK 74331
Cupp Gary
Director
Officers Who Do Not Hold Stock
106 Lakeview Drive Vinita, OK 74301
Dalquest Len
Director
Officers Who Do Not Hold Stock
100 N. Broadway 1500 Oklahoma City, OK 73102
Hager Don
Director
Officers Who Do Not Hold Stock
310 South Scraper Vinita, OK 74301
Hartley Robert(Bob)
President
Officers Who Do Not Hold Stock
PO Box 160 Langley, OK 74350
Sellers Jim
Director
Officers Who Do Not Hold Stock
3507 E. 66th Place Tulsa, OK 74136
Lynch Robert
Director
Officers Who Do Not Hold Stock
229 S. Smith St. Vinita, OK 74301
Montana Jo
Director eff 2014
Officers Who Do Not Hold Stock
20 East 5th St. 200 Tulsa, OK 74103
Frizzell Blaine
Director eff Sept 2015
Officers Who Do Not Hold Stock
2809 Summerfield Place Pryor, OK 74361
Brown Tim
Director Eff Sept 2015
Officers Who Do Not Hold Stock
37640 S. 4110 Rd. Big Cabin, OK 74322
Gibson Virginia
NH1812 918-256-8406954 West Hope Road Vinita, OK 74301
Home of Hope Macklanburg House
Director
Officers Who Do Not Hold Stock
6122 E. 107th St. Tulsa, OK 74137
Willis James A.
Operating Entity
900 Hope Avenue Vinita, OK 74301
Home Of Hope, Inc.
VP of Operations eff 09/2012
Officers Who Do Not Hold Stock
1005 West Canadian Vinita, OK 74301
Hartley Jot
Treasurer
Officers Who Do Not Hold Stock
332 N. Scraper Vinita, OK 74301
Luginbuel Jack
VP P&D
Officers Who Do Not Hold Stock
319 E. Illinois Vinita, OK 74301
Patrick Dennis
Secretary eff 09/2012 (Director eff
09/2011 end 09/2012)
Officers Who Do Not Hold Stock
450500 Happy Hollow Dr. Afton, OK 74331
Cupp Gary
President
Officers Who Do Not Hold Stock
PO Box 160 Langley, OK 74350
Sellers Jim
Page 122 of 265
Owner NameFacilities Owned
Board of Dir./CEO
Officers Who Do Not Hold Stock
3205 Par Ct Claremore, OK 74019
Home Of Home, Inc. Richardson Ralph
Director eff Sept 2015
Officers Who Do Not Hold Stock
2809 Summerfield Place Pryor, OK 74361
Brown Tim
Director Eff Sept 2015
Officers Who Do Not Hold Stock
37640 S. 4110 Rd. Big Cabin, OK 74322
Gibson Virginia
NH5811 918-540-06001615 20th Avenue Southwest Miami, OK 74354
Home of Hope Oakcrest House
Director eff. 09/2015
Officers Who Do Not Hold Stock
6122 E. 107th St. Tulsa, OK 74137
Willis James A.
Director eff. 09/2015
Officers Who Do Not Hold Stock
6122 E. 107th St. Tulsa, OK 74137
Willis James A.
Operating Entity
900 Hope Avenue Vinita, OK 74301
Home Of Hope, Inc.
VP Operations eff 09/2012
Officers Who Do Not Hold Stock
1005 West Canadian Vinita, OK 74301
Hartley Jot
Director
Officers Who Do Not Hold Stock
5924 Flagstaff Wichita, KS 67220
Harney Jerry
Treasure eff. 09/2015
Officers Who Do Not Hold Stock
332 N. Scraper Vinita, OK 74301
Luginbuel Jack
Vice President P & D eff. 09/2012
Officers Who Do Not Hold Stock
319 E. Illinois Vinita, OK 74301
Patrick Dennis
Secretary eff 09/2012
Officers Who Do Not Hold Stock
450500 Happy Hollow Dr. Afton, OK 74331
Cupp Gary
Director
Officers Who Do Not Hold Stock
106 Lakeview Drive Vinita, OK 74301
Dalquest Len
Director eff. 09/2015
Officers Who Do Not Hold Stock
100 N. Broadway 1500 Oklahoma City, OK 73102
Hager Don
Director
Officers Who Do Not Hold Stock
310 South Scraper Vinita, OK 74301
Hartley Robert(Bob)
President eff 07/18/2014
Officers Who Do Not Hold Stock
PO Box 160 Langley, OK 74350
Sellers Jim
Director
Officers Who Do Not Hold Stock
3507 E. 66th Place Tulsa, OK 74136
Lynch Robert
Director eff 09/2015
Officers Who Do Not Hold Stock
229 S. Smith St. Vinita, OK 74301
Montana Jo
Page 123 of 265
Owner NameFacilities Owned
CEO of Home of Hope, Inc.
Officers Who Do Not Hold Stock
3205 Par Ct Claremore, OK 74019
Home Of Home, Inc. Richardson Ralph
CEO of Home of Hope eff 06//
Officers Who Do Not Hold Stock
3205 Par Ct Claremore, OK 74019
Home Of Home, Inc. Richardson Ralph
Director eff. 09/2015
Officers Who Do Not Hold Stock
2809 Summerfield Place Pryor, OK 74361
Brown Tim
Director Eff Sept 2015
Officers Who Do Not Hold Stock
37640 S. 4110 Rd. Big Cabin, OK 74322
Gibson Virginia
NH1809 918-256-4957822 North Scraper Vinita, OK 74301
Home of Hope Scraper House
717 S. Houston Tulsa, OK
Brown Darvin L.
Director
Officers Who Do Not Hold Stock
6122 E. 107th St. Tulsa, OK 74137
Willis James A.
Operating Entity
900 Hope Avenue Vinita, OK 74301
Home Of Hope, Inc.
VP Operations
Officers Who Do Not Hold Stock
1005 West Canadian Vinita, OK 74301
Hartley Jot
Director eff. 09/2015
Officers Who Do Not Hold Stock
5924 Flagstaff Wichita, KS 67220
Harney Jerry
Treasurer
Officers Who Do Not Hold Stock
332 N. Scraper Vinita, OK 74301
Luginbuel Jack
VP P&D
Officers Who Do Not Hold Stock
319 E. Illinois Vinita, OK 74301
Patrick Dennis
Secretary
Officers Who Do Not Hold Stock
450500 Happy Hollow Dr. Afton, OK 74331
Cupp Gary
Director eff. 09/2015
Officers Who Do Not Hold Stock
100 N. Broadway 1500 Oklahoma City, OK 73102
Hager Don
Director eff. 09/2015
Officers Who Do Not Hold Stock
310 South Scraper Vinita, OK 74301
Hartley Robert(Bob)
CEO
Officers Who Do Not Hold Stock
P.O. Box 58 Vinita, OK 74301
Svedman David
President
Stockholders/partners -- Not Officers
PO Box 160 Langley, OK 74350
Sellers Jim
Director eff. 09/2015
Officers Who Do Not Hold Stock
229 S. Smith St. Vinita, OK 74301
Montana Jo
Page 124 of 265
Owner NameFacilities Owned
Director Eff. 9-2015
Officers Who Do Not Hold Stock
20 East 5th St. 200 Tulsa, OK 74103
Frizzell Blaine
CEO Eff. 9/2015
Officers Who Do Not Hold Stock
3205 Par Ct Claremore, OK 74019
Home Of Home, Inc. Richardson Ralph
Director eff Sept 2015
Officers Who Do Not Hold Stock
2809 Summerfield Place Pryor, OK 74361
Brown Tim
Director eff Sept 2015
Officers Who Do Not Hold Stock
2809 Summerfield Place Pryor, OK 74361
Brown Tim
Director Eff Sept 2015
Officers Who Do Not Hold Stock
37640 S. 4110 Rd. Big Cabin, OK 74322
Gibson Virginia
NH1805 918-256-8106804 East Sequoyah Vinita, OK 74301
Home Of Hope Sequoyah House
Director
Officers Who Do Not Hold Stock
6122 E. 107th St. Tulsa, OK 74137
Willis James A.
Operating Entity
900 Hope Avenue Vinita, OK 74301
Home Of Hope, Inc.
VP Operations
Officers Who Do Not Hold Stock
1005 West Canadian Vinita, OK 74301
Hartley Jot
VP Operations
Officers Who Do Not Hold Stock
1005 West Canadian Vinita, OK 74301
Hartley Jot
Director
Officers Who Do Not Hold Stock
5924 Flagstaff Wichita, KS 67220
Harney Jerry
Treasurer
Officers Who Do Not Hold Stock
332 N. Scraper Vinita, OK 74301
Luginbuel Jack
VP P&D
Officers Who Do Not Hold Stock
319 E. Illinois Vinita, OK 74301
Patrick Dennis
Secretary
Officers Who Do Not Hold Stock
450500 Happy Hollow Dr. Afton, OK 74331
Cupp Gary
Director
Officers Who Do Not Hold Stock
106 Lakeview Drive Vinita, OK 74301
Dalquest Len
Director
Officers Who Do Not Hold Stock
100 N. Broadway 1500 Oklahoma City, OK 73102
Hager Don
Director eff 11/20/2013
Officers Who Do Not Hold Stock
310 South Scraper Vinita, OK 74301
Hartley Robert(Bob)
President
Officers Who Do Not Hold Stock
PO Box 160 Langley, OK 74350
Sellers Jim
Page 125 of 265
Owner NameFacilities Owned
Director
Officers Who Do Not Hold Stock
3507 E. 66th Place Tulsa, OK 74136
Lynch Robert
Director eff 11/20/2013
Officers Who Do Not Hold Stock
229 S. Smith St. Vinita, OK 74301
Montana Jo
Director eff 2014
Officers Who Do Not Hold Stock
20 East 5th St. 200 Tulsa, OK 74103
Frizzell Blaine
Board of Dir./CEO
Officers Who Do Not Hold Stock
3205 Par Ct Claremore, OK 74019
Home Of Home, Inc. Richardson Ralph
Director eff Sept 2015
Officers Who Do Not Hold Stock
2809 Summerfield Place Pryor, OK 74361
Brown Tim
Director Eff Sept 2015
Officers Who Do Not Hold Stock
37640 S. 4110 Rd. Big Cabin, OK 74322
Gibson Virginia
NH1810 918-256-7825728 North Thompson Vinita, OK 74301
Home of Hope Thompson House
Director
Officers Who Do Not Hold Stock
6122 E. 107th St. Tulsa, OK 74137
Willis James A.
Operating Entity
900 Hope Avenue Vinita, OK 74301
Home Of Hope, Inc.
VP Operations
Officers Who Do Not Hold Stock
1005 West Canadian Vinita, OK 74301
Hartley Jot
Treasurer
Officers Who Do Not Hold Stock
332 N. Scraper Vinita, OK 74301
Luginbuel Jack
VP P&D
Officers Who Do Not Hold Stock
319 E. Illinois Vinita, OK 74301
Patrick Dennis
Secretary eff 09/2012
Officers Who Do Not Hold Stock
450500 Happy Hollow Dr. Afton, OK 74331
Cupp Gary
President
Officers Who Do Not Hold Stock
PO Box 160 Langley, OK 74350
Sellers Jim
Board of Dir./CEO
Officers Who Do Not Hold Stock
3205 Par Ct Claremore, OK 74019
Home Of Home, Inc. Richardson Ralph
Director eff Sept 2015
Officers Who Do Not Hold Stock
2809 Summerfield Place Pryor, OK 74361
Brown Tim
Director Eff Sept 2015
Officers Who Do Not Hold Stock
37640 S. 4110 Rd. Big Cabin, OK 74322
Gibson Virginia
Page 126 of 265
Owner NameFacilities Owned
NH1806 918-256-782524775 South 4400 Road Vinita, OK 74301
Home Of Hope Warren House
Director
Officers Who Do Not Hold Stock
6122 E. 107th St. Tulsa, OK 74137
Willis James A.
Operating Entity
900 Hope Avenue Vinita, OK 74301
Home Of Hope, Inc.
VP Operations
Officers Who Do Not Hold Stock
1005 West Canadian Vinita, OK 74301
Hartley Jot
Director
Officers Who Do Not Hold Stock
5924 Flagstaff Wichita, KS 67220
Harney Jerry
Treasurer
Officers Who Do Not Hold Stock
332 N. Scraper Vinita, OK 74301
Luginbuel Jack
VP P&D
Officers Who Do Not Hold Stock
319 E. Illinois Vinita, OK 74301
Patrick Dennis
Secretary
Officers Who Do Not Hold Stock
450500 Happy Hollow Dr. Afton, OK 74331
Cupp Gary
Director
Officers Who Do Not Hold Stock
106 Lakeview Drive Vinita, OK 74301
Dalquest Len
Director
Officers Who Do Not Hold Stock
100 N. Broadway 1500 Oklahoma City, OK 73102
Hager Don
Director eff 11/20/2013
Officers Who Do Not Hold Stock
310 South Scraper Vinita, OK 74301
Hartley Robert(Bob)
President
Officers Who Do Not Hold Stock
PO Box 160 Langley, OK 74350
Sellers Jim
Director
Officers Who Do Not Hold Stock
3507 E. 66th Place Tulsa, OK 74136
Lynch Robert
Director eff 11/20/2013
Officers Who Do Not Hold Stock
229 S. Smith St. Vinita, OK 74301
Montana Jo
Director
Officers Who Do Not Hold Stock
20 East 5th St. 200 Tulsa, OK 74103
Frizzell Blaine
CEO Eff. 2016
Officers Who Do Not Hold Stock
3205 Par Ct Claremore, OK 74019
Home Of Home, Inc. Richardson Ralph
Director
Officers Who Do Not Hold Stock
2809 Summerfield Place Pryor, OK 74361
Brown Tim
Director Eff Sept 2015
Officers Who Do Not Hold Stock
37640 S. 4110 Rd. Big Cabin, OK 74322
Gibson Virginia
Page 127 of 265
Owner NameFacilities Owned
NH5812 918-256-8406603 3rd Avenue Northwest Miami, OK 74354
Home of Hope Wilson House
Director
Officers Who Do Not Hold Stock
6122 E. 107th St. Tulsa, OK 74137
Willis James A.
Operating Entity
900 Hope Avenue Vinita, OK 74301
Home Of Hope, Inc.
VP Operations
Officers Who Do Not Hold Stock
1005 West Canadian Vinita, OK 74301
Hartley Jot
Director
Officers Who Do Not Hold Stock
5924 Flagstaff Wichita, KS 67220
Harney Jerry
Treasurer
Officers Who Do Not Hold Stock
332 N. Scraper Vinita, OK 74301
Luginbuel Jack
VP P & D eff2013
Officers Who Do Not Hold Stock
319 E. Illinois Vinita, OK 74301
Patrick Dennis
Secretary
Officers Who Do Not Hold Stock
450500 Happy Hollow Dr. Afton, OK 74331
Cupp Gary
Director
Officers Who Do Not Hold Stock
106 Lakeview Drive Vinita, OK 74301
Dalquest Len
Director
Officers Who Do Not Hold Stock
100 N. Broadway 1500 Oklahoma City, OK 73102
Hager Don
Direcor
Officers Who Do Not Hold Stock
310 South Scraper Vinita, OK 74301
Hartley Robert(Bob)
President
Officers Who Do Not Hold Stock
PO Box 160 Langley, OK 74350
Sellers Jim
Director
Officers Who Do Not Hold Stock
3507 E. 66th Place Tulsa, OK 74136
Lynch Robert
Director
Officers Who Do Not Hold Stock
229 S. Smith St. Vinita, OK 74301
Montana Jo
Director
Officers Who Do Not Hold Stock
20 East 5th St. 200 Tulsa, OK 74103
Frizzell Blaine
CEO
Officers Who Do Not Hold Stock
3205 Par Ct Claremore, OK 74019
Home Of Home, Inc. Richardson Ralph
Director
Officers Who Do Not Hold Stock
2809 Summerfield Place Pryor, OK 74361
Brown Tim
Director Eff Sept 2015
Officers Who Do Not Hold Stock
37640 S. 4110 Rd. Big Cabin, OK 74322
Gibson Virginia
Page 128 of 265
Owner NameFacilities Owned
NH1811 918-256-2809950 West Hope Road Vinita, OK 74301
Home of Hope Wodloe House
Director Eff 11-23-2016
Officers Who Do Not Hold Stock
10641 E. 18th Pl. Tulsa, OK 74128
Wedding Tony
Director eff 11-22-13
Officers Who Do Not Hold Stock
6122 E. 107th St. Tulsa, OK 74137
Willis James A.
Operating Entity
900 Hope Avenue Vinita, OK 74301
Home Of Hope, Inc.
VP Operations
Officers Who Do Not Hold Stock
1005 West Canadian Vinita, OK 74301
Hartley Jot
Director
Officers Who Do Not Hold Stock
5924 Flagstaff Wichita, KS 67220
Harney Jerry
Treasurer Eff. 11-22-13
Officers Who Do Not Hold Stock
332 N. Scraper Vinita, OK 74301
Luginbuel Jack
VP P&D
Officers Who Do Not Hold Stock
319 E. Illinois Vinita, OK 74301
Patrick Dennis
Secretary Eff. 11-22-13
Officers Who Do Not Hold Stock
450500 Happy Hollow Dr. Afton, OK 74331
Cupp Gary
Director
Officers Who Do Not Hold Stock
100 N. Broadway 1500 Oklahoma City, OK 73102
Hager Don
Director
Officers Who Do Not Hold Stock
310 South Scraper Vinita, OK 74301
Hartley Robert(Bob)
President eff- Nov 22-2013
Officers Who Do Not Hold Stock
PO Box 160 Langley, OK 74350
Sellers Jim
Director, eff.07/09/2012
Officers Who Do Not Hold Stock
3507 E. 66th Place Tulsa, OK 74136
Lynch Robert
Director
Officers Who Do Not Hold Stock
229 S. Smith St. Vinita, OK 74301
Montana Jo
director started 12/07/2015
Officers Who Do Not Hold Stock
20 East 5th St. 200 Tulsa, OK 74103
Frizzell Blaine
CEO eff 2014
Officers Who Do Not Hold Stock
3205 Par Ct Claremore, OK 74019
Home Of Home, Inc. Richardson Ralph
Director 12/07/2015
Officers Who Do Not Hold Stock
2809 Summerfield Place Pryor, OK 74361
Brown Tim
Director start 12/07/2015
Officers Who Do Not Hold Stock
37640 S. 4110 Rd. Big Cabin, OK 74322
Gibson Virginia
Page 129 of 265
Owner NameFacilities Owned
NH1202 580-326-77711001 Heritage Way Hugo, OK 74743
Homestead of Hugo
12.5% OP & RE
Stockholders/partners -- Not Officers
808 North 4140 Road Hugo, OK 74743
McEwing Chance Gwendolyn
12.5% OP & RE
Stockholders/partners -- Not Officers
3005 Candlestick Enid, OK 73703
McEwing Patrick
25% BGM Beneficiary Delores O
Mitchell Revocable Tr
Officers Who Do Not Hold Stock
P.O. Box 330 Muldrow, OK 74948
Tabor Angela
25% BGM Estate Beneficiary Delores O
Mitchell Revocable T
Stockholders/partners -- Not Officers
111522 S. 4740 Rd. Muldrow, OK 74948
Mitchell Robert Michael
25% BGM Beneficiary Delores O
Mitchell Revocable Tr
Stockholders/partners -- Not Officers
412 S. Dogwood Sallisaw, OK 74955
Mitchell Marcinda
25% BGM Beneficiary Delores O
Mitchell Revocable Tr
Stockholders/partners -- Not Officers
7240 Chase Oaks Blvd 121 Plano, TX 75025
Mitchell Kelly O.
Delores O. Mittchell Revocable Trust
Trustee
412 South Dogwood Sallisaw, OK 74955
Mitchell Delores O.
effective 9/26/11
Lessor Or Real Estate Owner
1505 W. Chickasaw Ave. Sallisaw, OK 74955
Hugo Health and Rehabilitation Center, L.L.C.
Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Green Reba
Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Ellis, fka Seay Tiffany Renee
Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Thurman Bronson Owen
Member 37.5% OP & RE
Stockholders/partners -- Not Officers
P.O. Box 1090 Sallisaw, OK 74955
Gilbert F. Green Trust
effective 6/30/17 (UPL Mgr)
Contracted Management
1001 Heritage Way Hugo, OK 74743
Homestead of Hugo, LLC
Manager, eff 03/28/13
Officers Who Do Not Hold Stock
1001 Heritage Way Huogo, OK 74743
Coffelt Linda
Gilbert F. Green Trust
Trustee
P.O. Box 1090 Sallisaw, OK 74955
Green Gilbert F.
18.75% Member OP & RE
Stockholders/partners -- Not Officers
412 S. Dogwood Sallisaw, OK 74955
Delores O. Mitchell Revocable Trust
18.75% OP eff 9-16-16
Stockholders/partners -- Not Officers
,
BGM Estate, LLC
UPL Owner eff. 6/30/2017
Operating Entity
201 S. 2nd Street Hugo, OK 74743
City of Hugo
Page 130 of 265
Owner NameFacilities Owned
NH6606 918-543-8800400 North Broadway Inola, OK 74036
Inola Health & Rehabilitation
100% OP
Stockholders/partners -- Not Officers
PO Box 17888 Hattiesburg Hattiesburg, MS 39404
Johnson Christopher W.
Eff. 01/01/2013
Lessor Or Real Estate Owner
303 W. Madison Chicago, Il 60606
Oklahoma Two Property, L.L.C. c/o Aviv Reit, Inc.
Eff 01/01/2013
Operating Entity
2100 E Washington Street D Idabel, OK 74745
Inola Health & Rehabilitation, LLC
NH7408 918-336-59285120 Jacquelyn Lane Bartlesville, OK 74006
Jacquelyn House
Operating Entity
616 SE 4th Street Bartlesville, OK 74003
ARC Group Homes, Inc.
President Eff - 11-4-2010
Officers Who Do Not Hold Stock
2400 Locust Rd Bartlesville, Ok 74006
Kirkpatrick Jane
Executive Director
Officers Who Do Not Hold Stock
393051 Bartlesville, Ok 74003
Aldredge Joyce
Secretary eff. 09-25-2013
Officers Who Do Not Hold Stock
1520 Smysor Dr. Bartlesville, OK 74006
Johnson Linda
Vice President-eff 09-25-2013
Officers Who Do Not Hold Stock
2832 Roanoke Bartlesville, ok 74006
Baughn Stan
NH6203 580-332-5328815 North Country Club Road Ada, OK 74820
Jan Frances Care Center
25% BGM Estate, LLC eff 9-16-16
Stockholders/partners -- Not Officers
P.O. Box 330 Muldrow, OK 74948
Tabor Angela
25% BGM Estate, LLC
Stockholders/partners -- Not Officers
111522 S. 4740 Rd. Muldrow, OK 74948
Mitchell Robert Michael
25% BGM Estat, LLC Eff 9-16-16
Stockholders/partners -- Not Officers
412 S. Dogwood Sallisaw, OK 74955
Mitchell Marcinda
12.5% Member OP 25% BGM Estate,
LLC eff 9-16-16
Stockholders/partners -- Not Officers
7240 Chase Oaks Blvd 121 Plano, TX 75025
Mitchell Kelly O.
UPL Mgr. eff. 6/30/2017
Contracted Management
815 N. Country Club Road Ada, OK 74820
Jan Frances Care Center, L.L.C.
Page 131 of 265
Owner NameFacilities Owned
Beneficiary of Gilbert F. Green Trust 20%
LP
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Green Reba
Beneficiary of Gilbert F. Green Trust and
5% LP
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Ellis, fka Seay Tiffany Renee
Beneficiary of Gilbert F. Green Trust and
5% LP
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Thurman Bronson Owen
Beneficiary of Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Michelle Green Lori
25% Member
Stockholders/partners -- Not Officers
P.O. Box 1454 Sallisaw, OK 74955
Philip M. Green Revocable Trust
25% Member
Stockholders/partners -- Not Officers
P.O. Box 1090 Sallisaw, OK 74955
Gilbert F. Green Trust
Trustee Philip M Green Tr. benef Gilbert
F Green Tr 10%LP
Trustee
P.O. Box 1090 Sallisaw, OK 74955
Green Philip M.
Trustee and beneficiary of Gilbert F.
Green Trust
Trustee
P.O. Box 1090 Sallisaw, OK 74955
Green Gilbert F.
Beneficiary of Philip M Green Revocable
Trust & 50%LP ef 4-23-14
Beneficiary
P.O. box 1090 Sallisaw, OK 74955
Stewart Lori Green
Beneficiary of Philip M. Green Revocable
Tr. 50%LP eff 4-23-14
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Green Philip R.
Manager of Jan Frances Care Center,
LLC eff 12-08-2014
Manager
1600 EAST HIGHWAY HOLDENVILLE, OK 74848
Williams Casey
37.50% OP eff 9-16-16
Stockholders/partners -- Not Officers
,
BGM Estate, LLC
UPL Owner eff 6/30/2017
Operating Entity
201 S. 2nd Street Hugo, OK 74743
City of Hugo
NH2406 580-233-2722502 West Pine Enid, OK 73701
Kenwood Manor
100% of Kenmetal, LLC
Stockholders/partners -- Not Officers
593 Atlanta Street Roswell, GA 30075
Brogdon Connie
Manager of Kenmetal, LLC eff 07/28/11
100% MPM, LLC eff 3/1/14
Stockholders/partners -- Not Officers
3050 Peachtree Rd 355 Atlanta, GA 30305
Brogdon Christopher
Operating Entity
502 West Pine Avenue Enid, OK 73701
Kenmetal, LLC
eff 3/1/2014
Contracted Management
Two Buckhead Plaza, 3050 Peachtree Road NW 355 Atlanta, GA 30305
Marsh Pointe Managment, LLC
Page 132 of 265
Owner NameFacilities Owned
NH4301 580-276-3318301 CE Colston Drive Marietta, OK 73448
Lake Country Nursing Center
100% RE
Lessor Or Real Estate Owner
1802 N.E. Loop 410 #111 San Antonil, TX 78217
Cotter James F.
Chair & CEO of Senior Care Group, Inc.
Officers Who Do Not Hold Stock
1240 Marbella Plaza Drive #12 Tampa, FL 33619
Vaughan David R.
eff. 11-01-06
Operating Entity
1240 Marbella drive Tampa, Fl
SCG Lake Country, LLC
eff. 11-01-06
Contracted Management
1240 Marbella Plaza Drive Tampa, FL 33619
SCG Red River Management, LLC
2.29% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Fridrich, LLC
sole manag.mem. of SCG Red River,
LLC/lessee
Managing Member
1240 Marbella Plaza Drive Tampa, FL 33619
Senior Care Group, Inc.
Senior VP, Sec, and Board Mem of
Senior Care Group, Inc.
Officers Who Do Not Hold Stock
1240 Marbella Drive Tampa, FL 33619
Thorn Rebecca
Board Member of Senior Care Group,
Inc.
Officers Who Do Not Hold Stock
1240 Marbella Plaza Drive Tampa, FL 33619
Fridrich, Sr. Gerald D.
Board Memboer of Senior Care Group,
Inc.
Officers Who Do Not Hold Stock
1240 Marbella Plaza Drive Tampa, FL 33619
Surtees Robert E.
Manager for TIC Owners (real estate) eff
1-01-08
Officers Who Do Not Hold Stock
2547 Mason Oaks Drive Vairico, FL 33596
Moran Consulting Group, LLC
CFO & Secretary
Officers Who Do Not Hold Stock
1240 Marbella Plaza Drive Tampa, FL 33619
Chudow Katherine (Kathy)
NH5605 918-652-8101600 Lake Road Henryetta, OK 74437
Lake Drive Care and Rehabilitation Center
100% of Peak Medical Corp
Stockholders/partners -- Not Officers
101 Sun Ave. NE Albuquerque, NM 87109
SunBridge Healthcare LLC
100% of SunBridge Healthcare
Corporation
Stockholders/partners -- Not Officers
101 Sun Avenue NE Albuquerque, NM 87109
Sun Healthcare Group, Inc.
100% of Sabra Lake Drive, LLC
Stockholders/partners -- Not Officers
18831 Von Karman Ave 400 Irvine, CA 92612
Sabra Health Care Limited Partnership
Page 133 of 265
Owner NameFacilities Owned
1% Limited Partner of Sabra Health Care
LP
Stockholders/partners -- Not Officers
18831 Von Karman Ave 400 Irvine, CA 92612
Sabra Health Care, LLC
99% GP of Sabra Health Care LP
Lessor Or Real Estate Owner
18831 Von Karman Ave. 400 Irvine, CA 92612
Sabra Health Care REIT, Inc.
7% South Park Health Care- 50%
Midwest Geriatric Mgmt 03-2017
Stockholders/partners -- Not Officers
14447 Chellington Ct. 430 Chesterfield, MO 63017
Bienstock Judah
Mgr Okla Acquisitions & 50% Midwest
Geriatric Mgmt eff 03-2017
Stockholders/partners -- Not Officers
8 Primrose Dr. Lakewood, NJ 08701
Jeremias Baruch
100% Sun Healthcare Group, Inc.
Stockholders/partners -- Not Officers
101 East State Street Kennett Square, PA 19348
GHC Holdings II, LLC
100% GHC Holdings II, LLC
Stockholders/partners -- Not Officers
101 East State Street Kennett Square, PA 19348
Genesis Healthcare, LLC
100% Genesis Healthcare, LLC
Stockholders/partners -- Not Officers
3820 Mansell Road 280 Alpharetta, GA 30022
GEN Operations II, LLC
100% GEN Operations II, LLC
Stockholders/partners -- Not Officers
3820 Mansel Road 280 Alpharetta, GA 30022
GEN Operations I, LLC
21% FC-GEN Operations Investment,
LLC
Stockholders/partners -- Not Officers
3820 Mansell Road 280 Alpharetta, GA 30022
HCCF Management Group XI, LLC
15% FC-GEN Operations Investment,
LLC
Stockholders/partners -- Not Officers
One South Street, 27th Flr Baltimore, MD 21202
Gazelle Gen LLC
14% FC-GEN Operations Investment,
LLC
Stockholders/partners -- Not Officers
101 East State Street Kennett Square, PA 19348
GEN Management, LLC
13% FC-GEN Operations Investment,
LLC
Stockholders/partners -- Not Officers
234 Church Street 901 New Haven, CT 06510
Senior Care Genesis, LLC
12% FC-GEN Operations Investment,
LLC
Stockholders/partners -- Not Officers
101 West Avenue, Third Floor Jenkintown, PA 19046
ZAC Properties XI, LLC
4% FC-GEN Operations Investment, LLC
Stockholders/partners -- Not Officers
6633 N. Lincoln Avenue Lincolnwood, IL 60712
Midway Gen Capital, LLC
57% Gazelle Gen LLC
Stockholders/partners -- Not Officers
One South Street, 27th Floor Baltimore, MD 21202
SL Gen LLC
92% Senior Care Genesis, LLC
Stockholders/partners -- Not Officers
234 Church Street 901 New Haven, CT 06510
Senior Care Holdings LLC
68% Senior Care Holdings LLC
Stockholders/partners -- Not Officers
19 Hilltop Place Rye, NY 10580
1995 Donna Reis Family Trust
10% Lake Drive Health Care
Stockholders/partners -- Not Officers
1111 Marcus Ave 107 Lake Success, NY 11042
Fensterman Howard
37% of Lake Drive Health Care eff
03-2017
Stockholders/partners -- Not Officers
1111 Marcus Ave. 107 Lake Success, NY 11042
Landa Benjamin
Page 134 of 265
Owner NameFacilities Owned
eff 03/13/13
Operating Entity
477 North Lindergh Blvd 310 St. Louis, MO 63141
Lake Drive Health Care, LLC
13% Lake Drive Health Care eff 03-2017
Stockholders/partners -- Not Officers
59 Causeway Lawrence, NY 11559
Taub Miriam
33% of Lake Drvie Health Care
Stockholders/partners -- Not Officers
8 Primrose Drive Lakewood, NJ 08701
Oklahoma Acquisitions, LLC
84.85% of Oklahoma Acquisitions
Stockholders/partners -- Not Officers
8 Primrose Drive Lakewood, NJ 08701
10-26 Nationwide Trust
15.15% of Oklahoma Acquisitions eff
03-2017 no members have 5%
Stockholders/partners -- Not Officers
445 Central Ave 304 Cedarhurst, NY 11516
MACB Resources, LLC
NH5411 918-650-93934 Hillcrest Way Okemah, OK 74859
Lake Place
Lessor Or Real Estate Owner
236 Main Street Uniontown, KY 42461
4-B Properties, L.L.C.
amended corp. name (fkaProdetik, Inc.)
eff 02-05-08
Operating Entity
P.O. Box 217 Weleetka, OK 74880
The Reach Corporation
Non-Profit Board President of The Reach
Corporation 1-8-08
Officers Who Do Not Hold Stock
P.O. Box 790 Uniontown, KY 42461
Welsh Richard
Non-Profit Board VP of The Reach
Corporation 1-8-08
Officers Who Do Not Hold Stock
PO Box 790 UnionTown, KY 42461
Bailey M. Geoffry
Non-Profit Board Sec/Treas of The Reach
Corporation
Stockholders/partners -- Not Officers
PO Box 790 Uniontown, KY 42461
Pyle William "Bill"
authorized agent for The Reach
Corporation
Officers Who Do Not Hold Stock
1201 West Trudgeon Place Henryetta, OK 74437
Bentley Roy
eff. 8-15-07
Lessor Or Real Estate Owner
P.O. Box 409 Sturgis, KY 42459
Maricopa Properties, LLC
100% of RE
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Maricopa Partners, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Rock River, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
MMB, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Lovenest, LLC
30.959% of Rock River, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gary
Page 135 of 265
Owner NameFacilities Owned
16.025% of Rock River, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Lisa
16.025% of Rock River, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Lisa
32.88% of MMB, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Tim
17.455% of MMB, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Vicki
29.421% of Lovenest, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Robert
13.957% of Lovenest, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Laura
53.016% of Rock River, LLC - 4 children
w/13.254% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
4 Irrevocable Trusts
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O.Box 409 Sturgis, KY 42459
Ervin Mallory
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Jade
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Luke
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gabe
49.665% of MMB, LLC - 5 children
w/9.933% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
3 Irrevocable Trusts
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Max
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box Sturgis, KY 42459
Linenger Jessica
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mitch
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Linenger Jennifer
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Brock
56.623% of Lovenest, LLC - 7 children
w/8.089% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
7 Irrevocable Trusts
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Thea
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugris, KY 42459
Ervin Issac
Page 136 of 265
Owner NameFacilities Owned
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugis, KY 42459
Ervin Samuel
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Elijah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Saul
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Micah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mathias
NH1005 580-223-4501604 Lake Murray Drive Ardmore, OK 73401
Lakeland Manor, Inc.
Pres & 0% of LM,Inc./Pres &
100%LTCMngmtCo.
Stockholders/partners Who Are Officers
P.O. Box 128 Ardmore, OK 73402-0128
Porter Gary L.
Operating Entity
604 Lake Murray Drive Ardmore, OK 73401
Lakeland Manor, Inc.
mngmt
Contracted Management
P.O. Box 128 Ardmore, OK 73402-0128
LTC Management Co.
100% LMNH,Inc.
Stockholders/partners Who Are Officers
P.O. Box 20688 Oklahoma City, OK 73156
Porter Mary E.
100% LM,Inc.
Stockholders/partners -- Not Officers
PO Box 20688 Okc, OK 73156
Lakeland Manor Nursing Home, Inc.
NH3902 918-465-2255103 Southwest 9th Street Wilburton, OK 74578
Latimer Nursing Home
Operating Entity
103 S.W. 9th Wilburton, OK 74578
Eastern Oklahoma Nursing Homes, Inc.
Pres 44%
Stockholders/partners Who Are Officers
Box 508 Wilburton, OK 74578
Reager Rita
VP 44%
Stockholders/partners Who Are Officers
58 Wingate Little Rock, AK 72205
Gray Bequita
6%
Stockholders/partners -- Not Officers
Box 337 Hartshorne, OK 74547
James Rozella
6%
Stockholders/partners -- Not Officers
2807 Briarwood Drive Huntsville, AL 35801
Petricek Ann Lynn
Page 137 of 265
Owner NameFacilities Owned
Authorizated to sign application for
renewals eff 11/22/2011
Officer
103 Southwest 9th Street Wilburton, OK 74578
Reager Robert
NH7216 918-622-47472154 South 85th East Avenue Tulsa, OK 74129
Leisure Village Health Care Center
33% of Leisure Village Health Care, LLC
eff 07/01/2014
Stockholders/partners -- Not Officers
14447 Chellington Ct. 430 Chesterfield, MO 63017
Bienstock Judah
33% of Leisure Village Health Care, LLC
eff 07/01/2014
Member
8 Primrose Dr. Lakewood, NJ 08701
Jeremias Baruch
100% RE eff 07/01/2014
Lessor Or Real Estate Owner
31110 Solon Road 9 Solon, OH 44139
Heatheridge and Leisure Village JDEK, LLC Heatheridge and Leisure Village
JDEK, LLC
OP eff 07/01/2014
Operating Entity
477 North Lindergh Blvd 310 St. Louis, MO 63141
Leisure Village Health Care, LLC
25% of Heatheridge and Leisure Village
jdek, LLC eff 07/01/2014
Stockholders/partners -- Not Officers
31110 Solon Road 9 Solon, OH 44139
GM Resources, LLC
8.93% of Heatheridge and Leisure Village
jdek, LLC eff 07/01/14
Stockholders/partners -- Not Officers
31110 Solon Road 9 Solon, OH 44139
Deustch Investments, LLC
12.51% Heatheridge and Leisure Village
jdek, LLC eff 07/01/2014
Stockholders/partners -- Not Officers
31110 Solon Road 9 Solon, OH 44139
Moondance Capital Corporation
17.8% Heatheridge and Leisure Village
jdek, LLC eff 07/01/2014
Stockholders/partners -- Not Officers
31110 Solon Road 9 Solon, OH 44139
KJH JDEK Gold Medallion, LLC
Contracted Management Company
Contracted Management
6 City Place Drive 430 St. Louis, MO 63141
MGM Healthcare MGM Healthcare
33.33% Leisure Village Health Care eff
11-17-15 (no authority)
Member
59 Causeway Lawrence, NY 11559
Tanb Miriam
NH1404 405-527-6531632 Southeast 3rd Street Lexington, OK 73051
Lexington Nursing Home, Inc.
Operating Entity
632 S E 3rd Lexington, OK 73051
Lexington Nursing Home, Inc.
100%
Stockholders/partners Who Are Officers
11 Brookside Drive Purcell, OK 73080
Lawson Gerald
Page 138 of 265
Owner NameFacilities Owned
NH5610 918-650-939314055 North 246th Street Okmulgee, OK 74447
Lexington Place
Lessor Or Real Estate Owner
236 Main Street Uniontown, KY 42461
4-B Properties, L.L.C.
amended corp. name (fkaProdetik, Inc.)
eff 02-05-08
Operating Entity
P.O. Box 217 Weleetka, OK 74880
The Reach Corporation
Non-Profit Board President of The Reach
Corporation 1-8-08
Officers Who Do Not Hold Stock
P.O. Box 790 Uniontown, KY 42461
Welsh Richard
Non-Profit Board VP of The Reach
Corporation 1-8-08
Officers Who Do Not Hold Stock
PO Box 790 UnionTown, KY 42461
Bailey M. Geoffry
Non-Profit Board Sec/Treas of The Reach
Corporation
Officers Who Do Not Hold Stock
PO Box 790 Uniontown, KY 42461
Pyle William "Bill"
authorized agent for The Reach
Corporation
Officers Who Do Not Hold Stock
1201 West Trudgeon Place Henryetta, OK 74437
Bentley Roy
eff. 8-15-07
Lessor Or Real Estate Owner
P.O. Box 409 Sturgis, KY 42459
Maricopa Properties, LLC
100% of RE
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Maricopa Partners, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Rock River, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
MMB, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Lovenest, LLC
30.959% of Rock River, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gary
16.025% of Rock River, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Lisa
32.88% of MMB, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Tim
17.455% MMB, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Vicki
29.421% of Lovenest, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Robert
13.957% of Lovenest, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Laura
53.016% of Rock River, LLC - 4 children
w/13.254% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
4 Irrevocable Trusts
Page 139 of 265
Owner NameFacilities Owned
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O.Box 409 Sturgis, KY 42459
Ervin Mallory
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Jade
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Luke
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gabe
49.665% of MMB, LLC - 5 children
w/9.933% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
3 Irrevocable Trusts
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Max
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box Sturgis, KY 42459
Linenger Jessica
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mitch
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Linenger Jennifer
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Brock
56.623% of Lovenest, LLC - 7 children
w/8.089% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
7 Irrevocable Trusts
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Thea
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugris, KY 42459
Ervin Issac
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugis, KY 42459
Ervin Samuel
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Elijah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Saul
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Micah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mathias
Page 140 of 265
Owner NameFacilities Owned
NH5611 918-650-939314140 North 246th Road Okmulgee, OK 74447
Liberty Place
Lessor Or Real Estate Owner
236 Main Street Uniontown, KY 42461
4-B Properties, L.L.C.
24%OP/25%RE
Stockholders/partners -- Not Officers
2801 S. Court Dr. Evansville, IN 47711
Brown George L.
amended corp. name (fkaProdetik, Inc.)
eff 02-05-08
Operating Entity
P.O. Box 217 Weleetka, OK 74880
The Reach Corporation
Non-Profit Board President of The Reach
Corporation 1-8-08
Officers Who Do Not Hold Stock
P.O. Box 790 Uniontown, KY 42461
Welsh Richard
Non-Profit Board VP of The Reach
Corporation 1-8-08
Officers Who Do Not Hold Stock
PO Box 790 UnionTown, KY 42461
Bailey M. Geoffry
Non-Profit Board Sec/Treas of The Reach
Corporation
Officers Who Do Not Hold Stock
PO Box 790 Uniontown, KY 42461
Pyle William "Bill"
authorized agent for The Reach
Corporation
Officers Who Do Not Hold Stock
1201 West Trudgeon Place Henryetta, OK 74437
Bentley Roy
eff. 8-15-07
Lessor Or Real Estate Owner
P.O. Box 409 Sturgis, KY 42459
Maricopa Properties, LLC
100% of RE
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Maricopa Partners, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Rock River, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
MMB, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Lovenest, LLC
30.959% of Rock River, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gary
16.025% of Rock River, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Lisa
32.88% of MMB, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Tim
17.455% of MMB, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Vicki
29.421% of Lovenest, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Robert
13.957% of Lovenest, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Laura
Page 141 of 265
Owner NameFacilities Owned
53.016% of Rock River, LLC - 4 children
w/13.254% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
4 Irrevocable Trusts
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O.Box 409 Sturgis, KY 42459
Ervin Mallory
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Jade
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Luke
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gabe
49.665% of MMB, LLC - 5 children
w/9.933% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
3 Irrevocable Trusts
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Max
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box Sturgis, KY 42459
Linenger Jessica
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mitch
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Linenger Jennifer
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Brock
56.623% of Lovenest, LLC - 7 children
w/8.089% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
7 Irrevocable Trusts
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Thea
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugris, KY 42459
Ervin Issac
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugis, KY 42459
Ervin Samuel
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Elijah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Saul
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Micah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mathias
Page 142 of 265
Owner NameFacilities Owned
NH2502 405-756-43341103 West Cherokee Lindsay, OK 73502
Lindsay Manor Nursing Home
Operating Entity
P. O. Box 582 Sulphur, OK 73086
Lindsay Manor Nursing Home, Inc.
100% & Managing Member of
Interhealth, LLC eff 02/17/2017
Stockholders/partners -- Not Officers
9 Professional Drive Bella Vista, AR 72715
Montgomery Bradford
95% Trinkik Holdings, LLC eff 7/1/2016
Stockholders/partners -- Not Officers
P.O. Box 130 Newport, AR 72112
Niksefat Saeed Sy
5% Trinkik Holdings, LLC eff 7/1/2016
Stockholders/partners -- Not Officers
P.O. Box 130 Newport, AR 72112
Niksefat Sharona
100% Real Estate eff 07/01/2016
Lessor Or Real Estate Owner
P.O. Box 130 Newport, AR 72112
Trinik Holdings, LLC
Receiver CJ-2016-3346 Lindsay Manor
eff 01/25/2017
Court Appointed Receiver
419886 East 1080 Road Checotah, OK 74426
Cockrell Travis
Contracted Management eff 02/17/2017
Contracted Management
9 Professional Drive Bella Vista, AR 72715
Interhealth, LLC
NH6001 918-225-2220530 South Linwood Cushing, OK 74023
Linwood Village Nursing & Retirement Apts.
14.50%OP Ent / 10%RE
Stockholders/partners -- Not Officers
14 Woodward Blvd. Tulsa, OK 74114
Anderson Robert L.
Lessor Or Real Estate Owner
1405 East Moses Cushing, OK 74023
Colonial Plaza Nursing Home, Inc.
21% RE 11.032% OP
Stockholders/partners -- Not Officers
1815 East Skelly Dr. Tulsa, OK 74105
Rucker Ed
2.% RE 3.232% OP
Stockholders/partners -- Not Officers
Route 2, Box 2465 Cushing, OK 74023
Reinecke David
14.085% OP 11% RE
Stockholders/partners -- Not Officers
66 Cedar Ridge Rod. Broken Arrow, OK 74011
Jack E. Thomas Trust,
15.% RE
Stockholders/partners -- Not Officers
1100 S. Highland Cushing, OK 74023
Danny W. Smith & Randy Smith, co-trustees of George W. Smith Tes
eff. 5-15-06
Operating Entity
530 S. Linwood Ave. Cushing, OK 74023
Colonial Plaza Management Company, L.L.C.
14.086% OP 10% RE
Stockholders/partners -- Not Officers
P.O. Box 2300 Tulsa, OK 74192
Ceylon S. Lewis, Jr., Trust A,
Page 143 of 265
Owner NameFacilities Owned
beneficary of Genevieve K. Gary
Revocable Trust
Beneficiary
11711 South Braden Tulsa, OK 74137
Gary Richard
beneficary of Genevieve K. Gary
Revocable Trust
Beneficiary
11711 South Braden Tulsa, OK 74137
Miles Deanna
beneficary of Genevieve K. Gary
Revocable Trust
Beneficiary
11711 South Braden Tulsa, OK 74137
Hughes Jenny
beneficary of Genevieve K. Gary
Revocable Trust
Beneficiary
11711 South Braden Tulsa, OK 74137
Rucker Edward
beneficary of Ceylon S. Lewis, Jr. Trust A
Beneficiary
,
Lewis Corinne H.
beneficary of Ceylon S. Lewis, Jr. Trust A
Beneficiary
,
Lorenz Sarah Lee
beneficary of Ceylon S. Lewis, Jr. Trust A
Beneficiary
,
Lewis, III C. S.
beneficary of Ceylon S. Lewis, Jr. Trust A
Beneficiary
,
Kast Carol D.
beneficary of Jack E. Thomas Trust
Beneficiary
66 Cedar Ridge Road Tulsa, OK 74012
Thomas Betty J.
benefiary of Jack E. Thomas Trust
Beneficiary
66 Cedar ridge Road Tulsa, OK 74012
Meek Mary Jean
beneficary of Jack E. Thomas Trust
Beneficiary
66 Cedar Ridge Road Tulsa, OK 74012
Thomas Randall E.
beneficary of Jack E. Thomas Trust
Beneficiary
66 Cedar Ridge Road Tulsa, OK 74012
Waggenblatt Deborah Lynn
NH5557 405-677-24213317 Southeast 18th Street Del City, OK 73115
Mansfield Manor
Operating Entity
3317 S.E. 18th Street Del City, OK 73115
Reliant Living Centers of Oklahoma, Inc.
Board Member EFF 02/15/2013
Officers Who Do Not Hold Stock
821 SW 38th Oklahoma City, OK 73109
Black Art
President EFF 02/15/2013
Officers Who Do Not Hold Stock
4932 North Portland Avenue Oklahoma City, OK 73113
Love Willa
VP
Officers Who Do Not Hold Stock
9804 Casa Linda Oklahoma City, OK 73139
Moon Tim
Exec Dir
Officers Who Do Not Hold Stock
2901 S.E. 22nd Oklahoma City, OK 73129
Jernigan Janelle F.
Page 144 of 265
Owner NameFacilities Owned
Secretary EFF 02/15/2012
Officers Who Do Not Hold Stock
325 W. Pinesway Mustang, OK 73064
Ellis Scott
NH0604 405-663-2455800 Arapaho Hydro, OK 73048
Maple Lawn Nursing and Rehabilitation
President of RE/co-trustee & beneficiary
of Abbott Family Trust
Officers Who Do Not Hold Stock
Rt. 3, Box 112 Hydro, OK 73048
Abbott Kent
Mngr eff 11/2/07/ OP eff 06-04-08
Operating Entity
PO Box 70 Hydro, OK 73048
Western Health Management, Inc.
100% of OP
Stockholders/partners -- Not Officers
PO Box 73048 Hydro, OK 73048
Russell Family Investment Trust
Pres OP/SoleTrustee & Bene. of Russell
Fam Invest.Trust
Officers Who Do Not Hold Stock
PO Box 70 Hydro, OK 73048
Russell Robert
Secretary/Treasurer of OP
Officers Who Do Not Hold Stock
PO Box 70 Hydro, OK 73048
Stegall Eichelberger Anita
Beneficiary of Russell Fam Trust
Beneficiary
PO Box 70 Hydro, OK 73048
Russell Rita
eff 05-30-08
Lessor Or Real Estate Owner
PO Box 130 Hydro, OK 73048
Deer Creek Investments, LLC
100% RE & manag.member eff
10/27/2016
Stockholders/partners Who Are Officers
PO Box 130 Hydro, OK 73048
Abbott Family, LLC
100% member of Abott Family, LLC
Stockholders/partners -- Not Officers
PO Box 130 Hydro, OK 73048
Abbott Family Trust
trustee of Russell Family Trust/ VP of OP
eff 07/26/2011
Officers Who Do Not Hold Stock
PO Box 130 Hydro, OK 73048
Abbott Jaylee
NH3207 405-452-3271620 South Alabama Wetumka, OK 74883
Maple Place Living Center, LLC
President/Beneficiary of Family Trust
Trustee
P.O. Box 488 Weleetka, OK 74880
Adkins Gerrol Dean
Secretary/Beneficiary of Family Trust
Trustee
P.O. Box 488 Weleetka, OK 74880
Adkins Arbret June
Lessor Or Real Estate Owner
P.O. Box 488 Wetumka, OK 74880
Pioneer Nursing Home Of Hughes County, Inc.
Beneficiary eff.12/31/12319 West 9th St. Weleetka, OK 74880
Majors Cynthia
Page 145 of 265
Owner NameFacilities Owned
Beneficiary eff.12/31/12319 West 9th St Weleetka, OK 74880
Simmons Donna Renee
Beneficiary eff.12/31/12Rt. 1, Box 121A Weleetka, OK 74880
Adkins, II Gerrol D.
52% RE and manag.member of Business
Trust
Stockholders/partners -- Not Officers
P.O. Box 488 Weleetka, OK 74880
Gerrol Dean Adkins & Arbret June Adkins Family Trust (GDA/AJA)
Operating Entity
620 South Alabama Wetumka, OK 74883
Maple Place Living Center, LLC
100% OP manag.member
Stockholders/partners -- Not Officers
P.O. Box 488 Weleetka, OK 74880
Maple Place Revocable Business Trust
16% RE eff 12/31/12Rt 1 Box 121A Weleetka, OK 74880
Gerrol Dean Adkins II Irrevocable Trust dated 12/28/12
16% RE eff 12/31/12Rt 1 Box 121A Weleekta, OK 74880
Cynthia Denise Majors Irrevocable Trust dated 12/28/12
16% RE eff 12/31/12Rt 1 Box 121A Weleetka, OK 74880
Donna Renee Simmons Irrevocable Trust dated 12/28/12
Trustee eff 12/31/12
Trustee
523 W. Main Henryetta, OK 74437
Palmer, C.P.A. Reginald
NH7226 918-494-88306202 East 61st Street Tulsa, OK 74136
MapleWood Care Center
David Rhoades Reciver of SHOC, LLC -
CJ-2015-4701 eff 05/03/2016
Operating Entity
6202 E. 61st St. Tulsa, OK 74136
Skyline Heights Operating Co., L.L.C.
Chair&CEOend 1/10/14 Broad Member
eff 1/10/14 Senior Care Group
Officers Who Do Not Hold Stock
1240 Marbella Plaza Drive #12 Tampa, FL 33619
Vaughan David R.
100% Mang Member eff 03/15/11
Managing Member
1240 Marbella Plaza Drive Tampa, FL 33619
Senior Care Group, Inc.
Exec VP & CFO Senior Care Group
Officers Who Do Not Hold Stock
1240 Marbella Plaza Drive Tampa, FL 33619
Kramer Mark D.
Board Member Senior Care Group, Inc.
Officers Who Do Not Hold Stock
1240 Marbella Plaza Drive Tampa, FL 33619
Fridrich, Sr. Gerald D.
Board Member of Senior Care Group,
Inc.
Officers Who Do Not Hold Stock
1240 Marbella Plaza Drive Tampa, FL 33619
Surtees Robert E.
Secretary/Board Member Senior Care
Group, Inc.
Officers Who Do Not Hold Stock
2547 Mason Oaks Drive Valrico, FL 33596
Moran Francis D.
CFO & Secretary eff 03/15/11, Treasurer
eff 01/10/14 of SCG
Officers Who Do Not Hold Stock
1240 Marbella Plaza Drive Tampa, FL 33619
Chudow Katherine (Kathy)
Page 146 of 265
Owner NameFacilities Owned
Broadmember of Senior Care Group, Inc,
eff 01/10/2014
Officers Who Do Not Hold Stock
1240 Marbella Plaza Drive Tampa, FL 33619
Vaughan Michelle
Broad Member eff 01/10/2014
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drvie Tampa, FL 33619
Martin J. Michael
100% Real Estate eff 04/08/2016
Lessor Or Real Estate Owner
2001 Route 46 310 Parsippany, NJ 07054
LQC Partners VII,LLC LQC Partners VII, LLC
100% LQC Partners VII, LLC eff
04/08/2016
Stockholders/partners -- Not Officers
1300 South University Drive 306 Fort Worth, TX 76107
Senior Living Properties, LLC Senior Living Properties, LLC
Manager of LQC Partners, VII, LLC eff
04/08/2016
Manager
885 3rd Ave 2403 New York, NY 10022
LQC Partners, LLC LQC Partners, LLC
50% of Senior Living Properties, LLC
Stockholders/partners -- Not Officers
3395 North Pine Way 102 Wilson, WY 83014
Eden James
24.995% Senior Living Properties, LLC
eff 04/08/2016
Stockholders/partners -- Not Officers
3395 North Pine Way 102 Wilson, WY 83014
Eden Allison
24.995% Senior Living Properties, LLC
Stockholders/partners -- Not Officers
3395 North Pine Way 102 Wilson, WY 83014
Bonds Larry
Contract manager and .010% Senior
Living Properties, LLC
Contracted Management
1300 South University Drive 306 Fort Worth, TX 76107
SLP Management, Inc. SLP Management, Inc.
Reciver of SHOC, LLC - CJ-2015-4701
eff 05/03/2016
Court Appointed Receiver
401 South Boston 2200 Tulsa, OK 74103
Rhoades, Receiver CJ-2015-4701 C. David
100% SLP Management, Inc. eff
05/03/2016
Stockholders/partners -- Not Officers
1300 South University Dr. 306 Fort Worth, OK 76107
SLP Management Holdings, LLC
50% of SLP Management Holdings, LLC
eff 05/03/16
Stockholders/partners -- Not Officers
1300 S. University Drive 306 Fort Worth, TX 76107
Whitworth Scott
50% SLP Management Holding eff
05/03/2016
Stockholders/partners -- Not Officers
1300 S. University Dr. 306 Fort Worth, TX 76107
Boswell Darren
President SLP Management, Inc. eff
05/03/2016
Officers Who Do Not Hold Stock
1300 S University Dr Fort Worth, TX 76107
Leonard Joshua
NH6907 580-658-5468702 South 9th Street Marlow, OK 73055
Marlow Manor
Operating Entity
702 South 9th Street Marlow, OK 73055
Marlow Manor Nursing Home, Inc.
100% & Managing Member of
Interhealth, LLC eff 02/17/2017
Stockholders/partners -- Not Officers
9 Professional Drive Bella Vista, AR 72715
Montgomery Bradford
Page 147 of 265
Owner NameFacilities Owned
95% Trinkik Holdings, LLC eff 7/1/2016
Stockholders/partners -- Not Officers
P.O. Box 130 Newport, AR 72112
Niksefat Saeed Sy
5% of Trinik Holdings, LLC eff
07/01/2016
Stockholders/partners -- Not Officers
P.O. Box 130 Newport, AR 72112
Niksefat Sharona
100% Real Estate eff 07/01/2016
Lessor Or Real Estate Owner
P.O. Box 130 Newport, AR 72112
Trinik Holdings, LLC
Recevier CJ-2016-3346 Marlow Manor
NH Inc eff 01/25/2017
Court Appointed Receiver
419886 East 1080 Road Checotah, OK 74426
Cockrell Travis
Contracted Management Co. eff
02/17/2017
Contracted Management
9 Professional Drive Bella Vista, AR 72715
Interhealth, LLC
NH6107 918-426-4010615 East Morris Street McAlester, OK 74501
McAlester Manor
Operating Entity
110 West Muskogee Sulphur, OK 73086
McAlester Manor, Inc.
100% & Managing Member of
Interhealth, LLC eff 02/17/2017
Stockholders/partners -- Not Officers
9 Professional Drive Bella Vista, AR 72715
Montgomery Bradford
95% Trinkik Holdings, LLC eff 7/1/2016
Stockholders/partners -- Not Officers
P.O. Box 130 Newport, AR 72112
Niksefat Saeed Sy
5% Trinkik Holdings, LLC eff 7/1/2016
Stockholders/partners -- Not Officers
P.O. Box 130 Newport, AR 72112
Niksefat Sharona
100% Real Estate eff 07/01/2016
Lessor Or Real Estate Owner
P.O. Box 130 Newport, AR 72112
Trinik Holdings, LLC
Receiver CJ-2016-3346 eff 01/25/2017
Court Appointed Receiver
419886 East 1080 Road Checotah, OK 74426
Cockrell Travis
Contracted Management Co. eff
02/17/2017
Contracted Management
9 Professional Drive Bella Vista, AR 72715
Interhealth, LLC
NH6211 580-436-037313546 CR 3600 Ada, OK 74820-5378
McCalls Chapel School Inc #12
Operating Entity
Route 7 Box 232 Ada, OK 74820
McCalls Chapel School, Inc.
Board
Officers Who Do Not Hold Stock
P.O. Box 280 Fittstown, OK 74842
Brunk Bill
Page 148 of 265
Owner NameFacilities Owned
Board
Officers Who Do Not Hold Stock
6226 Colony Lane Oklahoma City, OK 73112
Burpee Dick
Chairman
Officers Who Do Not Hold Stock
P.O. Box 1219 Ada, OK 74820
Davison Denver
CEO
Officers Who Do Not Hold Stock
13545 CR 3600 Ada, OK 74820
Peschka Nina
NH6207 580-272-660013546 CR 3600 Ada, OK 74820-5378
McCalls Chapel School Inc. #5
Lessor Or Real Estate Owner
P.O. Box 669 Ada, OK 74820
First National Bank And Trust Company Of Ada
Operating Entity
Route 7 Box 232 Ada, OK 74820
McCalls Chapel School, Inc.
Board
Officers Who Do Not Hold Stock
P.O. Box 280 Fittstown, OK 74842
Brunk Bill
Board
Officers Who Do Not Hold Stock
6226 Colony Lane Oklahoma City, OK 73112
Burpee Dick
Chairman
Officers Who Do Not Hold Stock
P.O. Box 1219 Ada, OK 74820
Davison Denver
CEO
Officers Who Do Not Hold Stock
13545 CR 3600 Ada, OK 74820
Peschka Nina
NH6213 580-272-660013546 CR 3600 Ada, OK 74820-5378
McCalls Chapel School Inc. #8
Operating Entity
Route 7 Box 232 Ada, OK 74820
McCalls Chapel School, Inc.
Board
Officers Who Do Not Hold Stock
P.O. Box 280 Fittstown, OK 74842
Brunk Bill
Board
Officers Who Do Not Hold Stock
6226 Colony Lane Oklahoma City, OK 73112
Burpee Dick
Chairman
Officers Who Do Not Hold Stock
P.O. Box 1219 Ada, OK 74820
Davison Denver
CEO
Officers Who Do Not Hold Stock
13545 CR 3600 Ada, OK 74820
Peschka Nina
Page 149 of 265
Owner NameFacilities Owned
NH6208 580-272-660013546 CR 3600 Ada, OK 74820-5378
McCalls Chapel School Inc. #9
Operating Entity
Route 7 Box 232 Ada, OK 74820
McCalls Chapel School, Inc.
Board
Officers Who Do Not Hold Stock
P.O. Box 280 Fittstown, OK 74842
Brunk Bill
Board
Officers Who Do Not Hold Stock
6226 Colony Lane Oklahoma City, OK 73112
Burpee Dick
Chairman
Officers Who Do Not Hold Stock
P.O. Box 1219 Ada, OK 74820
Davison Denver
CEO
Officers Who Do Not Hold Stock
13545 CR 3600 Ada, OK 74820
Peschka Nina
NH6210 580-436-037313546 CR 3600 Ada, OK 74820-5378
McCalls Chapel School, Inc. #10
Operating Entity
Route 7 Box 232 Ada, OK 74820
McCalls Chapel School, Inc.
Board
Officers Who Do Not Hold Stock
P.O. Box 280 Fittstown, OK 74842
Brunk Bill
Board
Officers Who Do Not Hold Stock
6226 Colony Lane Oklahoma City, OK 73112
Burpee Dick
Chairman
Officers Who Do Not Hold Stock
P.O. Box 1219 Ada, OK 74820
Davison Denver
CEO
Officers Who Do Not Hold Stock
13545 CR 3600 Ada, OK 74820
Peschka Nina
NH6217 580-436-037313546 CR 3600 Ada, OK 74820
McCalls Chapel School, Inc. #11
Operating Entity
Route 7 Box 232 Ada, OK 74820
McCalls Chapel School, Inc.
Board
Officers Who Do Not Hold Stock
P.O. Box 280 Fittstown, OK 74842
Brunk Bill
Board
Officers Who Do Not Hold Stock
6226 Colony Lane Oklahoma City, OK 73112
Burpee Dick
Chairman
Officers Who Do Not Hold Stock
P.O. Box 1219 Ada, OK 74820
Davison Denver
Page 150 of 265
Owner NameFacilities Owned
CEO
Officers Who Do Not Hold Stock
13545 CR 3600 Ada, OK 74820
Peschka Nina
NH6218 580-436-037313546 CR 3600 Ada, OK 74820
McCalls Chapel School, Inc. #13
Operating Entity
Route 7 Box 232 Ada, OK 74820
McCalls Chapel School, Inc.
Board
Officers Who Do Not Hold Stock
P.O. Box 280 Fittstown, OK 74842
Brunk Bill
Board
Officers Who Do Not Hold Stock
6226 Colony Lane Oklahoma City, OK 73112
Burpee Dick
Chairman
Officers Who Do Not Hold Stock
P.O. Box 1219 Ada, OK 74820
Davison Denver
CEO
Officers Who Do Not Hold Stock
13545 CR 3600 Ada, OK 74820
Peschka Nina
NH6219 580-272-660013546 CR 3600 Ada, OK 74820
McCalls Chapel School, Inc. #14
OpEnt eff 1-30-07
Operating Entity
Route 7 Box 232 Ada, OK 74820
McCalls Chapel School, Inc.
Board
Officers Who Do Not Hold Stock
P.O. Box 280 Fittstown, OK 74842
Brunk Bill
Board
Officers Who Do Not Hold Stock
6226 Colony Lane Oklahoma City, OK 73112
Burpee Dick
Chairman
Officers Who Do Not Hold Stock
P.O. Box 1219 Ada, OK 74820
Davison Denver
CEO
Officers Who Do Not Hold Stock
13545 CR 3600 Ada, OK 74820
Peschka Nina
NH6220 580-272-660013546 CR 3600 Ada, OK 74820
McCalls Chapel School, Inc. #15
Operating Entity eff 10/28/2008
Operating Entity
Route 7 Box 232 Ada, OK 74820
McCalls Chapel School, Inc.
Page 151 of 265
Owner NameFacilities Owned
Board Member
Officers Who Do Not Hold Stock
P.O. Box 280 Fittstown, OK 74842
Brunk Bill
Board Member
Officers Who Do Not Hold Stock
6226 Colony Lane Oklahoma City, OK 73112
Burpee Dick
Board Member
Officers Who Do Not Hold Stock
P.O. Box 1219 Ada, OK 74820
Davison Denver
Board Member
Officers Who Do Not Hold Stock
13545 CR 3600 Ada, OK 74820
Peschka Nina
CEO
Officers Who Do Not Hold Stock
13545 CR 3600 Ada, OK 74820
Peschka Nina
NH6214 580-272-660013546 CR 3600 Ada, OK 74820
McCalls Chapel School, Inc. #2
Operating Entity
Route 7 Box 232 Ada, OK 74820
McCalls Chapel School, Inc.
Board
Officers Who Do Not Hold Stock
P.O. Box 280 Fittstown, OK 74842
Brunk Bill
Board
Officers Who Do Not Hold Stock
6226 Colony Lane Oklahoma City, OK 73112
Burpee Dick
Chairman
Officers Who Do Not Hold Stock
P.O. Box 1219 Ada, OK 74820
Davison Denver
CEO
Officers Who Do Not Hold Stock
13545 CR 3600 Ada, OK 74820
Peschka Nina
NH6215 580-272-660013546 CR 3600 Ada, OK 74820
McCalls Chapel School, Inc. #3
Operating Entity
Route 7 Box 232 Ada, OK 74820
McCalls Chapel School, Inc.
Board
Officers Who Do Not Hold Stock
P.O. Box 280 Fittstown, OK 74842
Brunk Bill
Board
Officers Who Do Not Hold Stock
P.O. Box 280 Fittstown, OK 74842
Brunk Bill
Board
Officers Who Do Not Hold Stock
6226 Colony Lane Oklahoma City, OK 73112
Burpee Dick
Board
Officers Who Do Not Hold Stock
6226 Colony Lane Oklahoma City, OK 73112
Burpee Dick
Page 152 of 265
Owner NameFacilities Owned
Chairman
Officers Who Do Not Hold Stock
P.O. Box 1219 Ada, OK 74820
Davison Denver
CEO
Officers Who Do Not Hold Stock
13545 CR 3600 Ada, OK 74820
Peschka Nina
NH6216 580-272-660013546 CR 3600 Ada, OK 74820
McCalls Chapel School, Inc. #4
Operating Entity
Route 7 Box 232 Ada, OK 74820
McCalls Chapel School, Inc.
Board
Officers Who Do Not Hold Stock
P.O. Box 280 Fittstown, OK 74842
Brunk Bill
Board
Officers Who Do Not Hold Stock
6226 Colony Lane Oklahoma City, OK 73112
Burpee Dick
Chairman
Officers Who Do Not Hold Stock
P.O. Box 1219 Ada, OK 74820
Davison Denver
Chairman
Officers Who Do Not Hold Stock
P.O. Box 1219 Ada, OK 74820
Davison Denver
CEO
Officers Who Do Not Hold Stock
13545 CR 3600 Ada, OK 74820
Peschka Nina
NH6209 580-272-660013546 CR 3600 Ada, OK 74820
McCalls Chapel School, Inc. #7
Operating Entity
Route 7 Box 232 Ada, OK 74820
McCalls Chapel School, Inc.
Board
Officers Who Do Not Hold Stock
P.O. Box 280 Fittstown, OK 74842
Brunk Bill
Board
Officers Who Do Not Hold Stock
6226 Colony Lane Oklahoma City, OK 73112
Burpee Dick
Chairman
Officers Who Do Not Hold Stock
P.O. Box 1219 Ada, OK 74820
Davison Denver
CEO
Officers Who Do Not Hold Stock
13545 CR 3600 Ada, OK 74820
Peschka Nina
Page 153 of 265
Owner NameFacilities Owned
NH5613 918-650-9393405 West 18th Street Okmulgee, OK 74447
McCurdy Place
Lessor
Lessor Or Real Estate Owner
236 Main Street Uniontown, KY 42461
4-B Properties, L.L.C.
24%OP/25%RE
Stockholders/partners -- Not Officers
2801 S. Court Dr. Evansville, IN 47711
Brown George L.
amended corp. name (fkaProdetik, Inc.)
eff 02-05-08
Operating Entity
P.O. Box 217 Weleetka, OK 74880
The Reach Corporation
Non-Profit Board President of The Reach
Corporation 1-8-08
Officers Who Do Not Hold Stock
P.O. Box 790 Uniontown, KY 42461
Welsh Richard
Non-Profit Board VP of The Reach
Corporation 1-8-08
Officers Who Do Not Hold Stock
PO Box 790 UnionTown, KY 42461
Bailey M. Geoffry
Non-Profit Board Sec/Treas of The Reach
Corporation
Officers Who Do Not Hold Stock
PO Box 790 Uniontown, KY 42461
Pyle William "Bill"
authorized agent for The Reach
Corporation
Officers Who Do Not Hold Stock
1201 West Trudgeon Place Henryetta, OK 74437
Bentley Roy
eff. 8-15-07
Lessor Or Real Estate Owner
P.O. Box 409 Sturgis, KY 42459
Maricopa Properties, LLC
100% of RE
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Maricopa Partners, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Rock River, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
MMB, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Lovenest, LLC
30.959% of Rock River, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gary
16.025% of Rock River, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Lisa
32.88% of MMB, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Tim
17.455% of MMB, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Vicki
29.421% of Lovenest, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Robert
13.957% of Lovenest, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Laura
Page 154 of 265
Owner NameFacilities Owned
53.016% of Rock River, LLC - 4 children
w/13.254% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
4 Irrevocable Trusts
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O.Box 409 Sturgis, KY 42459
Ervin Mallory
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Jade
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Luke
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gabe
49.665% of MMB, LLC - 5 children
w/9.933% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
3 Irrevocable Trusts
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Max
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box Sturgis, KY 42459
Linenger Jessica
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mitch
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Linenger Jennifer
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Brock
56.623% of Lovenest, LLC - 7 children
w/8.089% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
7 Irrevocable Trusts
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Thea
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugris, KY 42459
Ervin Issac
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugis, KY 42459
Ervin Samuel
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Elijah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Saul
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Micah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mathias
Page 155 of 265
Owner NameFacilities Owned
NH6309 405-964-2961701 South 8th Street Mcloud, OK 74851
Mcloud Nursing Center
100% OP eff 09/19/2014, 100% RE eff
07/26/2013 & 100% of Manager
Officers Who Do Not Hold Stock
3050 Peachtree Rd 355 Atlanta, GA 30305
Brogdon Christopher
OP eff 07/26/2013
Operating Entity
Two Buckhead Plaza, 3050 Peachtree RD NW 355 Atlanta, GA 30305
MCL Nursing, LLC
RE owner eff 07/26/2013
Lessor Or Real Estate Owner
Two Buckhead Plaza, 3050 Peachtree RD NW 355 Atlanta, GA 30305
McLoud Property Holdings, LLC
Manager eff 03/01/2014
Contracted Management
Two Buckhead Plaza, 3050 Peachtree Road NW 355 Atlanta, GA 30305
Marsh Pointe Managment, LLC
NH1606 580-357-32402007 NW 52nd Street Lawton, OK 73505
McMahon-Tomlinson Nursing & Rehabilitation Center
Operating Entity
3401 W. Gore Blvd. Lawton, OK 73505
Comanche County Hospital Authority
Member eff
10/21/2014,Vice-Chair-4-12-17
Officers Who Do Not Hold Stock
411 S.W. 6th Street Lawton, OK 73501
Zelbst John
Chairman eff10/21/2014, Member eff
4-12-17
Officers Who Do Not Hold Stock
1130 SW Lee Blvd Lawton, OK 7501
Henry Pat
Secretary & Treasurer eff
10/21/2014,Chairman eff 4-12-17
Officers Who Do Not Hold Stock
810 SW C Avenue Lawton, OK 73501
Butler Dennis
Member eff 10/21/2014, Secretary eff
4-12-2017
Officers Who Do Not Hold Stock
15 SW Bishop Rd Lawton, OK 73501
Green Clayton (Buddy)
Member eff 4-12-17
Officers Who Do Not Hold Stock
3201 W. Gore Blvd. 100 Lawton, OK 73505
Legako Edward
NH4012 918-658-365621256 Meadow Lane Howe, OK 74940
Meadow Brook ICF/MR
Operating Entity
1200 Meadow Lane Howe, OK 74940
Meadow Brook Intermediate Care-M.R. Facility, L.L.C.
Lessor Or Real Estate Owner
1200 Meadow Lane Howe, OK 74940
Meadow Brook Intermediate Care-M.R. Facility, L.L.C.
Page 156 of 265
Owner NameFacilities Owned
Trustee Bobby Cox Living Trust eff
01/2015
Trustee
1000 Meadow Lane Howe, OK 74940
Cox, II Bobby D.
100% of Meadow Brook ICMR
Stockholders/partners -- Not Officers
21256 Meadow Lane Howe, OK 74940
Bobby Cox Living Trust, A Revocable Trusr 01-29-1997
NH4004 918-658-208821270 Meadow Lane Howe, OK 74940
Meadow Brook ICFMR #2
Trustee Bobby Cox Living Trust eff
01/2015
Trustee
1000 Meadow Lane Howe, OK 74940
Cox, II Bobby D.
eff 02/29/08
Operating Entity
1500 Meadow Lane Howe, OK 74940
Meadow Brook Intermediate Care - M.R. Facility, #2, L.L.C.
100% of Meadow Brook ICMR #2
Stockholders/partners -- Not Officers
21256 Meadow Lane Howe, OK 74940
Bobby Cox Living Trust, A Revocable Trusr 01-29-1997
NH4903 918-476-8918113 East Jones Chouteau, OK 74337
Meadowbrook Nursing Center
25% BGM Estate, LLC eff 9-16-16
Stockholders/partners -- Not Officers
P.O. Box 330 Muldrow, OK 74948
Tabor Angela
25% BGM Estate, LLC
Stockholders/partners -- Not Officers
111522 S. 4740 Rd. Muldrow, OK 74948
Mitchell Robert Michael
25% BGM Estate, LLC eff 9-16-16
Stockholders/partners -- Not Officers
412 S. Dogwood Sallisaw, OK 74955
Mitchell Marcinda
16.67% & 25% BGM Estate, LLC eff
9-16-16
Stockholders/partners -- Not Officers
7240 Chase Oaks Blvd 121 Plano, TX 75025
Mitchell Kelly O.
UPL Manager Eff 6/30/2017
Contracted Management
201 N. Elm Sallisaw, OK 74955
Colonial Care Center, L. L. C.
Manager EFF 03/11/2013
Contracted Management
113 East Jones Chouteau, OK 74337
Sosi Belinda
Manager of Colonial Care Center, LLC
eff 05/05/2014
Officers Who Do Not Hold Stock
210 S. Adair Pryor, OK 74362
Carson Jonathan
Manager of Colonial Care Center, LLC
eff 04/16/20156
Manager
113 East Jones Chouteau, OK 74337
Miller Jenifer
83.33% OP eff 9-16-16
Stockholders/partners -- Not Officers
,
BGM Estate, LLC
Page 157 of 265
Owner NameFacilities Owned
UPL Owner eff. 6/30/2017
Operating Entity
201 S. 2nd Street Hugo, OK 74743
City of Hugo
NH5531 405-703-3400959 Southwest 107th Street Oklahoma City, OK 73139
Meadowlake Estates
Trustee of the Denver McCormick
Reocabel Trust
Trustee
9813 S. Penn OKC, OK 73159
McCormick Denver
Trustee of the Linda McCormick
Revocable Trust
Stockholders/partners -- Not Officers
9813 S. Penn OKC, OK 73159
McCormick Linda
Trustee of the Arlena Dunbar Revocable
Trust
Trustee
5413 NW 107th Street Oklahoma City, OK 73162
Dunbar Arlena
eff 3/1/05
Operating Entity
9813 S. Penn Oklahoma City, OK 73159
Meadow Lake Operating, L.L.C.
Trustee of the Donald Nevard Revocable
Trust
Trustee
4800 N. Lincoln OKC, OK 73105
Nevard Donald
15% of OP & RE
Stockholders/partners -- Not Officers
P.O. Box 130 Durant, OK 74701
1st United Venture Cap Corp
46.806% WR Invest,59.9 Lake
Creek,100% LC Gen Part 100% WR
InvGP
Stockholders/partners -- Not Officers
1500 Waters Ridge Dr 200 Lewisville, TX 75077
Taylor John F.
30.323% WR Investments, LP
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, TX 75057
Lake Creek Capital Partners, LP
10.709% WR Investments, LP
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, TX 75057
Fisher James (Jim)
10.065% WR Investments, LP
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, TX 75057
Pierce Paula
0.1% GP Lake Creek Capital Partners, LP
General Partner
1500 Waters Ridge Drive 200 Lewisville, TX 75057
LC General Partner, LLC
42.5%OP/21.25%Real Estate
Stockholders/partners -- Not Officers
9813 S. Penn Oklahoma City, OK 73159
Denver McCormick Revocable Trust
21.25% Meadow Lake Estate (RE)
07/17/2013
Stockholders/partners -- Not Officers
9813 S. Penn Oklahoma City, OK 73159
Linda McCormick Revocable Trust
21.25% OP/RE and 40% Mangt.Entity
Stockholders/partners -- Not Officers
5413 N.W. 107th Okla. City, OK 73162
Arlena Dunbar Revocable Trust
21.25% OP/RE eff 07/17/2013
Stockholders/partners -- Not Officers
5 S.W. 9th Okla. City, OK
Donald Nevard, Revocable Trust
Trustee Nevard Debra
Page 158 of 265
Owner NameFacilities Owned
Beneficiary Donald Nevard Revocable
Trust4800 N. Lincoln Blvd. Okla. City, OK 73105
Beneficiary Donald Nevard Revocable
Trust
Trustee
4800 N. Lincoln Blvd. Okla. City, OK 73105
Nevard Lisa
Beneficiary Donald Nevard Revocable
Trust
Trustee
4800 N. Lincoln Blvd. Okla. City, OK 73105
Nevard Michael
Beneficiary of Linda & Denver
McCormicks Revocable Trusts
Trustee
4108 Opus Ct. Flower Mound, TX 75022
Pennington Amy
Beneficiary of Linda & Denver
McCormicks Revocable Trusts
Beneficiary
2433 Glenoak Dr. Norman, OK 73071
Petrone Alison
Beneficiary of Linda & Denver
McCormicks Revocable Trusts
Beneficiary
8594 D East 133 Holdenville, OK 74850
Jones Joshua
Beneficiary of Linda & Denver
McCormicks Revocable Trusts
Beneficiary
8594 D East 133 Holdenville, OK 74850
Jones Tanner
Beneficiary of Arlena Dunbar Revocable
Trust
Trustee
5413 NW 107th Okla. City, OK 73159
Dunbar William
Beneficiary of Arlena Dunbar Revocable
Trust
Trustee
3913 Spyglass Rd. Okla. City, OK 73162
Nard Charlotte
Beneficiary of Arlena Dunbar Revocable
Trust
Trustee
12204 N. Kimberlyn Rd. Okla. City, OK 73162
Dunbar Teresa
Subcontracted management Eff 6/30/2017
Contracted Management
1500 Waters Ridge Drive 200 Lewisville, TX 75057
Stonegate Senior Living, LLC
Lessor Or Real Estate Owner
9813 South Penn Okla. City, OK 73159
Meadow Lake Estates, LLC
3.097% WR Investments, LP 20% Lake
Creek Cap Partners, LP
Stockholders/partners -- Not Officers
1500 Waters Ridge Dt Lewisville, TX 75057
Taylor John P.
100% SGSL Management Holdings
Stockholders/partners -- Not Officers
1500 Waters Ridge Dirve 200 Lewisville, TX 75057
WR Investments, LP (WRI, LP)
General Partner WR Investments, LP
100% WR Invest GP Manager
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, TX 75057
WR Investments GP, Inc.
20% Lake Creek Capital Partners, LP
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, TX 75057
Campbell Scott
100% Stonegate Senior Living, LLC
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, OK 75057
SGSL Management Holdings, LLC
managing member SGSL Management
Holdings, LLC
Managing Member
1500 waters Ridge Dr. Lewisville, TX 75057
WR Investments GP Manager, Inc. (WRIGPMI)
Page 159 of 265
Owner NameFacilities Owned
NH1418 405-321-21883110 Healthplex Drive Norman, OK 73072-9705
Medical Park West Rehabilitation and Skilled Care
45.806% of WR Invest,LP, 100% WR
GP, 59.9% LCCP, 100% LC GP
Stockholders/partners -- Not Officers
1500 Waters Ridge Dr 200 Lewisville, TX 75077
Taylor John F.
30.323% of WR Investments, LP Eff
02/10/2014
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, TX 75057
Lake Creek Capital Partners, LP
10.709% WR Investments, LP
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, TX 75057
Fisher James (Jim)
10.065% of WR Investments, LP
Stockholders/partners Who Are Officers
1500 Waters Ridge Drive 200 Lewisville, TX 75057
Pierce Paula
General Partner of Lake Creek Capital
Partners, LP 02/10/2014
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, TX 75057
LC General Partner, LLC
Contracted Mangement Company eff
03/15/13
Contracted Management
1500 Waters Ridge Drive 200 Lewisville, TX 75057
Stonegate Senior Living, LLC
UPL Manager Eff 6/30/2017
Contracted Management
1500 Waters Ridge Dr Lewisville, TX 75057
EM Operations, LLC
3.0970% WR Inv LP, 20% Lake Creek
Cap Part
Stockholders/partners -- Not Officers
1500 Waters Ridge Dt Lewisville, TX 75057
Taylor John P.
100% of RE eff 03/15/2013
Lessor Or Real Estate Owner
200 International Circle 3500 Hunt Valley, MD 21030
Texas Lessor-Stonegate, LP
Sub Lessor to the OP
Lessor Or Real Estate Owner
1500 Waters Ridge Drive 200 Lewisville, TX 75057
Stonegate SNF Properties, LP
100% of EM Operations, LLC & 100%
Stonegate SNF GP, LLC
Stockholders/partners -- Not Officers
1500 Waters Ridge Dr. 200 Lewisville, TX 75057
Southwest SNF Holdings, LLC (SW SNFH)
100% of Southwest SNF Holdings, LLC
& 100% SGSL Mgt Holdings
Stockholders/partners -- Not Officers
1500 Waters Ridge Dirve 200 Lewisville, TX 75057
WR Investments, LP (WRI, LP)
General Partner of WR Investments, LP
eff 02/10/2014
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, TX 75057
WR Investments GP, Inc.
20% of Lake Creek Capital Partners, LP
eff 02/10/2014
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, TX 75057
Campbell Scott
100% Stonegate Senior Living, LLC
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, OK 75057
SGSL Management Holdings, LLC
UPL Owner eff. 6/30/2017
Operating Entity
100 W. Paul Avenue Pauls Valley, OK 73075
City of Pauls Valley
Page 160 of 265
Owner NameFacilities Owned
NH7404 918-534-2848430 Bartles Road Dewey, OK 74029
Medicalodges Dewey
100%
Stockholders/partners Who Are Officers
201 W. 8th Coffeyville, KS 67337
Medicalodges, Inc., Employee Stock Ownership
Pres./CEO eff 7/8/10 - Gen.
Counsel/Secretary/Board of Dir-.3/16
Officers Who Do Not Hold Stock
3113 Crown Drive Independence, KS 67301
Cox Garen
VP Financial Reporting
Officers Who Do Not Hold Stock
P.O. Box 702 S. Coffeyville, OK 67337
McCord Cathy
Operating Entity
201 W. 8th Coffeyville, KS 67337
Medicalodges, Inc.
Chairman of Board
Officers Who Do Not Hold Stock
4050 Washington Indianapolis, IN 67337
Butler Dick
VP/CFO eff 07/08/2010 eff. 3/16 Treas.
Board of Dir.
Officers Who Do Not Hold Stock
2905 Royal Court Independence, KS 67301
Hines Scott
V.P./COO
Officers Who Do Not Hold Stock
903 South Oak PLATTBURG, MO 64477
Ledger Shannon
Corporate Compliance & Gen. Counsel
eff 3/16
Officers Who Do Not Hold Stock
9773 West 125th Street Burlingame, KS 66413
Smith Pamela
Regional V. P. eff. 3/16
Officers Who Do Not Hold Stock
804 C Street Washington, KS 66968
Cardenas Staci
Regional VP eff 3.16
Officers Who Do Not Hold Stock
6624 SW Fieldwood Topeka, KS 66619
Lantz Kathy
Regional VP eff. 3/16
Officers Who Do Not Hold Stock
1103 South 220th Pittsburg, ks
McBride Travis
Assistant Secetary eff 3/16
Officers Who Do Not Hold Stock
Route 1 Box 207-12 So. Coffeyville, OK
Belty Mecca
Board of Directors eff 3/16
Officers Who Do Not Hold Stock
220 NW. RD Mize Rd. Blue Springs, MO
Voss Diane
Board of Director
Officers Who Do Not Hold Stock
103 Leasure Hall Manhatten, KS
Doll Gayle
Board of Directors
Officers Who Do Not Hold Stock
6904 Stockton Drive Fort Worth, TX
Marshall Carol
Board of Directors
Officers Who Do Not Hold Stock
8201 Limerick Lane Wichita, KS
Ott Ron
NH4106 405-279-3521500 North Dawson Street Meeker, OK 74855
Meeker Nursing Center
Page 161 of 265
Owner NameFacilities Owned
100% of RE, 100% OP, & 100% of
Manager
Officers Who Do Not Hold Stock
3050 Peachtree Rd 355 Atlanta, GA 30305
Brogdon Christopher
100% RE Owner - eff 07/26/2013
Lessor Or Real Estate Owner
3050 Peachtree Road 355 Atlanta, GA 30305
Meeker Property Holdings,LLC
OP eff 07/26/2013
Operating Entity
Two Buckhead Plaza, 3050 Peachtree RD NW 355 Atlanta, GA 30305
Meeker North Dawson Nursing, LLC
Manager eff 03/01/2014
Contracted Management
Two Buckhead Plaza, 3050 Peachtree Road NW 355 Atlanta, GA 30305
Marsh Pointe Managment, LLC
NH4504 580-286-33661305 Southeast Adams Idabel, OK 74745
Memorial Heights Nursing Center
Operating Entity
1305 Southeast Adams Street Idabel, OK 74745
Heartway Corporation
Director end 6/1/10 Secetary, Board of
Directors eff 6/1/10
Officers Who Do Not Hold Stock
2202 Sunset Ridge Muskogee, OK 74403
Black Vletta (Kathy)
President, Board of Directors
Officers Who Do Not Hold Stock
13490 Old Livingston Road Naples, FL 34109
Lam Charles H
Treasurer, Board of Directors
Officers Who Do Not Hold Stock
3254 Roan Way San Antonio, TX 78205
Johnson Thomas R
VP, Board of Directors eff 6/1/10
Officers Who Do Not Hold Stock
1302 S. Lynn Lane Idabel, OK 74745
Salyer Dr. Thomas W.
Director, Board of Directors Eff 6/1/10
Officers Who Do Not Hold Stock
810 W. Adams Street Broken Arrow, OK 74728
Darby, Jr Pastor Charles L. (Chuck)
NH7103 580-335-6646319 East Josephine Frederick, OK 73542
Memorial Nursing Center
Name change 4/25/2016
Operating Entity
319 E. Josephine Frederick, OK 73542
County of Tillman-City Of Frederick Hospital Authority
Vice Chairman eff 08/12/2013
Officers Who Do Not Hold Stock
Route 1 Box 20 Frederick, OK 73542
Oxford Jay
Chariman eff 08/12/2012
Officers Who Do Not Hold Stock
702 North 15th Street Frederick, OK 73542
Tyler Gary
Interim Site Administrator Eff 7/15/15
Managing Member
310 N Mary Davidson, OK 73530
Coleman Ricky
Page 162 of 265
Owner NameFacilities Owned
NH6908 580-439-2398Route 2, Box 335 Comanche, OK 73529
Meridian Nursing Home
50%
Stockholders/partners Who Are Officers
1908 12th Ave N.W. E Ardmore, OK 73401
Coble Tom C.
Operating Entity
1908 12th Avenue NW, Suite E Ardmore, OK 73401
Meridian Health Care LLC
50%
Stockholders/partners -- Not Officers
110 Barr Avenue Pauls Valley, OK 73075
Washita Valley Investments, L.L.C.
100% Washita Valley Investments, LLC
eff 04-30-2016
Stockholders/partners -- Not Officers
110 Burr Aveneu Pauls Valley, OK 73075
Justice Julie
NH5805 918-542-33351100 East Street Northeast Miami, OK 74354
Miami Nursing Center, LLC
9.61494% Oklahoma Nursing Home, Ltd,
Manager Eff 4/25/2016
Contracted Management
210 E. Choctaw, P.O. Box 429 Sallisaw, OK 74955-0429
Oklahoma Nursing Homes, Ltd. (ONH,Ltd.)
1.118067% OP/ 1.14% RE
Stockholders/partners -- Not Officers
P.O. Box 188 Muskogee, OK 74402
Glen Armstrong Trust c/o Armstrong Bank, Ray King & Billy Taylor
2.121569% OP/ 2.14% RE
Stockholders/partners -- Not Officers
P.O. Box 435 Vian, OK 74962
Armstrong Estate, Sally Armstrong, Executor James
8.314% OP & Mgr./ 8.4112% RE/
9.401287% Okla. Nurs. Homes, Inc.
Stockholders/partners -- Not Officers
P.O. Box 40 Sallisaw, OK 74955
Cheek Barnie J.
1.838339% OP/ 1.86% RE
Stockholders/partners -- Not Officers
10105 S. 77th East Place Tulsa, OK 74133
Masako Cheek Trust, Masako Cheek Trustee
8.314% OP & Mgmt. / 8.4112% RE
Stockholders/partners -- Not Officers
3520 East 110th Place Tulsa, OK 74137
Sandra Cheek Farmer Trust (SCFT)
5.834% OP & Mgmt/5.9190% mgr
RE/6.597394% Okla. Nurs.Homes,Inc.
Stockholders/partners Who Are Officers
4814 S. 164th East Ave. Tulsa, OK 74134
Haskins Lloyd
5.192% OP & Mgmt. / 5.2626% RE/
12.535047% Okla.Nurs.Homes,Inc.
Stockholders/partners -- Not Officers
51 green acre village #51 Sallisaw, OK 74955
Watts Cleo
5.893% OP & Mgmt. / 5.9746% RE
Stockholders/partners -- Not Officers
51 Green Acre Village Sallisaw, OK 74955
Watts Beneficiaries Trust (WBT)
5.612090% OP/ 5.67% RE
Stockholders/partners -- Not Officers
20852 S. Shannon Dr. Claremore, OK 74017
William McKesson Wilson Sr. 1997 Trust
14.022% OP & Mgmt/ 14.2078% RE/
21.936335% Okla.Nurs.Homes,Inc.
Stockholders/partners Who Are Officers
Box 856 Miami, OK 74355
Tubbs Steven
5.376% OP & Mgmt. / 5.4406% RE
Stockholders/partners -- Not Officers
3910 Cherry Forest Drive Houston, TX 77088
Tubbs, Jr. Stanley I.
Page 163 of 265
Owner NameFacilities Owned
5.542% OP & Mgr./ 5.6186% RE/
6.267525% Okla Nurs Homes, Inc.
Stockholders/partners -- Not Officers
416 Fairway Dr. Athens, TX 75751
Estep Pat
2.771% OP & Mgmt. / 2.8037% RE
Stockholders/partners -- Not Officers
1500 West Elm Stroud, OK 74079
Julie Kay Bivin Revocable Trust (JKBRT)
5.135% OP/MANAGEMENT/ RE
5.2207%
Stockholders/partners -- Not Officers
6708 South 256th East Avenue Broken Arrow, OK 74014
Caroyln D. Leaverton Revocable Trust
2.771% OP & Mgmt./ 2.8037% RE
Stockholders/partners -- Not Officers
PO Box 370 Adair, OK 74330
Dr. William R. VanDeLinder Trust (DWVT)
2.771% OP & Mgmt. / 2.8037% RE
Stockholders/partners -- Not Officers
3808 NW Marquess Drive Bentonville, AR 72712
Lynn M. Yowell Trust
3.89% of Midwest Nursing Home, LLC
9.7298% RE
Lessor Or Real Estate Owner
210 East Choctaw Sallisaw, OK 74955
Midwest Nursing Homes, LLC (MNHLLC)
2.771% OP & Mgmt. / 2.8038% RE
Stockholders/partners -- Not Officers
2802 West Country Club Drive Oklahoma City, OK 73116
Richard Armstrong Trust (RAT)
8.61494% of Miami Nurisng Center, LLC
Eff 4/25/2016
Operating Entity
P.O. Box 400 Sallisaw, OK 74955
Miami Nursing Center, LLC
1.219% mgr OP & Mgmt.
Stockholders/partners Who Are Officers
P.O. Box 400 Sallisaw, OK 74955
Oklahoma Nursing Homes, Inc. General Partner (ONH,Inc)
9.401287% Oklahoma Nursing Homes,
Inc. Beneficiary RGA Trust
Stockholders/partners -- Not Officers
2802 W. Country Club Dr. Oklahoma City, OK 73116
Armstrong Richard James
9.401287% Oklahoma Nursing Homes,
Inc. Trustee SCFT
Stockholders/partners -- Not Officers
3520 East 110th Place Tulsa, OK 74137
Farmer Sandra
1.283% OP&Mgmt./ 1.3156%
RE/9.401287%
Ok.Nurs.Hms,Inc.eff5/24/12
Stockholders/partners -- Not Officers
20852 South Shannon Drive Claremore, OK 74017
Wilson James G.
2.079% OP & Mgmt. / 2.1028% RE
Stockholders/partners -- Not Officers
P.O. Box 173 Gore, OK 74435
Ferguson Debra M.
5.5630%RE/5.55600%OP/5.657265% ok
nr hm,inc EFF 05/24/2012 Treas
Stockholders/partners -- Not Officers
607 Mayo Street Sallisaw, OK 74955
McGrew Justin
2.771% OP & Mgmt/ 2.8038% RE
Stockholders/partners -- Not Officers
HCR 68 Box 1260 Vian, OK 74962
Armstrong Sally
9.401287% Oklahoma Nursing Home,
Inc. President
Stockholders/partners Who Are Officers
PO Box 370 Adair, OK 74330
VanDeLinder Dr. William R.
RE 0.70095% & 0.69275% OP
Stockholders/partners -- Not Officers
1405 E. Seattle St. Broken Arrow, OK 74012
Heath Armstrong VanDeLinder Trust (HAVT)
RE 0.70095% & 0.69275% OP
Stockholders/partners -- Not Officers
2812 West 114th Street Jenks, OK 74037
Meredith Margaret Marie VanDeLinder Trust (MMMVT)
RE 0.70095% & 0.69275% OP
Stockholders/partners -- Not Officers
8 Dinton Circle Bella Vista, AR 72714
Nicolas Edmund VanDeLinder Trust (NEVT)
Page 164 of 265
Owner NameFacilities Owned
RE 0.70095% & 0.69275% OP
Stockholders/partners -- Not Officers
2116 Whitney Lane McKinney, TX 75070
William Glen VanDelinder Trust (WGVT)
Julie Kay Bivin Revocable Trust
Trustee
1500 West Elm Stroud, OK 74079
Bivin Julie K.
Succ.Trustee & Benf-Carolyn D.
Leaverton Rev. Trust eff 05/24/12
Beneficiary
6708 South 256th East Ave Broken Arrow, OK 74014
Johnson Karen Diane
Succ.Trustee & Benf-Carolyn D.
Leaverton Rev. Trust eff 05/24/12
Beneficiary
6708 South 256th East Ave Broken Arrow, OK 74014
Fine Michael B.
Successor Trustee & Beneficiary -WBT
eff 5/24/12
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Byers Karen
Beneficiary - SCFT eff 5/24/12
Beneficiary
3520 East 110th Place Tulsa, OK 74137
Farmer Cassandra C.
Beneficiary - SCFT eff 5/24/12
Beneficiary
3520 East 110th Place Tulsa, OK 74137
Farmer Alexandra C.
Trustee MMMV Trust
Beneficiary
2812 West 114th St. south Jenks, ok 74037
Leutz William K.
Richard Armstrong Trust
Trustee
c/o Ben Bryers, 2802 W. Country Club DR. Oklahoma City, ok 73116
Heritage Trust Co.,
Dr. WIlliam R. VanDeLinder Trust
Trustee
P.O. Box 370 Adair, ok 74330
VanDeLinder Dr. William R.
Lynn M. Yowell Trust eff- 11/27/2013
Trustee
3808 NW Marquess Drive Bentonville, AR 72712
Yowell Lynn
Lynn M. Yowell Trust eff- 11/27/2013
Trustee
3808 NW Marquess Drive Bentonville,, AR 72712
Yowell Ron
4.77%OP, 4.77% of ONH LTD 4.8398%
Midwest Nursing Homes eff 8/14
Stockholders/partners -- Not Officers
4248 A Street #201 Auburn, WA 98002
Young Sindy
Trustee & Beneficiary HAV Trust
Trustee
1405 E. Seattle St. Broken Arrow, OK 74012
VanDelinder Heath Armstrong
Beneficiary MMMV Trust
Beneficiary
2812 West 114th Street South Jenks, OK 74037
VanDeLinder Meredith Margaret Marie
Trustee & Beneficiary Nicolas Edmund
VanDelinder trust
Trustee
8 Dinton Circle Bella Vista, AR 71714
VanDelinder Nicolas Edmund
Beneficiary Julie Kay Biven Revocable
Trust
Beneficiary
1500 West Elm Stroud, OK 74079
Bivin Jeremy
Beneficiary Julie Kay Biven Revocable
Trust
Beneficiary
1500 West Elm Stroud, OK 74049
Bivin Ryan
Page 165 of 265
Owner NameFacilities Owned
NH5552 405-737-82008200 National Avenue Midwest City, OK 73110
Midwest City Healthcare Residence
OP eff 09/01/2015
Operating Entity
111 Clifton Avenue Lakewood, NJ 08701
Midwest City Healthcare Residence Operator, LLC
Lessor eff 09/01/2015
Lessor Or Real Estate Owner
111 Clifton Ave Lakewood, NJ 08701
Midwest Texas Realty, LLC
100% RE eff 09/01/2015
Lessor Or Real Estate Owner
111 Clifton Ave Lakewood, TX 08701
Strawberry Fields REIT
50% MWC Healthcare Res OP, LLC &
Midwest TX CEO eff 09/01/2015
Stockholders/partners Who Are Officers
20 Aspen Court Lakewood, NJ 08701
Neuman Joe
50% MWC Healthcare Res OP &
Midwest TX, President 09/01/2015
Stockholders/partners Who Are Officers
6203 Tuner Way Dallas, TX 75230
Rosenberg Oscar
NH6104 918-423-4661315 West Electric Ave. McAlester, OK 74501
Mitchell Manor Convalescent Home LLC
Pres49%w/wife as JT and 51%
individually
Stockholders/partners Who Are Officers
5643 South US HWY 69 Mcalester, OK 74501
Mitchell Joe
VP49%w/husb
Stockholders/partners Who Are Officers
5643 South US HWY 69 Mcalester, OK 74501
Mitchell Niva
Eff 04/08/2010
Operating Entity
315 W. Electric Ave McAlester, OK 74501
Mitchell Manor Convalescent Home, LLC
NH2104 918-253-4500226 East Monroe Street Jay, OK 74346
Monroe Manor
op
Operating Entity
5134 East 107th Place Tulsa, OK 71437
Grand Union HealthCare, L.L.C.
50% interest holder/Managing Member
Stockholders/partners Who Are Officers
12112 South 4th Street Jenk, OK 74037
DuBois Charles R.
50% interest holder/Member
Stockholders/partners Who Are Officers
1705 Sunset Circle Grove, OK 74344
VanLear Michael
Sec
Officers Who Do Not Hold Stock
31234 South 613 Lane Grove, OK 74344
VanLear Shirley
0%/Board Member
Officers Who Do Not Hold Stock
1015 E. 9th Place Cushing, OK 74023
DuBois Connie M.
Page 166 of 265
Owner NameFacilities Owned
NH1605 580-536-28667604 NW Quanah Parker Trailway Lawton, OK 73505
Montevista Rehabilitation and Skilled Care
eff. 12-11-06
Lessor Or Real Estate Owner
1500 Waters Ridge Drive 200 Lewisville, TX 75057
Lawton SNF Realty, LLC
45.806% of WR,LP, 100% WR GP,
80.91% S-SNF Prp, 100% SSL
Managing Member
1500 Waters Ridge Dr 200 Lewisville, TX 75077
Taylor John F.
30.323% of WR Investments, LP Eff
12-2013
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, TX 75057
Lake Creek Capital Partners, LP
10.7090% of WR Investment, LP eff
12-2013
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, TX 75057
Fisher James (Jim)
10.0650% WR Investment, LP eff
12-2013- Authorized Officer
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, TX 75057
Pierce Paula
0.1% general partner in Lake Creek
Captial Partners, LP
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, TX 75057
LC General Partner, LLC
eff. 9-25-07,ended 6/29/17; UPL Manager
eff 06/30/17
Manager
1500 Waters Ridge Drive 200 Lewisville, OK 75057
Lawton SNF Operations, LLC
eff.06-30-10
Contracted Management
1500 Waters Ridge Drive 200 Lewisville, TX 75057
Stonegate Senior Living, LLC
3.0970% of WR Investment, LP, Lake
Creek 20% eff 12-2013
Stockholders/partners -- Not Officers
1500 Waters Ridge Dt Lewisville, TX 75057
Taylor John P.
96.506% of OP Lawton SNF Operations,
LLC eff 4/25/2014
Stockholders/partners -- Not Officers
1500 Waters Ridge Dr. 200 Lewisville, TX 75057
Southwest SNF Holdings, LLC (SW SNFH)
100% of Southwest SNF Holdings, LLC
eff 12-2013
Stockholders/partners -- Not Officers
1500 Waters Ridge Dirve 200 Lewisville, TX 75057
WR Investments, LP (WRI, LP)
General Partner of WR Investments, LP
eff 12-2013
General Partner
1500 Waters Ridge Drive 200 Lewisville, TX 75057
WR Investments GP, Inc.
20% of Lake Creek Capital Partners, LP
eff 12-2013
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, TX 75057
Campbell Scott
Chairman/Mayor, City of Pauls Valley, eff
6/30/17
Officers Who Do Not Hold Stock
PO Box 778 Pauls Valley, OK 73075
Alfred Gary
V-Chairman/V-Mayor, City of Pauls
Valley, eff 6/30/17
Officers Who Do Not Hold Stock
PO Box 778 Pauls Valley, OK 73075
Rushing Jocelyn
Member, City of Pauls Valley, eff 6/30/17
Member
PO Box 778 Pauls Valley, OK 73075
Grimmett Patrick
Member, City of Pauls Valley, eff 6/30/17
Member
PO Box 778 Pauls Valley, Ok 73075
Parrish Michael
Page 167 of 265
Owner NameFacilities Owned
Member, City of Pauls Valley, eff 6/30/17
Member
PO Box 778 Pauls Valley, OK 73075
Montgomery Shirley
UPL Owner eff. 6/30/2017
Operating Entity
100 W. Paul Avenue Pauls Valley, OK 73075
City of Pauls Valley
NH7702 580-994-5570402 Southeast 6th Street Mooreland, OK 73852
Mooreland Heritage Manor
Operating Entity
P.O. Box 468 Nowata, OK 74048
Lightning Creek Investment Group, Inc.
33.3% OP/Pres.
Stockholders/partners Who Are Officers
Rt. 1, Box 546 Nowata, OK 74048
Maddux Douglas G.
33.3% OP/Sec/Tres
Stockholders/partners Who Are Officers
Rt. 1, Box 210 Nowata, OK 74048
Krouse Johnny W.
33.3% OP VP
Stockholders/partners Who Are Officers
4600 Centre Court Rogers, AK 72756
Honea Sherman D.
Employment Tax Entity
P.O. Box 1014 Mooreland, OK 73852
Arney & Associates, Inc.
NH5609 918-756-9211900 East Airport Road Okmulgee, OK 74447
Muscogee (Creek) Nation Skilled Nursing Facility
A Division of the Muscogee (Creek)
Nation eff 12-03-2013
Operating Entity
FNB Dept 001, PO Box 1312 Okmulgee, OK 74447
Creek Nation Hospitals & Clinics
100% of OP eff 12-03-2013 & RE
11-25-2013
Stockholders/partners -- Not Officers
FNB Dept 001, PO Box 1312 Okmulgee, OK 74447-1312
Muscogee (Creek) Nation
Chief of the Muscogee (Creek) Nation eff
12-03-13 end 05-03-16
Officers Who Do Not Hold Stock
FNB Dept 001, P.O. Box 1312 Okmulgee, OK 74447
Tiger George
Lt. Commander of Creek Nation Hospital
& Clinics eff 12-03-2013
Officers Who Do Not Hold Stock
FNB Dept. 001, P.O. Box 1312 Okmulgee, OK 74447
Smith Seneca
Chief of the Muscogee (Creek) Nation eff.
05/03/2016
Officers Who Do Not Hold Stock
FNB Dept 001, PO Box 1312 Okmulgee, ok 74447
Floyd James
(A) Secretary of Health
Officers Who Do Not Hold Stock
FNB Dept 001, PO Box 1312 Okmulgee, ok 74447
Alexander-Ross Shoneen
Page 168 of 265
Owner NameFacilities Owned
NH5108 918-682-9232602 North "M" Street Muskogee, OK 74403
Muskogee Nursing Center
100% OpEntity and Real Estate Entity
Stockholders/partners Who Are Officers
1929 Betty Jane Lane Muskogee, OK 74403
Montgomery Tom
Lessor Or Real Estate Owner
,
Muskogee Nursing Center, Inc.
eff 11-01-04
Operating Entity
1929 Betty Jane Lane Muskogee, OK 74403
Muskogee Health Services, L.L.C.
NH6101 918-423-90951220 East Electric Boulevard McAlester, OK 74501
New Hope Retirement & Care Center
100% Bully Good 100% Aspire
Management eff 10-01-2016
Stockholders/partners Who Are Officers
1929 Betty Jane Lane Muskogee, OK 74403
Montgomery Tom
OP eff 10/01/2016 MGMT03/01/2016
end 10/01/2016
Operating Entity
1929 Betty Jane Lane Muskogee, OK 74403
Aspire Management, LLC
RE eff 10-01-2016
Lessor Or Real Estate Owner
1925 Betty Jane Lane Muskogee, OK 74403
Bully Good, Inc.
NH1414 405-872-71021501 North 8th Street Noble, OK 73068
Noble Health Care Center
Contracted Management
9813 S. Penn Okla. City, OK 73159
Southwest Health Care Management, Inc.
33.4%PresOpEnt/60%Mngmt Entity
Stockholders/partners Who Are Officers
9813 S. Penn Oklahoma City, OK 73159
Denver McCormick Revocable Trust
33.3% S/T OpEnt
Stockholders/partners Who Are Officers
9813 S. Penn Oklahoma City, OK 73159
Linda McCormick Revocable Trust
33.3%OP/40%Mngmt Entity
Stockholders/partners Who Are Officers
5413 N.W. 107th Okla. City, OK 73162
Arlena Dunbar Revocable Trust
Beneficiary of Linda & Denver
McCormicks Revocable Trusts
Trustee
4108 Opus Ct. Flower Mound, TX 75022
Pennington Amy
Beneficiary of Linda & Denver
McCormicks Revocable Trusts
Beneficiary
2433 Glenoak Dr. Norman, OK 73071
Petrone Alison
Beneficiary of Linda & Denver
McCormicks Revocable Trusts
Beneficiary
8594 D East 133 Holdenville, OK 74850
Jones Joshua
Page 169 of 265
Owner NameFacilities Owned
Beneficiary of Linda & Denver
McCormicks Revocable Trusts
Beneficiary
8594 D East 133 Holdenville, OK 74850
Jones Tanner
Beneficiary of Arlena Dunbar Revocable
Trust
Trustee
5413 NW 107th Okla. City, OK 73159
Dunbar William
Beneficiary of Arlena Dunbar Revocable
Trust
Trustee
12204 N. Kimberlyn Rd. Okla. City, OK 73162
Dunbar Teresa
Beneficiary of Arlena Dunbar Revocable
Trust
Trustee
3913 Spyglass Road Okla. City, OK 73167
Nard Charlotte
Mayor/Chairman, City of Pauls Valley, eff
06/30/17
Officers Who Do Not Hold Stock
PO Box 778 Pauls Valley, OK 73075
Alfred Gary
Vice Mayor/Vice Chair, City of Pauls
Valley, eff 6/30/17
Officers Who Do Not Hold Stock
PO Box 778 Pauls Valley, OK 73075
Rushing Jocelyn
Councilman, City of Pauls Valley, eff
6/30/17
Member
PO Box 778 Pauls Valley, OK 73075
Grimmett Patrick
Councilman, City of Pauls Valley, eff
6/30/17
Member
PO Box 778 Pauls Valley, Ok 73075
Parrish Michael
Councilwoman, City of Pauls Valley, eff
6/30/17
Member
PO Box 778 Pauls Valley, OK 73075
Montgomery Shirley
UPL Owner eff. 6/30/2017
Operating Entity
100 W. Paul Avenue Pauls Valley, OK 73075
City of Pauls Valley
UPL Manager, eff 6/30/17
Manager
1500 Waters Ridge Drive Lewisville, TX 75057
NHCC OPCO, LLC
NH7207 918-371-25452300 West Broadway Collinsville, OK 74021
North County Center for Nursing and Rehabilitation
EFF 03/01/2013
Lessor Or Real Estate Owner
P.O. Box 990 Edmond, OK 73083
CVille Holding, LLC
100% CVille Holding, LLC/100% North
County Sr. Living EFF 3/1/13
Stockholders/partners -- Not Officers
P.O. Box 990 Edmond, OK 73083
LEP Holdings, LLC
99% LEP Hldgs,LLC/Mgr CVille
Hldg/Mgr Nth cnty sr. liv EFF3/1/13
Stockholders/partners -- Not Officers
P.O. Box 990 Edmond, OK 73083
Pilgrim Lee E.
Operating Entity
P.O. Box 990 Edmond, OK 73083
North County Senior Living, LLC
Page 170 of 265
Owner NameFacilities Owned
NH5528 405-942-10143718 North Portland Oklahoma City, OK 73112
North Winds Living Center
President 100%
Stockholders/partners Who Are Officers
3714 N. Portland Oklahoma City, OK 73112
Crane Judy M.
Operating Entity
,
North Winds Living Center, Inc.
NH5524 405-842-66012801 Northwest 61st Street Oklahoma City, OK 73112
Northwest Nursing Center
EFF 01/01/2016
Operating Entity 2
1145 Hembree Rd. Roswell, GA 30076
NW 61st Nursing, LLC
Lessor Or Real Estate Owner
1145 Hembree Rd. Roswell, GA 30076
Northwest Property Holdings, LLC
Contracted Management Co. Eff
06/10/2015
Contracted Management
1518 Legacy Dr. #110 Frisco, TX 75034
Southwest LTC Management Services, LLC
1% Southwest LTC-NW OKC,
LLC,72.62% SW,LTC,LTD, eff 01/01/16
Stockholders/partners -- Not Officers
1518 Legacy Drive 110 Frisco, TX 75034
Payne Ronald
20% of Southwest LTC-Mgt
Services,9.5%SW,LTC, LTD eff
01/01/2016
Stockholders/partners -- Not Officers
1518 Legacy Drive 110 Frisco, TX 75034
Brashier Craig
99% OP
Stockholders/partners -- Not Officers
1518 Legacy Drive 110 Frisco, OK 75034
Southwest LTC Oklahoma Holdings,LLC
100% Southwest LTC Oklahoma
Holdings, LLC eff 01/01/16
Stockholders/partners -- Not Officers
1518 Legacy Dr. 110 Frisco, TX 75034
Southwest LTC, LTD
11.98% SW LTC, LTD eff 01/01/16
Stockholders/partners -- Not Officers
5731 Jackson St. Ext C Alexandria, LA 71303
Quality Care Givers, Inc.
Eff 01/01/2016
Operating Entity
1518 Legacy Drive 110 Frisco, TX 75034
Southwest LTC-NW OKC, LLC
4.9% SW LTC, LTD eff 01/01/16
Stockholders/partners -- Not Officers
1518 Legacy Drive 110 Frisco, TX 75034
Guilbeaux Richard
1% SW LTC, LTD eff 01/01/16
Stockholders/partners -- Not Officers
1518 Legacy Drive 110 Frisco, TX 75034
Southwest LTC Mgt I LLC
NH5302 918-273-2236436 South Joe Nowata, OK 74048
Nowata Nursing Center
Page 171 of 265
Owner NameFacilities Owned
Operating Entity
,
Nowata Nursing Center, Inc.
100% BG Mgt., Inc.; 99% GD2 Inv., LP
eff. 5/1/2012
Stockholders/partners -- Not Officers
19143 Chestermere Circle Edmond, OK 73012
Guymon Gregory L
100% GRH Mgt., Inc.; 99% Cat Daddy
Inv., LP eff. 5/1/2012
Stockholders/partners -- Not Officers
22122 East 63rd Street Broken Arrow, OK 74014
Huxall Garrett
1% GD2 Inv., LP; 1% Health Care
Properties of Oklahoma, L.L.C.
Stockholders/partners -- Not Officers
19413 Chestermere Circle Edmond, OK 73012
BG Management, Inc.
1% Cat Daddy Inv, LP;1% Health Care
Properties of Oklahoma, L.LC
Stockholders/partners -- Not Officers
22122 East 63rd Street Broken Arrow, OK 74014
GRH Managment, Inc.
49% Health Care Properties of Oklahoma,
L.L.C.
Stockholders/partners -- Not Officers
19413 Chestermere Circle Edmond, OK 73012
GD2 Invstments, LP
49% Health Care Properties of Oklahoma,
L.L.C.
Stockholders/partners -- Not Officers
22122 E. 63rd Street Broken Arrow, OK 74014
Cat Daddy Investments, LP
100% Nowata Nursing Center, Inc.
Stockholders/partners -- Not Officers
PO Box 140338 Broken Arrow, OK 74014
Health Care Properties of Oklahoma, L.L.C.
NH5525 405-399-22941100 West Georgia Jones, OK 73049
Oak Hills Living Center
100% Managing Member
Stockholders/partners Who Are Officers
3595 E. State Highway 9 Norman, OK 73071
Stout John H.
Op Ent eff 5/23/2007
Operating Entity
1100 West Georgia Jones, OK 73049
Oak Hills Care Center, L.L.C.
Real Estate
Lessor Or Real Estate Owner
3595 EAST STATE HWY 9 Norman, OK 73071
OH Holdings, L.L.C.
NH3213 405-452-3299201 East Second Street Wetumka, OK 74883
Oak Place Living Center, LLC
President/Beneficiary of Family Trust
Trustee
P.O. Box 488 Weleetka, OK 74880
Adkins Gerrol Dean
Secretary/Beneficiary of Family Trust
Trustee
P.O. Box 488 Weleetka, OK 74880
Adkins Arbret June
Lessor Or Real Estate Owner
P.O. Box 488 Wetumka, OK 74880
Pioneer Nursing Home Of Hughes County, Inc.
Page 172 of 265
Owner NameFacilities Owned
Beneficiary eff.12/31/12319 West 9th St. Weleetka, OK 74880
Majors Cynthia
Beneficiary eff.12/31/12319 West 9th St Weleetka, OK 74880
Simmons Donna Renee
Beneficiary eff.12/31/12Rt. 1, Box 121A Weleetka, OK 74880
Adkins, II Gerrol D.
52% RE and manag.member of Business
Trust
Stockholders/partners -- Not Officers
P.O. Box 488 Weleetka, OK 74880
Gerrol Dean Adkins & Arbret June Adkins Family Trust (GDA/AJA)
Operating Entity
201 East Second Street Wetumka, OK 74883
Oak Place Living Center, LLC
100% OP manag.member
Managing Member
P.O. Box 488 Weleetka, OK 74880
Oak Place Revocable Business Trust
16% RE eff 12/31/12Rt 1 Box 121A Weleetka, OK 74880
Gerrol Dean Adkins II Irrevocable Trust dated 12/28/12
16% RE eff 12/31/12Rt 1 Box 121A Weleekta, OK 74880
Cynthia Denise Majors Irrevocable Trust dated 12/28/12
16% RE eff 12/31/12Rt 1 Box 121A Weleetka, OK 74880
Donna Renee Simmons Irrevocable Trust dated 12/28/12
Trustee eff 12/31/12
Trustee
523 W. Main Henryetta, OK 74437
Palmer, C.P.A. Reginald
NH6703 405-257-58007th & Compton Wewoka, OK 74884
Oakridge Home
Successor Trustee & Beneficiary -WBT
eff 5/24/12
Trustee
P.O. Box 2230 Waldron, AR 72958
Watts Fred
9.61494% Oklahoma Nursing Home, Ltd,
Manager
Contracted Management
210 E. Choctaw, P.O. Box 429 Sallisaw, OK 74955-0429
Oklahoma Nursing Homes, Ltd. (ONH,Ltd.)
8.314% OP & Mgr./ 8.4112% RE/
9.401287% Okla. Nurs. Homes, Inc.
Stockholders/partners -- Not Officers
P.O. Box 40 Sallisaw, OK 74955
Cheek Barnie J.
8.314% OP & Mgmt. / 8.4112% RE
Stockholders/partners -- Not Officers
3520 East 110th Place Tulsa, OK 74137
Sandra Cheek Farmer Trust (SCFT)
5.834% OP & Mgmt/5.9190%
RE/6.597394% ONH,Inc. & Secretary
Stockholders/partners Who Are Officers
4814 S. 164th East Ave. Tulsa, OK 74134
Haskins Lloyd
5.192% OP & Mgmt. / 5.2626% RE/
12.535047% Okla.Nurs.Homes,Inc.
Stockholders/partners -- Not Officers
51 green acre village #51 Sallisaw, OK 74955
Watts Cleo
5.893% OP & Mgmt. / 5.9746% RE
Stockholders/partners -- Not Officers
51 Green Acre Village Sallisaw, OK 74955
Watts Beneficiaries Trust (WBT)
Page 173 of 265
Owner NameFacilities Owned
14.022% OP & Mgmt/ 14.2078% RE/
21.936335% ONH,Inc. & VP
Stockholders/partners Who Are Officers
Box 856 Miami, OK 74355
Tubbs Steven
5.376% OP & Mgmt. / 5.4406% RE
Stockholders/partners -- Not Officers
3910 Cherry Forest Drive Houston, TX 77088
Tubbs, Jr. Stanley I.
5.542% OP & Mgr./ 5.6186% RE/
6.267525% Okla Nurs Homes, Inc.
Stockholders/partners -- Not Officers
416 Fairway Dr. Athens, TX 75751
Estep Pat
2.771% OP & Mgmt. / 2.8037% RE
Stockholders/partners -- Not Officers
1500 West Elm Stroud, OK 74079
Julie Kay Bivin Revocable Trust (JKBRT)
5.135% OP/MANAGEMENT/ RE
5.2207%
Stockholders/partners -- Not Officers
6708 South 256th East Avenue Broken Arrow, OK 74014
Caroyln D. Leaverton Revocable Trust
2.771% OP & Mgmt./ 2.8037% RE
Stockholders/partners -- Not Officers
PO Box 370 Adair, OK 74330
Dr. William R. VanDeLinder Trust (DWVT)
2.771% OP & Mgmt. / 2.8037% RE
Stockholders/partners -- Not Officers
3808 NW Marquess Drive Bentonville, AR 72712
Lynn M. Yowell Trust
9.7298% of Midwest Nursing Home, LLC
Lessor Or Real Estate Owner
210 East Choctaw Sallisaw, OK 74955
Midwest Nursing Homes, LLC (MNHLLC)
2.771% Mgmt. / 2.8038% RE
Stockholders/partners -- Not Officers
2802 West Country Club Drive Oklahoma City, OK 73116
Richard Armstrong Trust (RAT)
9.61494% Oakridge Home, LLC
Operating Entity
P.O. Box 400 Sallisaw, OK 74955
Oakridge Home, LLC
1.219% Manager, OP and Management
Co.
Stockholders/partners -- Not Officers
P.O. Box 400 Sallisaw, OK 74955
Oklahoma Nursing Homes, Inc. General Partner (ONH,Inc)
9.401287% Oklahoma Nursing Homes,
Inc./Ben. of RA Trust
Stockholders/partners -- Not Officers
2802 W. Country Club Dr. Oklahoma City, OK 73116
Armstrong Richard James
Trustee-SCFT/9.401287% Oklahoma
Nursing Homes, Inc.
Stockholders/partners -- Not Officers
3520 East 110th Place Tulsa, OK 74137
Farmer Sandra
1.28306% OP & Mgmt./ 1.3156%
RE/9.401287% Okla.Nurs. Homes,Inc.
Stockholders/partners -- Not Officers
20852 South Shannon Drive Claremore, OK 74017
Wilson James G.
2.079% OP & Mgmt. / 2.1028% RE
Stockholders/partners -- Not Officers
P.O. Box 173 Gore, OK 74435
Ferguson Debra M.
5.563% RE,5.556% OP & Manager,
5.657265% ONH, Inc & Treas.
Stockholders/partners Who Are Officers
607 Mayo Street Sallisaw, OK 74955
McGrew Justin
2.771% OP & Mgmt/ 2.8038% RE
Stockholders/partners -- Not Officers
HCR 68 Box 1260 Vian, OK 74962
Armstrong Sally
9.401287% ONH, Inc. President; Trustee
of DWRVT
Stockholders/partners Who Are Officers
PO Box 370 Adair, OK 74330
VanDeLinder Dr. William R.
RE 0.70095% & 0.69275% OP & Mgmt
Stockholders/partners -- Not Officers
1405 E. Seattle St. Broken Arrow, OK 74012
Heath Armstrong VanDeLinder Trust (HAVT)
Page 174 of 265
Owner NameFacilities Owned
RE 0.70095% & 0.69275% OP
Stockholders/partners -- Not Officers
2812 West 114th Street Jenks, OK 74037
Meredith Margaret Marie VanDeLinder Trust (MMMVT)
RE 0.70095% & 0.69275% OP
Stockholders/partners -- Not Officers
8 Dinton Circle Bella Vista, AR 72714
Nicolas Edmund VanDeLinder Trust (NEVT)
RE 0.70095% & 0.69275% OP & Mgmt
Stockholders/partners -- Not Officers
2116 Whitney Lane McKinney, TX 75070
William Glen VanDelinder Trust (WGVT)
Trustee of JKBRT
Trustee
1500 West Elm Stroud, OK 74079
Bivin Julie K.
2.77100% OP
Stockholders/partners -- Not Officers
2802 W. Country Club Dr. Oklahoma City, OK 73116
Richard Glen Armstrong Trust (RGAT)
Trustee-Carolyn D. Leaverton Rev. Trust
eff 05/24/12
Trustee
6708 South 256th East Ave Broken Bow, OK 74014
Leaverton Carolyn
Trustee-Carolyn D. Leaverton Rev. Trust
eff 05/24/12
Trustee
6708 South 256th East Ave Broken Arrow, OK 74014
Leaverton Ronald
Succ.Trustee & Benf-Carolyn D.
Leaverton Rev. Trust eff 05/24/12
Beneficiary
6708 South 256th East Ave Broken Arrow, OK 74014
Johnson Karen Diane
Succ.Trustee & Benf-Carolyn D.
Leaverton Rev. Trust eff 05/24/12
Beneficiary
6708 South 256th East Ave Broken Arrow, OK 74014
Fine Michael B.
Successor Trustee & Beneficiary -WBT
eff 5/24/12
Trustee
51 Green Acre Village Sallisaw, OK 74955
Byers Karen
Successor Trustee & Beneficiary -WBT
eff 5/24/12
Trustee
51 Green Acre Village Sallisaw, OK 74955
Rhodes Sharon
Beneficiary - WTB eff 5/24/12
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Rhodes Grant
Beneficiary - WTB eff 5/24/12
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Miles Sydney
Beneficiary - WTB eff 5/24/12
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Cameron Amber
Successor Trustee - SCFT eff 5/24/12
Trustee
3520 east 110th Place Tulsa, OK 74137
Farmer Frederick Sinclair
Beneficiary - SCFT eff 5/24/12
Beneficiary
3520 East 110th Place Tulsa, OK 74137
Farmer Cassandra C.
Beneficiary - SCFT eff 5/24/12
Beneficiary
3520 East 110th Place Tulsa, OK 74137
Farmer Alexandra C.
Trustee of the MMMV Trust, & WGVT
Trustee
2812 West 114th St. south Jenks, ok 74037
Leutz William K.
Trustee of RA Trust
Trustee
c/o Ben Bryers, 2802 W. Country Club DR. Oklahoma City, ok 73116
Heritage Trust Co.,
Page 175 of 265
Owner NameFacilities Owned
Trustee and Beneficiary of the HAVT
Trustee
1405 E. Seattle St. Broken Arrow, OK 74012
VanDelinder Heath Armstrong
Beneficiary of MMMVT
Beneficiary
2812 West 114th Street South Jenks, OK 74037
VanDeLinder Meredith Margaret Marie
Trustee & Ben NEVT; Ben. of Dr WRVT
Trustee
8 Dinton Circle Bella Vista, AR 71714
VanDelinder Nicolas Edmund
Trustee Ben. of WGVT; Ben. DWRVT
Trustee
6260 Dark Forest Drive McKinney, TX 75070
VanDelinder William Glen
Beneficiary of JKBRT
Beneficiary
1500 West Elm Stroud, OK 74079
Bivin Jeremy
Beneficiary of JKBRT
Beneficiary
1500 West Elm Stroud, OK 74049
Bivin Ryan
Beneficiary of RA & RGA Trust
Beneficiary
2802 W. Country Club Dr. Oklahoma, OK 73116
Heritage Trust Company Armstrong Carol
Beneficiary of LMYT
Beneficiary
3808 NW Marquess Drive Bentonville, AR 74017
Lamp Jo Ann
Beneficiary of LMYT
Beneficiary
3808 NW Marquess Drive Bentonville, ar 74017
Austin Jennifer
NH0706 580-924-32441100 Oak Ridge Drive Durant, OK 74701
Oakridge Nursing Center
Chair&CEOend 1/10/14 Broad Member
eff 1/10/14 Senior Care Group
Officers Who Do Not Hold Stock
1240 Marbella Plaza Drive #12 Tampa, FL 33619
Vaughan David R.
eff. 11-01-06 Senior Care Group Mang
Member
Operating Entity
1240 Marbella Plaza Drive Tampa, FL 33619-7905
SCG Oak Ridge, LLC
eff. 11-01-06
Lessor Or Real Estate Owner
1115 Marbella Plaza Drive Tampa, FL 33619
Investors in Real and Personal Property, Tenants in Common
eff. 11-01-06 Senior Care Group 100%
Contracted Management
1240 Marbella Plaza Drive Tampa, FL 33619
SCG Red River Management, LLC
manager for RE owner
Stockholders/partners -- Not Officers
1115 Marbella Plaza Drive Tampa, FL 33619
Red River, LLC
1.71% RE
Stockholders/partners -- Not Officers
1240Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Christy, LLC
2.29% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Fridrich, LLC
2.86% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Drobeck, LLC
Page 176 of 265
Owner NameFacilities Owned
1.21% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Correia, LLC
4.11% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Klatt, LLC
1.37% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Mealer, LLC
2.86% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Fish, LLC
3.43% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Page, LLC
2.29% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Stalker, LLC
3.43% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Pendleton, LLC
2.51% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Brauburger, LLC
1.71% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Mathews-Bingham, LLC
1.14% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - DeMane, LLC
1.14% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Crowley, LLC
2.11% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - May, LLC
4.57% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Young, LLC
2.29% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Robert Yeh, LLC
2.29% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Albert Yeh, LLC
5.39% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Levenson, LLC
2.86% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Wallace, LLC
3.75% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Evelyn Wallace, LLC
5.91% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Stangl, LLC
6.72% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Shull, LLC
Page 177 of 265
Owner NameFacilities Owned
1.14% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Restivo, LLC
2.29% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - McIntosh, LLC
2.29% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Essayli, LLC
3.43% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Hall, LLC
11.43% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Alexander, LLC
2.29% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Hijazi, LLC
1.26% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Wang, LLC
0.29% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Howard, LLC
1.0% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Roberts, LLC
1.71% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Sandra Shaner, LLC
4.92% RE
Stockholders/partners -- Not Officers
1240 Marbella Plaza Drive Tampa, FL 33619
Red River TIC - Kelley, LLC
sole manag.mem. of SCG Red River,
LLC/lessee
Managing Member
1240 Marbella Plaza Drive Tampa, FL 33619
Senior Care Group, Inc.
Board Memboer of Senior Care Group,
Inc.
Officers Who Do Not Hold Stock
1240 Marbella Plaza Drive Tampa, FL 33619
Fridrich, Sr. Gerald D.
Board Memboer of Senior Care Group,
Inc.
Officers Who Do Not Hold Stock
1240 Marbella Plaza Drive Tampa, FL 33619
Surtees Robert E.
Manager for TIC Owners (real estate) eff
1-01-08
Officers Who Do Not Hold Stock
2547 Mason Oaks Drive Vairico, FL 33596
Moran Consulting Group, LLC
CFO & Secretary/Treasurer of Senior
Care Group, Inc. eff 1/10/14
Officers Who Do Not Hold Stock
1240 Marbella Plaza Drive Tampa, FL 33619
Chudow Katherine (Kathy)
Board Member of Senior Care Group,
Inc.
Officers Who Do Not Hold Stock
1240 Marbella Plaza Drive Tampa, FL 33619
Swart Louis
Lessor Or Real Estate Owner
1240 Marbella Plaza Drive Tampa, FL 33619
SCG Red River, LLC
Broad Member of Senior Care Group, Inc
eff 1/10/2014
Officers Who Do Not Hold Stock
1240 Marbella Plaza Drive Tampa, FL 33619
Vaughan Michelle
Page 178 of 265
Owner NameFacilities Owned
Board Member eff 1/10/2014
Officers Who Do Not Hold Stock
1240 Marbella Plaza Drvie Tampa, FL 33619
Martin J. Michael
NH5404 918-623-1126112 North Woody Guthrie Okemah, OK 74859-0446
Okemah Care Center
100%-AlphaCare
Stockholders/partners Who Are Officers
PO Box 2 Holdenville, OK 74848
Humphreys Doug
eff 7-23-01
Operating Entity
202 N. Woody Guthrie Okemah, OK 74859
Okemah Care Center, L.L.C.
100%OpEnt
Stockholders/partners -- Not Officers
3218 North 372 Holdenville, OK 74848
Alpha Care Properties, L.L.C.
NH7218 918-743-25654134 East 31st Street Tulsa, OK 74135
Oklahoma Methodist Manor, Inc.
Operating Entity
4134 E. 31st Street Tulsa, OK 74135
Oklahoma Methodist Manor, Inc.
exec director/CEO - signature authortiy
eff 10/22/2008
Officers Who Do Not Hold Stock
4134 E 31st Street Tulsa, OK 74135
Dickie Steven
Vice president EFF 04/29/2013 Pres-2015
Officers Who Do Not Hold Stock
4134 E. 31st Street Tulsa, OK 74135
Funk Bob
Vice President - 2015
Officers Who Do Not Hold Stock
4134 E 31st Street Tulsa, OK 74135
Belitz Gary
Secretary 2015
Officers Who Do Not Hold Stock
4134 E. 31st Street Tulsa, OK 74135
Teter Stan
Treasurer 2015
Officers Who Do Not Hold Stock
4134 E. 31st Street Tulsa, OK 74135
Early Sharon
NH1010 580-223-22661015 South Commerce Ardmore, OK 73402
Oklahoma Veterans Center, Ardmore Division
Operating Entity
2311 N. Central, Box 53067 Oklahoma City, OK 73152
Oklahoma Department Of Veterans Affairs
Executive Director eff 02-02-2015
Officers Who Do Not Hold Stock
P.O. Box 53067 Oklahoma City, OK 73152
Deering Myles
Page 179 of 265
Owner NameFacilities Owned
NH6607 918-283-29633001 West Blue Starr Drive Claremore, OK 74018
Oklahoma Veterans Center, Claremore Division
OP SB629 eff 5/29/2013
Operating Entity
2311 N. Central, Box 53067 Oklahoma City, OK 73152
Oklahoma Department Of Veterans Affairs
Deputy Director
Officer
,
Stewart Danny
Executive Director eff 02-02-2015
Officer
P.O. Box 53067 Oklahoma City, OK 73152
Deering Myles
NH2007 580-331-2200Hwy 183 South Clinton, OK 73601
Oklahoma Veterans Center, Clinton Division
OP SB629 eff 5/29/2013
Operating Entity
2311 N. Central, Box 53067 Oklahoma City, OK 73152
Oklahoma Department Of Veterans Affairs
Executive Director eff 02-02-2015
Officer
P.O. Box 53067 Oklahoma City, OK 73152
Deering Myles
NH1608 580-351-6511501 S.E. Flowers Mound Road Lawton, OK 73501
Oklahoma Veterans Center, Lawton/Ft Sill Division
OP eff 05/29/2013
Operating Entity
2311 N. Central, Box 53067 Oklahoma City, OK 73152
Oklahoma Department Of Veterans Affairs
Deputy Director
Officer
,
Stewart Danny
Executive Director eff 02-02-2015
Officer
P.O. Box 53067 Oklahoma City, OK 73152
Deering Myles
NH1413 405-360-56001776 East Robinson Norman, OK 73070
Oklahoma Veterans Center, Norman Division
OP SB629 eff 5/29/2013
Operating Entity
2311 N. Central, Box 53067 Oklahoma City, OK 73152
Oklahoma Department Of Veterans Affairs
Executive Director eff 02-02-2015
Officer
P.O. Box 53067 Oklahoma City, OK 73152
Deering Myles
Page 180 of 265
Owner NameFacilities Owned
NH5004 580-622-2144304 East Fairlane Sulphur, OK 73086
Oklahoma Veterans Center, Sulphur Division
OP SB629 eff 5/29/2013
Operating Entity
2311 N. Central, Box 53067 Oklahoma City, OK 73152
Oklahoma Department Of Veterans Affairs
Executive Director eff 02-02-2015
Officer
P.O. Box 53067 Oklahoma City, OK 73152
Deering Myles
NH4011 918-567-225110014 SE 1138th Ave Talihina, OK 74571
Oklahoma Veterans Center, Talihina Division
OP SB629 eff 5/29/2013
Operating Entity
2311 N. Central, Box 53067 Oklahoma City, OK 73152
Oklahoma Department Of Veterans Affairs
Executive Director eff 02-02-2015
Officer
P.O. Box 53067 Oklahoma City, OK 73152
Deering Myles
NH5607 918-756-3556720 North Miami Okmulgee, OK 74447
Okmulgee Terrace
Successor Trustee & Beneficiary -WBT
eff 5/24/12
Trustee
P.O. Box 2230 Waldron, AR 72958
Watts Fred
9.61494% Oklahoma Nursing Home, Ltd,
Manager
Contracted Management
210 E. Choctaw, P.O. Box 429 Sallisaw, OK 74955-0429
Oklahoma Nursing Homes, Ltd. (ONH,Ltd.)
8.314% OP & Mgr./ 8.4112% RE/
9.401287% Okla. Nurs. Homes, Inc.
Stockholders/partners -- Not Officers
P.O. Box 40 Sallisaw, OK 74955
Cheek Barnie J.
8.314% OP & Mgmt. / 8.4112% RE
Stockholders/partners -- Not Officers
3520 East 110th Place Tulsa, OK 74137
Sandra Cheek Farmer Trust (SCFT)
5.834% OP & Mgmt/5.9190% mgr
RE/6.597394% Okla. Nurs.Homes,Inc.
Stockholders/partners -- Not Officers
4814 S. 164th East Ave. Tulsa, OK 74134
Haskins Lloyd
5.192% OP &Mgmt./5.2626%
RE/12.535047%ONH,Inc.TrusteeWBTeff
5/12
Stockholders/partners -- Not Officers
51 green acre village #51 Sallisaw, OK 74955
Watts Cleo
5.893% OP & Mgmt. / 5.9746% RE
Stockholders/partners -- Not Officers
51 Green Acre Village Sallisaw, OK 74955
Watts Beneficiaries Trust (WBT)
5.612090% OP/ 5.67% RE
Stockholders/partners -- Not Officers
20852 S. Shannon Dr. Claremore, OK 74017
William McKesson Wilson Sr. 1997 Trust
Page 181 of 265
Owner NameFacilities Owned
14.022% OP & Mgmt/ 14.2078% RE/
21.936335% ONH,Inc. & VP
Stockholders/partners Who Are Officers
Box 856 Miami, OK 74355
Tubbs Steven
5.376% OP & Mgmt. / 5.4406% RE
Stockholders/partners -- Not Officers
3910 Cherry Forest Drive Houston, TX 77088
Tubbs, Jr. Stanley I.
5.542% OP & Mgr./ 5.6186% RE/
6.267525% Okla Nurs Homes, Inc.
Stockholders/partners -- Not Officers
416 Fairway Dr. Athens, TX 75751
Estep Pat
2.771% OP & Mgmt. / 2.8037% RE
Stockholders/partners -- Not Officers
1500 West Elm Stroud, OK 74079
Julie Kay Bivin Revocable Trust (JKBRT)
5.135% OP/MANAGEMENT/ RE
5.2207%
Stockholders/partners -- Not Officers
6708 South 256th East Avenue Broken Arrow, OK 74014
Caroyln D. Leaverton Revocable Trust
2.771% OP & Mgmt./ 2.8037% RE
Stockholders/partners -- Not Officers
PO Box 370 Adair, OK 74330
Dr. William R. VanDeLinder Trust (DWVT)
2.771% OP & Mgmt. / 2.8037% RE
Stockholders/partners -- Not Officers
3808 NW Marquess Drive Bentonville, AR 72712
Lynn M. Yowell Trust
9.7298% of Midwest Nursing Home, LLC
Lessor Or Real Estate Owner
210 East Choctaw Sallisaw, OK 74955
Midwest Nursing Homes, LLC (MNHLLC)
2.771% Mgmt. / 2.8038% RE
Stockholders/partners -- Not Officers
2802 West Country Club Drive Oklahoma City, OK 73116
Richard Armstrong Trust (RAT)
9.61494% Okmulgee Terrace, LLC
Operating Entity
P.O.Box 400 Sallisaw, OK 74955
Okmulgee Terrace, LLC
1.219% mgr OP & Mgmt.
Stockholders/partners Who Are Officers
P.O. Box 400 Sallisaw, OK 74955
Oklahoma Nursing Homes, Inc. General Partner (ONH,Inc)
9.401287% Oklahoma Nursing Homes,
Inc./ Ben. RA Trust
Stockholders/partners -- Not Officers
2802 W. Country Club Dr. Oklahoma City, OK 73116
Armstrong Richard James
Trustee-SCFT/9.401287% Oklahoma
Nursing Homes, Inc.
Stockholders/partners -- Not Officers
3520 East 110th Place Tulsa, OK 74137
Farmer Sandra
1.28306% OP & Mgmt./ 1.3156%
RE/9.401287% Okla.Nurs. Homes,Inc.
Stockholders/partners -- Not Officers
20852 South Shannon Drive Claremore, OK 74017
Wilson James G.
2.079% OP & Mgmt. / 2.1028% RE
Stockholders/partners -- Not Officers
P.O. Box 173 Gore, OK 74435
Ferguson Debra M.
5.556% OP & Mgmt./5.5630% RE/
5.657265% in ONH, Inc. & Treas
Stockholders/partners Who Are Officers
607 Mayo Street Sallisaw, OK 74955
McGrew Justin
2.771% OP & Mgmt/ 2.8038% RE
Stockholders/partners -- Not Officers
HCR 68 Box 1260 Vian, OK 74962
Armstrong Sally
Trustee of DWRVT/9.401287%
Oklahoma Nursing Home, Inc. Presid
Stockholders/partners Who Are Officers
PO Box 370 Adair, OK 74330
VanDeLinder Dr. William R.
RE 0.70095% & 0.69275% OP & Mgmt
Stockholders/partners -- Not Officers
1405 E. Seattle St. Broken Arrow, OK 74012
Heath Armstrong VanDeLinder Trust (HAVT)
Page 182 of 265
Owner NameFacilities Owned
RE 0.70095% & 0.69275% OP & Mgmt
Stockholders/partners -- Not Officers
2812 West 114th Street Jenks, OK 74037
Meredith Margaret Marie VanDeLinder Trust (MMMVT)
RE 0.70095% & 0.69275% OP
Stockholders/partners -- Not Officers
8 Dinton Circle Bella Vista, AR 72714
Nicolas Edmund VanDeLinder Trust (NEVT)
RE 0.70095% & 0.69275% OP & Mgmt
Stockholders/partners -- Not Officers
2116 Whitney Lane McKinney, TX 75070
William Glen VanDelinder Trust (WGVT)
Trustee of the JKBRT
Trustee
1500 West Elm Stroud, OK 74079
Bivin Julie K.
2.77100%OP
Stockholders/partners -- Not Officers
2802 W. Country Club Dr. Oklahoma City, OK 73116
Richard Glen Armstrong Trust (RGAT)
Trustee-Carolyn D. Leaverton Rev. Trust
eff 05/24/12
Trustee
6708 South 256th East Ave Broken Bow, OK 74014
Leaverton Carolyn
Trustee-Carolyn D. Leaverton Rev. Trust
eff 05/24/12
Trustee
6708 South 256th East Ave Broken Arrow, OK 74014
Leaverton Ronald
Succ.Trustee & Benf-Carolyn D.
Leaverton Rev. Trust eff 05/24/12
Beneficiary
6708 South 256th East Ave Broken Arrow, OK 74014
Johnson Karen Diane
Succ.Trustee & Benf-Carolyn D.
Leaverton Rev. Trust eff 05/24/12
Trustee
6708 South 256th East Ave Broken Arrow, OK 74014
Fine Michael B.
Successor Trustee & Beneficiary -WBT
eff 5/24/12
Trustee
51 Green Acre Village Sallisaw, OK 74955
Byers Karen
Successor Trustee & Beneficiary -WBT
eff 5/24/12
Trustee
51 Green Acre Village Sallisaw, OK 74955
Rhodes Sharon
Beneficiary - WTB eff 5/24/12
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Rhodes Grant
Beneficiary - WTB eff 5/24/12
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Miles Sydney
Beneficiary - WTB eff 5/24/12
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Byers Jack
Beneficiary - WTB eff 5/24/12
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Cameron Amber
Sucessor Trustee-SCFT EFF 05/24/2012
Trustee
3520 east 110th Place Tulsa, OK 74137
Farmer Frederick Sinclair
Beneficiary - SCFT eff 5/24/12
Beneficiary
3520 East 110th Place Tulsa, OK 74137
Farmer Cassandra C.
Beneficiary - SCFT eff 5/24/12
Beneficiary
3520 East 110th Place Tulsa, OK 74137
Farmer Alexandra C.
Trustee of MMMVT & WGVT
Trustee
2812 West 114th St. south Jenks, ok 74037
Leutz William K.
Page 183 of 265
Owner NameFacilities Owned
Trustee of RA Trust
Trustee
c/o Ben Bryers, 2802 W. Country Club DR. Oklahoma City, ok 73116
Heritage Trust Co.,
Beneficiary of LMYT
Beneficiary
3808 NW Marquess Drive Bentonville, AR 72712
Yowell Lynn
Beneficiary LMYT
Beneficiary
3808 NW Marquess Drive Bentonville,, AR 72712
Yowell Ron
Trustee and Beneficiary of HAVT
Trustee
1405 E. Seattle St. Broken Arrow, OK 74012
VanDelinder Heath Armstrong
Beneficiary of MMMVT
Beneficiary
2812 West 114th Street South Jenks, OK 74037
VanDeLinder Meredith Margaret Marie
Trustee & Beneficiary of NEVT; Trustee
of DWRVT
Trustee
8 Dinton Circle Bella Vista, AR 71714
VanDelinder Nicolas Edmund
Trustee & Beneficiary of WGVT;
Beneficiary of DWRVT
Trustee
6260 Dark Forest Drive McKinney, TX 75070
VanDelinder William Glen
Beneficiary of JKBRT
Beneficiary
1500 West Elm Stroud, OK 74079
Bivin Jeremy
Beneficiary of JKBRT
Beneficiary
1500 West Elm Stroud, OK 74049
Bivin Ryan
Beneficiary of RA & RGA Trust &
Richard Glen Armstrong Trust
Beneficiary
2802 W. Country Club Dr. Oklahoma, OK 73116
Heritage Trust Company Armstrong Carol
Beneficiary of LMYT
Beneficiary
3808 NW Marquess Drive Bentonville, AR 74017
Lamp Jo Ann
Beneficiary of LMYT
Beneficiary
3808 NW Marquess Drive Bentonville, ar 74017
Austin Jennifer
NH5414 918-650-9393103 North Oneida Weleetka, OK 74880
Oneida Place
Lessor Or Real Estate Owner
236 Main Street Uniontown, KY 42461
4-B Properties, L.L.C.
amended corp. name (fkaProdetik, Inc.)
eff 02-05-08
Operating Entity
P.O. Box 217 Weleetka, OK 74880
The Reach Corporation
Non-Profit Board President of The Reach
Corporation 1-8-08
Officers Who Do Not Hold Stock
P.O. Box 790 Uniontown, KY 42461
Welsh Richard
Non-Profit Board VP of The Reach
Corporation 1-8-08
Officers Who Do Not Hold Stock
PO Box 790 UnionTown, KY 42461
Bailey M. Geoffry
Non-Profit Board Sec/Treas of The Reach
Corporation
Stockholders/partners -- Not Officers
PO Box 790 Uniontown, KY 42461
Pyle William "Bill"
Page 184 of 265
Owner NameFacilities Owned
authorized agent for The Reach Corp. Eff
12/07
Officers Who Do Not Hold Stock
1201 West Trudgeon Place Henryetta, OK 74437
Bentley Roy
eff. 8-15-07
Lessor Or Real Estate Owner
P.O. Box 409 Sturgis, KY 42459
Maricopa Properties, LLC
100% of RE
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Maricopa Partners, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Rock River, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
MMB, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Lovenest, LLC
30.959% of Rock River, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gary
16.025% of Rock River, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Lisa
32.88% of MMB, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Tim
17.455% of MMB, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Vicki
29.421% of Lovenest, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Robert
13.957% of Lovenest, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Laura
53.016% of Rock River, LLC - 4 children
w/13.254% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
4 Irrevocable Trusts
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O.Box 409 Sturgis, KY 42459
Ervin Mallory
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Jade
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Luke
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gabe
49.665% of MMB, LLC - 5 children
w/9.933% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
3 Irrevocable Trusts
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Max
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box Sturgis, KY 42459
Linenger Jessica
Page 185 of 265
Owner NameFacilities Owned
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mitch
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Linenger Jennifer
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Brock
56.623% of Lovenest, LLC - 7 children
w/8.089% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
7 Irrevocable Trusts
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Thea
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugris, KY 42459
Ervin Issac
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugis, KY 42459
Ervin Samuel
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Elijah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Saul
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Micah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mathias
NH5303 918-273-2012822 West Osage Nowata, OK 74048
Osage Nursing Home
Successor Trustee & Beneficiary -WBT
eff 5/24/12
Trustee
P.O. Box 2230 Waldron, AR 72958
Watts Fred
9.61494% Oklahoma Nursing Home, Ltd,
Manager
Contracted Management
210 E. Choctaw, P.O. Box 429 Sallisaw, OK 74955-0429
Oklahoma Nursing Homes, Ltd. (ONH,Ltd.)
8.314% OP & Mgr./ 8.4112% RE/
9.401287% Okla. Nurs. Homes, Inc.
Stockholders/partners -- Not Officers
P.O. Box 40 Sallisaw, OK 74955
Cheek Barnie J.
8.314% OP & Mgmt. / 8.4112% RE
Stockholders/partners -- Not Officers
3520 East 110th Place Tulsa, OK 74137
Sandra Cheek Farmer Trust (SCFT)
5.834% OP & Mgmt/5.9190% mgr
RE/6.597394% Okla. Nurs.Homes,Inc.
Stockholders/partners -- Not Officers
4814 S. 164th East Ave. Tulsa, OK 74134
Haskins Lloyd
5.192% OP&Mgmt./5.2626%
RE/12.535047%ONH,Inc.TrusteeWBTeff
5/12
Stockholders/partners -- Not Officers
51 green acre village #51 Sallisaw, OK 74955
Watts Cleo
Page 186 of 265
Owner NameFacilities Owned
5.893% OP & Mgmt. / 5.9746% RE
Stockholders/partners -- Not Officers
51 Green Acre Village Sallisaw, OK 74955
Watts Beneficiaries Trust (WBT)
14.022% OP & Mgmt/ 14.2078% RE/
21.936335% VP of ONH,Inc.
Stockholders/partners Who Are Officers
Box 856 Miami, OK 74355
Tubbs Steven
5.376% OP & Mgmt. / 5.4406% RE
Stockholders/partners -- Not Officers
3910 Cherry Forest Drive Houston, TX 77088
Tubbs, Jr. Stanley I.
5.542% OP & Mgr./ 5.6186% RE/
6.267525% Okla Nurs Homes, Inc.
Stockholders/partners -- Not Officers
416 Fairway Dr. Athens, TX 75751
Estep Pat
2.771% OP & ONH,Ltd / 2.8037% RE eff
5/24/12 & Trustee of JKBRT
Stockholders/partners -- Not Officers
1500 West Elm Stroud, OK 74079
Julie Kay Bivin Revocable Trust (JKBRT)
5.135% OP/MANAGEMENT/ RE
5.2207%
Stockholders/partners -- Not Officers
6708 South 256th East Avenue Broken Arrow, OK 74014
Caroyln D. Leaverton Revocable Trust
2.771% OP & Mgmt./ 2.8037% RE
Stockholders/partners -- Not Officers
PO Box 370 Adair, OK 74330
Dr. William R. VanDeLinder Trust (DWVT)
2.771% OP & Mgmt. / 2.8037% RE
Stockholders/partners -- Not Officers
3808 NW Marquess Drive Bentonville, AR 72712
Lynn M. Yowell Trust
9.7298% of Midwest Nursing Home, LLC
Lessor Or Real Estate Owner
210 East Choctaw Sallisaw, OK 74955
Midwest Nursing Homes, LLC (MNHLLC)
2.77100% Mgmt. / 2.8038% RE
Stockholders/partners -- Not Officers
2802 West Country Club Drive Oklahoma City, OK 73116
Richard Armstrong Trust (RAT)
9.61494% of Osage Nursing Center, LLC
Operating Entity
P.O. box 400 Sallisaw, OK 74955
Osage Nursing Center, LLC
1.2190 mgr OP & Mgmt.
Stockholders/partners Who Are Officers
P.O. Box 400 Sallisaw, OK 74955
Oklahoma Nursing Homes, Inc. General Partner (ONH,Inc)
9.401287% Oklahoma Nursing Homes,
Inc.; Ben. of RA Trust
Stockholders/partners -- Not Officers
2802 W. Country Club Dr. Oklahoma City, OK 73116
Armstrong Richard James
Trustee-SCFT/9.401287% Oklahoma
Nursing Homes, Inc.
Stockholders/partners -- Not Officers
3520 East 110th Place Tulsa, OK 74137
Farmer Sandra
1.28306% OP & Mgmt./ 1.3156%
RE/9.401287% Okla.Nurs. Homes,Inc.
Stockholders/partners -- Not Officers
20852 South Shannon Drive Claremore, OK 74017
Wilson James G.
2.079% OP & Mgmt. / 2.1028% RE
Stockholders/partners -- Not Officers
P.O. Box 173 Gore, OK 74435
Ferguson Debra M.
5.556% OP & Mgmt./5.5630% RE/ Treas
w/5.657265% in ONH, Inc.
Stockholders/partners Who Are Officers
607 Mayo Street Sallisaw, OK 74955
McGrew Justin
2.771% OP & Mgmt/ 2.8038% RE
Stockholders/partners -- Not Officers
HCR 68 Box 1260 Vian, OK 74962
Armstrong Sally
9.401287% Oklahoma Nursing Home,
Inc. President; Trustee of DWRV
Stockholders/partners -- Not Officers
PO Box 370 Adair, OK 74330
VanDeLinder Dr. William R.
Page 187 of 265
Owner NameFacilities Owned
RE 0.70095% & 0.69275% OP & Mgmt
Stockholders/partners -- Not Officers
1405 E. Seattle St. Broken Arrow, OK 74012
Heath Armstrong VanDeLinder Trust (HAVT)
RE 0.70095% & 0.69275% OP & Mgmt
Stockholders/partners -- Not Officers
2812 West 114th Street Jenks, OK 74037
Meredith Margaret Marie VanDeLinder Trust (MMMVT)
RE 0.70095% & 0.69275% OP & Mgmt
Stockholders/partners -- Not Officers
8 Dinton Circle Bella Vista, AR 72714
Nicolas Edmund VanDeLinder Trust (NEVT)
RE 0.70095% & 0.69275% OP & Mgmt
Stockholders/partners -- Not Officers
2116 Whitney Lane McKinney, TX 75070
William Glen VanDelinder Trust (WGVT)
2.77100% OP
Stockholders/partners -- Not Officers
2802 W. Country Club Dr. Oklahoma City, OK 73116
Richard Glen Armstrong Trust (RGAT)
Trustee-Carolyn D. Leaverton Rev. Trust
eff 05/24/12
Trustee
6708 South 256th East Ave Broken Bow, OK 74014
Leaverton Carolyn
Trustee-Carolyn D. Leaverton Rev. Trust
eff 05/24/12
Trustee
6708 South 256th East Ave Broken Arrow, OK 74014
Leaverton Ronald
Succ.Trustee & Benf-Carolyn D.
Leaverton Rev. Trust eff 05/24/12
Beneficiary
6708 South 256th East Ave Broken Arrow, OK 74014
Johnson Karen Diane
Successor Trustee & Beneficiary -WBT
eff 5/24/12
Trustee
51 Green Acre Village Sallisaw, OK 74955
Byers Karen
Successor Trustee & Beneficiary -WBT
eff 5/24/12
Trustee
51 Green Acre Village Sallisaw, OK 74955
Rhodes Sharon
Beneficiary - WTB eff 5/24/12
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Rhodes Grant
Beneficiary - WTB eff 5/24/12
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Miles Sydney
Beneficiary - WTB eff 5/24/12
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Cameron Amber
Successor Trustee - SCFT eff 5/24/12
Trustee
3520 east 110th Place Tulsa, OK 74137
Farmer Frederick Sinclair
Beneficiary - SCFT eff 5/24/12
Beneficiary
3520 East 110th Place Tulsa, OK 74137
Farmer Cassandra C.
Beneficiary - SCFT eff 5/24/12
Beneficiary
3520 East 110th Place Tulsa, OK 74137
Farmer Alexandra C.
Trustee of RGAT
Trustee
c/o Ben Bryers, 2802 W. Country Club DR. Oklahoma City, ok 73116
Heritage Trust Co.,
Registered Agent
Officer
317 N.W. 12th St. Oklahoma City, OK 73103
Burnsed (C. Craig Cole & Assoc.) Carrie
Ben. of Julie Kay bivin Revocable Trust
Eff. 2016
Beneficiary
1500 West Elm Stroud, OK 74079
Bivin Jeremy
Page 188 of 265
Owner NameFacilities Owned
Ben. pf Julie Kay Bivin Revocable Trust
Beneficiary
1500 West Elm Stroud, OK 74049
Bivin Ryan
NH5504 405-946-69326312 North Portland Oklahoma City, OK 73112
PARCway
100% of Oklahoma Senior Care, eff
08/1/2015
Stockholders/partners -- Not Officers
1126 Rambling Oaks Dr. Norman, OK 73072
OHara Dirk
100% Senior Comfort Corp.
Stockholders/partners Who Are Officers
1825 E. 15th Tulsa, OK 74104
Jiles Jon P.
eff. 12-18-06
Operating Entity
6312 N. Portland Okla. City, OK 73102
N-Vest Skilled Nursing of Oklahoma LLC
50% OP eff.09/09/2013 ( 69% RE ended
10/28/2014)
Stockholders/partners -- Not Officers
1825 East 15th Street Tulsa, OK 74104
Senior Comfort Corp.
30% OP eff. 09/09/2013 (RE end
10/28/2014)
Stockholders/partners -- Not Officers
2080 Verona Way Edmond, OK 73034
Kittco, LLC
100% Kittco, LLC eff. 12-18-06
Stockholders/partners Who Are Officers
2808 Verpma Wau Edmond, OK 73034
Wakeley Kitt
30% N-Vest Skilled Nursing eff 08/01/15
Stockholders/partners -- Not Officers
1126 Rambling Oaks Drive Norman, OK 73072
Oklahoma Senior Care, L.L.C.
Employment Tax Entity
4005 NW Expressway 500 Oklahoma City, OK 73112
Paycom, LLC
100% of Sabra Health Care Holdings III,
LLC
Stockholders/partners -- Not Officers
18831 Von Karman Ave 400 Irvine, CA 92612
Sabra Health Care Limited Partnership
1% of Sabra Health Care Limited
Parnership eff 10/29/2014
Limited Partner
18831 Von Karman Ave 400 Irvine, CA 92612
Sabra Health Care, LLC
99% & GP of Sabra Health Care Limited
Partnership eff 10/29/14
General Partner
18831 Von Karman Ave. 400 Irvine, CA 92612
Sabra Health Care REIT, Inc.
RE eff 10/29/2014
Lessor Or Real Estate Owner
18831 Von Karman Ave 400 Irvine, CA 92612
Sabra Health Care Holdings III, LLC
President of Sabra Health Care Holding
III, LLC, SHC, & Reit
Officers Who Do Not Hold Stock
18500 Von Karman Avenue 550 Lrvine, CA 92612
Matros Richard
CFO and Secretary of Sabra Health Care
Holdings III, SHC & Reit
Officers Who Do Not Hold Stock
18500 Von Karman Ave 550 Irvine, CA 92612
Andrews, Jr. Harold
CFO-Secretary of Sabra Health Care
Holdings III, SHC & Reit
Officers Who Do Not Hold Stock
18500 Von Karman Ave 550 Irvine, CA 92612
Nevo-Hacohen Talya
Page 189 of 265
Owner NameFacilities Owned
NH4904 918-434-5600319 N. Owen Walters Blvd. Salina, OK 74365
Parkhill North Nursing Home
25% BGM Estate, LLC Eff 9-16-16
Stockholders/partners -- Not Officers
P.O. Box 330 Muldrow, OK 74948
Tabor Angela
25% BGM Estate, LLC Eff 9-16-16
Stockholders/partners -- Not Officers
111522 S. 4740 Rd. Muldrow, OK 74948
Mitchell Robert Michael
25% BGM Estate, LLC eff 9-16-16
Stockholders/partners -- Not Officers
412 S. Dogwood Sallisaw, OK 74955
Mitchell Marcinda
12.5% of OP and 25% BGM Estate, LLC
eff 9-16-16
Stockholders/partners -- Not Officers
7240 Chase Oaks Blvd 121 Plano, TX 75025
Mitchell Kelly O.
Operating Entity
319 N. Owen Walters Blvd. Salina, OK 74365
Salina Care Center, L.L.C.
25% of OP
Stockholders/partners -- Not Officers
P.O. Box 1454 Sallisaw, OK 74955
Philip M. Green Revocable Trust
25% of OP
Stockholders/partners -- Not Officers
P.O. Box 1090 Sallisaw, OK 74955
Gilbert F. Green Trust
Manager of OpEntity
Officers Who Do Not Hold Stock
319 N. Owen Walters Blvd. Salina, OK 74365
Hobbs Jeanan
37.50% OP eff 9-16-16
Stockholders/partners -- Not Officers
,
BGM Estate, LLC
NH4103 405-567-2201200 West Parkland Avenue Prague, OK 74864
Parkland Manor Living Center
51% Mbr of JNH
Stockholders/partners Who Are Officers
105 Washington Pauls Valley, OK 73075
Justice Jack
100% of Parkland Manor Living Center,
LLC
Stockholders/partners -- Not Officers
110 Barr Avenue Pauls Valley, OK 73075
Washita Valley Investments, L.L.C.
49% Mng Mbr of JNH Prop/100%Mem
of Wash Val Inv Eff 9/1/16
Stockholders/partners Who Are Officers
110 Burr Aveneu Pauls Valley, OK 73075
Justice Julie
Op Ent eff 3/27/2007
Operating Entity
110 Burr Ave Pauls Valley, OK 73075
Parkland Manor Living Center, L.L.C.
Real Estate
Lessor Or Real Estate Owner
110 Burr Ave. Pauls Valley, OK 73075
Parkland Properties, LLC
100% member of Parkland Properties,
LLC
Stockholders/partners Who Are Officers
110 Burr Ave Pauls Valley, OK 73075
JNH Properties, LLC
Page 190 of 265
Owner NameFacilities Owned
NH7219 918-627-52385115 East 51st Street Tulsa, OK 74135
Parks Edge Nursing And Rehabilitation Center
100%
Stockholders/partners -- Not Officers
415 Rogers Avenue Ft. Smith, AK 72902
Morton Michael
eff 1-3-05
Operating Entity
5115 East 51st Street Tulsa, Ok 74135
Parks Edge Care Center, Inc.
eff. 11-16-04
Lessor Or Real Estate Owner
415 Rogers Avenue Fort Smith, AR 72901
Parks Edge Nursing Property, Inc.
NH2504 405-238-64111413 South Chickasaw Pauls Valley, OK 73075
Pauls Valley Care Center
Mng Mem 100% PVCC, LLC/100% Mng
Mem of BK Strategies, LLC
Stockholders/partners Who Are Officers
131 North Broadway Ada, OK 74820
Reed Bart
Member 100% interest in Pauls Valley
Care Center, LLC
Stockholders/partners -- Not Officers
131 North Broadway Ada, OK 74820
BK Strategies, LLC
100% of Pauls Valley Real Estate,LLC eff
02/01/2012
Stockholders/partners -- Not Officers
131 North Broadway Ada, OK 74820
BK Strategies Real Estate, LLC
UPL Mgr. eff. 6/30/2017
Operating Entity
131 N. Broadway Ada, OK 74820
Pauls Valley Care Center, LLC
UPL Mgr. eff. 6/30/2017
Operating Entity
131 N. Broadway Ada, OK 74820
Pauls Valley Care Center, LLC
(1%RE END06/1/09)/OP General Partner
Stockholders/partners -- Not Officers
PO Box 977 Guthrie, OK 73044
GMGP, INC.
100% of RE Eff 02/01/2012
Lessor Or Real Estate Owner
131 North Broadway Ada, OK 74820
Pauls Valley Real Estate, LLC
UPL Owner eff. 6/30/2017
Operating Entity
100 W. Paul Avenue Pauls Valley, OK 73075
City of Pauls Valley
NH5704 918-287-39401228 South Pecan Pawhuska, OK 74056
Pawhuska Nursing Home, LLC
Successor Trustee & Beneficiary - WBT
eff 5/24/12
Trustee
P.O. Box 2230 Waldron, AR 72958
Watts Fred
Page 191 of 265
Owner NameFacilities Owned
9.61494% Oklahoma Nursing Home, Ltd,
Manager
Contracted Management
210 E. Choctaw, P.O. Box 429 Sallisaw, OK 74955-0429
Oklahoma Nursing Homes, Ltd. (ONH,Ltd.)
8.314% OP & Mgr./ 8.4112% RE/
9.401287% ONH Inc.
Stockholders/partners -- Not Officers
P.O. Box 40 Sallisaw, OK 74955
Cheek Barnie J.
8.314% OP & Mgmt. / 8.4112% RE
Stockholders/partners -- Not Officers
3520 East 110th Place Tulsa, OK 74137
Sandra Cheek Farmer Trust (SCFT)
5.834% OP & Mgmt/5.9190% mgr
RE/6.597394% Okla. Nurs.Homes,Inc.
Stockholders/partners -- Not Officers
4814 S. 164th East Ave. Tulsa, OK 74134
Haskins Lloyd
5.192% OP & Mgmt./ 5.2626% RE/
12.535047% ONH,Inc/TrsteWBTef5/12
Stockholders/partners -- Not Officers
51 green acre village #51 Sallisaw, OK 74955
Watts Cleo
Successor Trustee of Julie Kay Bivin
Revocable Trust
Trustee
Rt. 2 Box 339 Idabel, OK 74745
Bivin Steve
5.893% OP & Mgmt. / 5.9746% RE
Stockholders/partners -- Not Officers
51 Green Acre Village Sallisaw, OK 74955
Watts Beneficiaries Trust (WBT)
5.612090% OP/ 5.67% RE
Stockholders/partners -- Not Officers
20852 S. Shannon Dr. Claremore, OK 74017
William McKesson Wilson Sr. 1997 Trust
14.022% OP & Mgmt/ 14.2078% RE/
21.936335% VP of ONH,Inc.
Stockholders/partners Who Are Officers
Box 856 Miami, OK 74355
Tubbs Steven
5.376% OP & Mgmt. / 5.4406% RE.
Stockholders/partners -- Not Officers
3910 Cherry Forest Drive Houston, TX 77088
Tubbs, Jr. Stanley I.
5.542% OP & Mgr./ 5.6186% RE/
6.267525% Okla Nurs Homes, Inc.
Stockholders/partners -- Not Officers
416 Fairway Dr. Athens, TX 75751
Estep Pat
2.771% OP & Mgmt. / 2.8037% RE
Stockholders/partners -- Not Officers
1500 West Elm Stroud, OK 74079
Julie Kay Bivin Revocable Trust (JKBRT)
5.135% OP/MANAGEMENT/ RE
5.2207%
Stockholders/partners -- Not Officers
6708 South 256th East Avenue Broken Arrow, OK 74014
Caroyln D. Leaverton Revocable Trust
2.771% OP & Mgmt./ 2.8037% RE
Stockholders/partners -- Not Officers
PO Box 370 Adair, OK 74330
Dr. William R. VanDeLinder Trust (DWVT)
2.771% OP & Mgmt. / 2.8037% RE
Stockholders/partners -- Not Officers
3808 NW Marquess Drive Bentonville, AR 72712
Lynn M. Yowell Trust
9.7298% of Midwest Nursing Home, LLC
Lessor Or Real Estate Owner
210 East Choctaw Sallisaw, OK 74955
Midwest Nursing Homes, LLC (MNHLLC)
2.771% OP & Mgmt. / 2.8038% RE
Stockholders/partners -- Not Officers
2802 West Country Club Drive Oklahoma City, OK 73116
Richard Armstrong Trust (RAT)
9.61494% of Pawhuska Nursing Home,
LLC
Operating Entity
PO Box 400 Sallisaw, OK 74955
Pawhuska Nursing Home, LLC
1.219% mgr OP & Mgmt.
Stockholders/partners Who Are Officers
P.O. Box 400 Sallisaw, OK 74955
Oklahoma Nursing Homes, Inc. General Partner (ONH,Inc)
Page 192 of 265
Owner NameFacilities Owned
9.401287% ONH, Inc./ Ben. R A Trust/
RGA Trust
Stockholders/partners -- Not Officers
2802 W. Country Club Dr. Oklahoma City, OK 73116
Armstrong Richard James
Trustee-SCFT/9.401287% Oklahoma
Nrsng Homes, Inc. EFF 05/24/2012
Stockholders/partners -- Not Officers
3520 East 110th Place Tulsa, OK 74137
Farmer Sandra
1.28306% OP & Mgmt./1.31560%
RE/9.401287% Okla.Nurs. Homes,Inc.
Stockholders/partners -- Not Officers
20852 South Shannon Drive Claremore, OK 74017
Wilson James G.
2.079% OP & Mgmt. / 2.1028% RE
Stockholders/partners -- Not Officers
P.O. Box 173 Gore, OK 74435
Ferguson Debra M.
5.556% OP & Mgmt./5.5630% RE/Treas.
w/ 5.657265% in ONH, Inc.
Stockholders/partners -- Not Officers
607 Mayo Street Sallisaw, OK 74955
McGrew Justin
2.771% OP & Mgmt/ 2.8038% RE
Stockholders/partners -- Not Officers
HCR 68 Box 1260 Vian, OK 74962
Armstrong Sally
9.401287% & Pres. of ONH, Inc. Trustee
of DWVT
Stockholders/partners Who Are Officers
PO Box 370 Adair, OK 74330
VanDeLinder Dr. William R.
RE 0.70095% & 0.69275% OP & Mgmt
Stockholders/partners -- Not Officers
1405 E. Seattle St. Broken Arrow, OK 74012
Heath Armstrong VanDeLinder Trust (HAVT)
RE 0.70095% & 0.69275% OP & Mgmt
Stockholders/partners -- Not Officers
2812 West 114th Street Jenks, OK 74037
Meredith Margaret Marie VanDeLinder Trust (MMMVT)
RE 0.70095% & 0.69275% OP & Mgmt
Stockholders/partners -- Not Officers
8 Dinton Circle Bella Vista, AR 72714
Nicolas Edmund VanDeLinder Trust (NEVT)
RE 0.70095% & 0.69275% OP & Mgmt
Stockholders/partners Who Are Officers
2116 Whitney Lane McKinney, TX 75070
William Glen VanDelinder Trust (WGVT)
Trustee of Julie Kay Bivin Revocable
Trust
Trustee
1500 West Elm Stroud, OK 74079
Bivin Julie K.
2.77100% of OP
Stockholders/partners -- Not Officers
2802 W. Country Club Dr. Oklahoma City, OK 73116
Richard Glen Armstrong Trust (RGAT)
Trustee-Carolyn D. Leaverton Rev. Trust
EFF 05/24/2012
Trustee
6708 South 256th East Ave Broken Bow, OK 74014
Leaverton Carolyn
Trustee-Carolyn D. Leaverton Rev. Trust
eff 05/24/12
Trustee
6708 South 256th East Ave Broken Arrow, OK 74014
Leaverton Ronald
Sucssor Trstee/BEN-Carolyn D.
Leaverton Rev.Trust EFF 05/24/2012
Beneficiary
6708 South 256th East Ave Broken Arrow, OK 74014
Johnson Karen Diane
Sucesr Trustee/BEN-Carolyn D.
Leaverton Rev.Trust EFF 05/24/2012
Trustee
6708 South 256th East Ave Broken Arrow, OK 74014
Fine Michael B.
Successor Trustee/Ben-WBTeff 5/24/12
Trustee
51 Green Acre Village Sallisaw, OK 74955
Byers Karen
Successor Trustee & Beneficiary - WBT
eff 5/24/12
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Rhodes Sharon
Page 193 of 265
Owner NameFacilities Owned
Beneficiary - WTB eff 5/24/12
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Rhodes Grant
Beneficiary - WTB eff 5/24/12
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Miles Sydney
Beneficiary - WTB eff 5/24/12
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Byers Jack
Beneficiary - WTB eff 5/24/12
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Cameron Amber
Sucessor Trustee-SCFT EFF 05/24/2012
Trustee
3520 east 110th Place Tulsa, OK 74137
Farmer Frederick Sinclair
Beneficiary-SCFT EFF 05/24/2012
Beneficiary
3520 East 110th Place Tulsa, OK 74137
Farmer Cassandra C.
Beneficiary-SCFT EFF 05/24/2012
Beneficiary
3520 East 110th Place Tulsa, OK 74137
Farmer Alexandra C.
Trustee / Richard Armstrong Trust &
Richard Glen Armstrong Trust
Trustee
c/o Ben Bryers, 2802 W. Country Club DR. Oklahoma City, ok 73116
Heritage Trust Co.,
Registered Agent
Officer
317 N.W. 12th St. Oklahoma City, OK 73103
Burnsed (C. Craig Cole & Assoc.) Carrie
Ben. of Julie Kay Bivin Revocable Trust
Beneficiary
1500 West Elm Stroud, OK 74079
Bivin Jeremy
Ben. of Julie Kay Bivin Revocable Trust
Beneficiary
1500 West Elm Stroud, OK 74049
Bivin Ryan
Beneficiary of RATrust % RGA Trust
Beneficiary
2802 W. Country Club Dr. Oklahoma, OK 73116
Heritage Trust Company Armstrong Carol
Succ. Trustee of DWVT
Trustee
,
VanDeLinder Patricia Rene
NH5202 580-336-22851103 Birch Street Perry, OK 73077
Perry Green Valley Nursing Home, LLC
7% Mbr HMLC, LLC
Stockholders/partners -- Not Officers
P.O. Box 1095 Guthrie, OK 73044
Golden Age Nursing Home Of Guthrie, Inc.(GAN)
Trustee-Mary Lou Chappell Trust
Trustee
Box 1095 Guthrie, OK 73044
Chappell Mary Lou
3%Mbr HMLC, LLC
Stockholders/partners -- Not Officers
P.O. Box 1095 Guthrie, OK 73044
Perry Green Valley Nursing Home, Inc.(PGV)
3%Mbr HMLC, LLC
Stockholders/partners -- Not Officers
PO Box 1095 Guthrie, OK 73044
Stilwell Nursing Home, Inc.(SNH)
Page 194 of 265
Owner NameFacilities Owned
Beneficiary - Chappell 2012 Succession
Trust dated 01/03/2012
Beneficiary
P.O. Box 1095 Guthrie, OK 73044
Chappell Jeff
Real Estate
Lessor Or Real Estate Owner
P.O. Box 1095 Guthrie, OK 73044
H & M Noble Property, LLC
Mgr. GAN,PGV,SNH; Mgr. of OP/RE
06/01/2016
Manager
P.O. Box 1095 Guthrie, OK 73044
Hastings Tandie
Eff 7/1/2007
Operating Entity
PO Box 1095 Guthrie, OK 73044
Perry Green Valley Nursing Home, LLC
100% Mmbr OP & RE, eff 04/18/12
Stockholders/partners -- Not Officers
PO Box 1095 Guthrie, OK 73044
HMLC, LLC
Mgr of HMCL, LLC,Trustee Chappell
2012 Succession Trust
Officers Who Do Not Hold Stock
PO Box 1095 Guthrie, OK 73044
Chappell Hollie "Joe"
72% member HMLC, LLC 4/15/16 Benef
MLC Trust Eff 6/1/16
Stockholders/partners -- Not Officers
P.O. Box 1095 Guthrie, OK 73044
Chappell 2012 Succession Trust dated 1/3/2012
15% mbr HMLC, 100% SNH, PGV Inc.,
GAN 06/01/2016
Stockholders/partners -- Not Officers
P.O. Box 1095 Guthrie, OK 73044
Mary Lou Chappell Trust
Beneficiary - Chappell 2012 Succession
Trust dated 01/03/2012
Beneficiary
,
Chappell Jon D.
Beneficiary - Chappell 2012
SuccessionTrust dated 01/03/2012
Beneficiary
,
Crockett Mary Janice
NH3305 580-480-18002610 Cedar Creek Drive Altus, OK 73521
Plantation Village Nursing Center
Manager/President Altus Operations LLC
(Manager)
Trustee
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Greiner Don
Manager/Secretary of Altus Operations,
LLC (Manager)
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Dimond Mike
eff 7/27/2006
Contracted Management
4350 Will Rogers Parkway 300 Okc, OK 73108
Amity Care, L.L.C.
78% Altus Operations, LLC (Manager)
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Don Greiner Trustee Kenneth D.Greiner III Revocable Trust, Don Greiner
Benef/Trustee
22% of Altus Operations, LLC (Manager)
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Okc, OK 73108
Don Greiner Trust
eff 1/9/07
Operating Entity
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Altus Operations, L.L.C.
RE eff 7/27/2006
Lessor Or Real Estate Owner
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Altus Real Estate, LLC
Page 195 of 265
Owner NameFacilities Owned
NH5109 918-682-53911120 Illinois Muskogee, OK 74403
Pleasant Valley Health Care Center
Operating Entity
,
Pleasant Valley Health Care Center, Inc.
65% President
Stockholders/partners Who Are Officers
3412 Riverbend Rd. Muskogee, OK 74403
Nevitt Mary
35% Sec/Treas
Stockholders/partners Who Are Officers
3707 East Harris Road Muskogee, OK 74403
Nevitt Danny
NH4008 918-436-2228200 Home Street Pocola, OK 74902
Pocola Health and Rehab
CN04-016
Stockholders/partners Who Are Officers
P.O. Box 586 Sallisaw, OK 74902
Farmer, Jr. Archie Don
eff 9-30-02
Lessor Or Real Estate Owner
115 Washington Street Pocola, OK 72958
Pocola Manor, L.L.C.
eff 09/29/04
Operating Entity
200 Home Street Pocola, OK 72958
Pocola Nursing Center, L.L.C.
100% manag.member Pocola Nursing
Center, LLC
Stockholders/partners Who Are Officers
200 Home Street Pocola, OK 744902
Hensley Chris
NH3606 580-762-66681400 North Waverly Ponca City, OK 74601
Ponca City Nursing & Rehabilitation Center
34% N&R Ponca City & Health Systems
of Oklahoma eff 01/01/2017
Stockholders/partners Who Are Officers
329 Townepark Circle 100 Louisville, KY 40243
Vinson John
Management
Contracted Management
329 Townepark Circle 100 Louisville, KY 40243
Health Systems of Oklahoma, L.L.C.
eff 10-01-02
Operating Entity
2450 Shelbyville Rd Shelbyville, KY 40065
N & R of Ponca City, L.L.C.
Lessor Or Real Estate Owner
200 Inernational Circle 3500 Hunt Valley, MD 21030
CSE Ponca City LLC
Member with 100% interest of CSE
Ponca City
Stockholders/partners -- Not Officers
4445 Willard Ave, 12th Floor Chevy Chase, MD 20815
CSE Casablanca Holdings LLC
Page 196 of 265
Owner NameFacilities Owned
100% interest and Member of CSE
Casablanca LLC
Stockholders/partners -- Not Officers
4445 Willard Ave, 12th Floor Chevy Chase, MD 20815
CSE SLB LLC
100% interest and Member of CSE SLB,
LLC
Stockholders/partners -- Not Officers
4445 Willard Ave, 12th Floor Chevy Chase, MD 20815
CSE Mortgage LLC
CEO of CSE/RE
Stockholders/partners Who Are Officers
,
Pickett Taylor
COO of CSE/RE
Stockholders/partners Who Are Officers
,
Booth Daniel J.
Senior VP of CSE/RE
Stockholders/partners Who Are Officers
,
Crabill, Jr R. Lee
100% Owner of CSE Ponca City LLC
Stockholders/partners -- Not Officers
200 International Circle 3500 Hunt Valley, MD 21030
Omega Healthcare Investors, Inc.
33% N&R Ponca City & Health Systems
of Oklahoma eff 01/01/2017
Stockholders/partners -- Not Officers
329 Townepark Circle Louisville, KY 40243
Vinson, Jr John
33% N&R of Ponca City & Health
Systems of Oklahoma eff 01-1-2017
Stockholders/partners -- Not Officers
329 Towepark Circle Louisville, KY 40243
Trumbo Jay H.
NH4208 405-282-8166405 North 20th Street Guthrie, OK 73044
Providence House
100% of Op Entity and Real Estate Entity
Stockholders/partners -- Not Officers
PO Box 990 Edmond, OK 73013
Diakonos Group, LLC
99% Diakonos Group, LLC
Stockholders/partners -- Not Officers
PO Box 990 Edmond, OK 73013
Pilgrim Scott
EFF 09-01-2015
Operating Entity
P.O. Box 990 Edmond, OK 73083
Guthrie Cottages, LLC
EFF 09-01-2015
Lessor Or Real Estate Owner
P.O Box 990 Edmond, OK 73083
Guthrie Holding, LLC
1% of Diakonos Group, LLC
Stockholders/partners -- Not Officers
P.O. Box 990 Edmond, OK 73083
Servant Living Center Holding Company
NH4402 405-527-7798801 North 6th Street Purcell, OK 73080
Purcell Care Center, LLC
100% Purcell Care Care & RE eff
09/16/2015
Stockholders/partners -- Not Officers
131 North Broadway Ada, OK 74820
Reed Bart
Page 197 of 265
Owner NameFacilities Owned
UPL Mgr. eff. 6/30/2017
Contracted Management
131 N Broadway Ada, OK 74820
Purcell Care Center, LLC
100% of RE
Lessor Or Real Estate Owner
131 North Broadway Ada, OK 74820
Purcell Real Estate, LLC
UPL Owner eff. 6/30/2017
Operating Entity
100 W. Paul Avenue Pauls Valley, OK 73075
City of Pauls Valley
NH5546 405-720-001013500 Brandon Place Oklahoma City, OK 73142
Quail Creek Nursing And Rehabilitation Center
RE 100% Eff 11/1/2012
Lessor Or Real Estate Owner
1145 Hembree Rd Roswell, GA 30076
QC Property Holding LLC
OP eff 12-1-2012, eff 01/01/16
Operating Entity 2
13500 Brandon Place Oklahoma City, OK 73142
QC Nursing, LLC
100% of QC Nursing, LLC
Stockholders/partners -- Not Officers
1145 Hembree Rd. Roswell, GA 30076
AdCare Operations, LLC
Contracted Management eff 05/2015
Contracted Management
1518 Legacy Dr. #110 Frisco, TX 75034
Southwest LTC Management Services, LLC
1% Southwest LTC-Quail Creek
LLC,72.62% SW LTC,LTD eff 01/01/16
Stockholders/partners -- Not Officers
1518 Legacy Drive 110 Frisco, TX 75034
Payne Ronald
9.5%SW,LTC, LTD,20% of Southwest
LTC-Mgt Services eff 01/01/2016
Stockholders/partners -- Not Officers
1518 Legacy Drive 110 Frisco, TX 75034
Brashier Craig
Sr. VP-OP AdCare, Manager QC Nursing,
LLC eff 01/31/2015
Officers Who Do Not Hold Stock
1145 Hembree Road Roswell, GA 30076
AdCare Health Systems Thomas John C.
CEO-AdCare Health Systems, Manager
QC Nursingeff 01/31/2015
Officers Who Do Not Hold Stock
1145 Hembree Road Roswell, GA 30076
AdCare McBride William
99% Southwest LTC-Quail CReek LLC
eff 01/01/16
Stockholders/partners -- Not Officers
1518 Legacy Drive 110 Frisco, OK 75034
Southwest LTC Oklahoma Holdings,LLC
100% Southwest LTC Oklahoma
Holdings, LLC eff 01/01/16
Stockholders/partners -- Not Officers
1518 Legacy Dr. 110 Frisco, TX 75034
Southwest LTC, LTD
11.98% SW LTC, LTD eff 01/01/16
Stockholders/partners -- Not Officers
5731 Jackson St. Ext C Alexandria, LA 71303
Quality Care Givers, Inc.
1% SW LTC, LTD eff 01/01/16
Stockholders/partners -- Not Officers
1518 Legacy Drive 110 Frisco, TX 75034
Southwest LTC Mgt I LLC
OP eff 01/01/2016
Operating Entity
1518 Legacy Drive 110 Frisco, TX 75034
Southwest LTC-Quail Creek LLC
Page 198 of 265
Owner NameFacilities Owned
NH2105 918-422-5138564 State Line Road Colcord, OK 74338
Quail Ridge Living Center, Inc.
29.2%
Stockholders/partners -- Not Officers
606 E. Boone Tahlequah, OK 74464
Burris Lynn
21.6%
Stockholders/partners Who Are Officers
1500 East Downing 110 Tahlequah, OK 74464
Pointer Ed
21.6%
Stockholders/partners Who Are Officers
Rt. 7, Box 67 Tahlequah, OK 74464
Pointer Patrick
Operating Entity
P.O. Box 1005 Siloam Springs, AR 72761
Quail Ridge Living Center, Inc.
6.9%
Stockholders/partners Who Are Officers
P.O. Box 9 Gentry, AR 72734
Weaver, M.D. Robert
6.9%
Stockholders/partners Who Are Officers
8520 S. 36th Terrace Fort Smith, AR 72908
Stein James
6.9%
Stockholders/partners -- Not Officers
8520 S. 36th Terrace Fort Smith, AR 72908
Stein Paul
6.9%
Stockholders/partners -- Not Officers
PO Box 1005 Siloam Springs, AR 74955
Zambrano Tamara & Rene
NH6106 918-469-26001209 West Main Quinton, OK 74561
Quinton Manor Nursing Home
50% IPC Healthcare, LLC & Tidwell Fam
HealthCare eff 01/01/2016
Stockholders/partners Who Are Officers
900 Ranchwood Dr Wilburton, OK 74578
Tidwell Melissa
50% IPC Healthcare, LLC & Tidwell Fam
HealthCare eff 01/01/2016
Stockholders/partners Who Are Officers
225 W Main St Wilburton, OK 74578
Tidwell Darren
Eff 10/01/2016
Lessor Or Real Estate Owner
225 W Main St Wilburton, OK 74578
IPC HealthCare, LLC
Eff 01/01/2016
Operating Entity
225 W Main St Wilburton, OK 74578
Tidwell Family HealthCare, LLC
NH5401 405-786-2244300 West 9th Street Weleetka, OK 74880
Rainbow Terrace Care Center
Operating Entity
300 W. 9th Weleetka, OK 74880
Williamson Care Centers, Inc.
Page 199 of 265
Owner NameFacilities Owned
President 50% EFF 11-17-2014
Stockholders/partners Who Are Officers
P.O. Box 703 Weleetka, OK 74880
Williamson Jerry R.
Vice-President 50% EFF 11-17-2014
Stockholders/partners Who Are Officers
P.O. Box 246 Weleetka, OK 74880
Williamson Donald L.
NH1905 918-224-25781310 East Cleveland Sapulpa, OK 74066
Ranch Terrace Nursing Home
33.33% Hillside Prop Hold & Three Oaks
eff 02/23/2016
Stockholders/partners -- Not Officers
P.O. Box 749 Warner, OK 74469
Rogers Justin Todd
33.33% Hillside Prop Hold and Three
Oaks eff 02/23/2016
Stockholders/partners -- Not Officers
P. O. box 749 Warner, OK 74469
Three Oaks LLC Rogers Jack
33.33% Hillside Prop Hold and Three
Oaks eff 02/23/2016
Stockholders/partners -- Not Officers
P.O. Box 749 Warner, OK 74469
Three Oaks Rogers John Eric
33.33 02/02/2016
Stockholders/partners Who Are Officers
P.O. Box 749 Warner, OK 74469
Three Oaks LLC Rogers Todd
OP eff 02/23/2016
Operating Entity
P.O. Box 749 Warner, OK 74469
Three Oaks, LLC Three Oaks, LLC
100% RE eff 02/23/2016
Lessor Or Real Estate Owner
312 Cary Place Muskogee, OK 74403
Hillside Property Holdings, LLC Hillside Property Holdings, LLC
NH0908 405-354-2022824 S. Yukon Parkway Yukon, OK 73099
Ranchwood Nursing Center
Trustee of the Denver McCormick
Revocable Trust
Trustee
9813 S. Penn OKC, OK 73159
McCormick Denver
Trustee Linda McCormick Revocable
Trust & Beneficary Denver McCo
Trustee
9813 S. Penn OKC, OK 73159
McCormick Linda
Trustee Arlena Dunbar Revocable Trust
Trustee
5413 NW 107th Street Oklahoma City, OK 73162
Dunbar Arlena
Eff 6/30/2017
Lessor Or Real Estate Owner
9813 S. Penn Oklahoma City, OK 73159
Southwest Elderly Care Center, LLC
33.4% Member RE
Stockholders/partners Who Are Officers
9813 S. Penn Oklahoma City, OK 73159
Denver McCormick Revocable Trust
33.3%Member RE
Stockholders/partners Who Are Officers
9813 S. Penn Oklahoma City, OK 73159
Linda McCormick Revocable Trust
Page 200 of 265
Owner NameFacilities Owned
33.3% RE
Stockholders/partners -- Not Officers
5413 N.W. 107th Okla. City, OK 73162
Arlena Dunbar Revocable Trust
Beneficiary of Linda & Denver
McCormicks Revocable Trusts
Trustee
4108 Opus Ct. Flower Mound, TX 75022
Pennington Amy
Beneficiary of Linda & Denver
McCormicks Revocable Trusts
Beneficiary
2433 Glenoak Dr. Norman, OK 73071
Petrone Alison
Beneficiary of Linda & Denver
McCormicks Revocable Trusts
Beneficiary
8594 D East 133 Holdenville, OK 74850
Jones Joshua
Beneficiary of Linda & Denver
McCormicks Revocable Trusts
Beneficiary
8594 D East 133 Holdenville, OK 74850
Jones Tanner
Beneficiary of Arlena Dunbar Revocable
Trust
Trustee
5413 NW 107th Okla. City, OK 73159
Dunbar William
Beneficiary of Arlena Dunbar Revocable
Trust
Trustee
12204 N. Kimberlyn Rd. Okla. City, OK 73162
Dunbar Teresa
Subcontracted management Eff 6/30/2017
Contracted Management
1500 Waters Ridge Drive 200 Lewisville, TX 75057
Stonegate Senior Living, LLC
Beneficiary of Arlena Dunbar Revocable
Trust
Trustee
3913 Spyglass Road Okla. City, OK 73167
Nard Charlotte
UPL Owner eff. 6/30/2017
Operating Entity
100 W. Paul Avenue Pauls Valley, OK 73075
City of Pauls Valley
UPL Manager Eff 6/30/2017
Contracted Management
,
South Yukon SNF OPCO, LLC (SY)
NH5608 918-756-19671701 East 6th Street Okmulgee, OK 74447
Rebold Manor
100% RE OP Mgr
Managing Member
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Greiner Don
1% OP
Stockholders/partners -- Not Officers
Box 23017 Oklahoma City, OK 73123
E. C. Properties, Inc.
Property
Lessor Or Real Estate Owner
1915 Parkview Dr. Okmulgee, OK 74447
Diversified Investments
Contracted Management
4350 Will Rogers Parkway 300 Okc, OK 73108
Amity Care, L.L.C.
99% OP 78% Mgt
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Don Greiner Trustee Kenneth D.Greiner III Revocable Trust, Don Greiner
Benef/Trustee
22% OP & Amity Care, LLC
eff.10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Okc, OK 73108
Don Greiner Trust
Page 201 of 265
Owner NameFacilities Owned
0% RE OP Mgmt
Contracted Management
4350 Will Rogers Parkway 300 Okc, OK 73108
Diamond Mike
Property
Lessor Or Real Estate Owner
4850 Will Rogers Parkway 300 Oklahoma City, OK 73108
Okmulgee Real Estate, L.L.C.
Operating Entity
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Rebold Manor, L.L.C.
NH3211 405/452-3271623 South Alabama Wetumka, OK 74883
Redwood Place Living Center, LLC
President /Beneficiary of Family Trust
Trustee
P.O. Box 488 Weleetka, OK 74880
Adkins Gerrol Dean
Secretary/Beneficiary of Family Trust
Trustee
P.O. Box 488 Weleetka, OK 74880
Adkins Arbret June
Lessor Or Real Estate Owner
P.O. Box 488 Wetumka, OK 74880
Pioneer Nursing Home Of Hughes County, Inc.
Beneficiary eff.12/31/12319 West 9th St. Weleetka, OK 74880
Majors Cynthia
Beneficiary eff.12/31/12319 West 9th St Weleetka, OK 74880
Simmons Donna Renee
Beneficiary eff.12/31/12Rt. 1, Box 121A Weleetka, OK 74880
Adkins, II Gerrol D.
52% RE and manag. member of Business
Trust
Stockholders/partners -- Not Officers
P.O. Box 488 Weleetka, OK 74880
Gerrol Dean Adkins & Arbret June Adkins Family Trust (GDA/AJA)
eff. 1-1-07
Operating Entity
623 South Alabama Wetumka, OK 74883
Redwood Place Living Center, LLC
100% OP manag. member
Managing Member
P.O. Box 488 Weleetka, OK 74880
Redwood Place Revocable Business Trust
16% RE eff 12/31/12Rt 1 Box 121A Weleetka, OK 74880
Gerrol Dean Adkins II Irrevocable Trust dated 12/28/12
16% RE eff 12/31/12Rt 1 Box 121A Weleekta, OK 74880
Cynthia Denise Majors Irrevocable Trust dated 12/28/12
16% RE eff 12/31/12Rt 1 Box 121A Weleetka, OK 74880
Donna Renee Simmons Irrevocable Trust dated 12/28/12
Trustee eff 12/31/12
Trustee
523 W. Main Henryetta, OK 74437
Palmer, C.P.A. Reginald
Page 202 of 265
Owner NameFacilities Owned
NH5537 405-677-05022901 Southeast 22nd Street Oklahoma City, OK 73129
Reliant Living Center
Operating Entity
3317 S.E. 18th Street Del City, OK 73115
Reliant Living Centers of Oklahoma, Inc.
Board Member
Officers Who Do Not Hold Stock
821 SW 38th Oklahoma City, OK 73109
Black Art
Secretary
Officers Who Do Not Hold Stock
4932 North Portland Avenue Oklahoma City, OK 73113
Love Willa
President
Officers Who Do Not Hold Stock
8800 S. Drexel Apt 809 Oklahoma City, OK 73159
Stokes Steve
VP
Officers Who Do Not Hold Stock
9804 Casa Linda Oklahoma City, OK 73139
Moon Tim
Exec Director
Officers Who Do Not Hold Stock
2901 S.E. 22nd Oklahoma City, OK 73129
Jernigan Janelle F.
Secretary
Officers Who Do Not Hold Stock
325 W. Pinesway Mustang, OK 73064
Ellis Scott
NH5547 405-677-24213317 Southeast 18th Street Del City, OK 73115
Reliant Living Center of Del City
Operating Entity
3317 S.E. 18th Street Del City, OK 73115
Reliant Living Centers of Oklahoma, Inc.
Board Member
Officers Who Do Not Hold Stock
8305 N.W. 35th Bethany, OK 73008
Mcniff Harold
Board Member
Officers Who Do Not Hold Stock
821 SW 38th Oklahoma City, OK 73109
Black Art
Secretary
Officers Who Do Not Hold Stock
4932 North Portland Avenue Oklahoma City, OK 73113
Love Willa
President
Officers Who Do Not Hold Stock
8800 S. Drexel Apt 809 Oklahoma City, OK 73159
Stokes Steve
VP
Officers Who Do Not Hold Stock
9804 Casa Linda Oklahoma City, OK 73139
Moon Tim
Member
Officers Who Do Not Hold Stock
P.O. Box 567 Wheatland, OK 73097
King Zil
Exec Dir
Officers Who Do Not Hold Stock
2901 S.E. 22nd Oklahoma City, OK 73129
Jernigan Janelle F.
Treasurer
Officers Who Do Not Hold Stock
3201 NW 20th Okla. City, OK 73107
Lewis George B.
Page 203 of 265
Owner NameFacilities Owned
Secretary EFF 06/25/2012
Officers Who Do Not Hold Stock
325 W. Pinesway Mustang, OK 73064
Ellis Scott
NH5412 918-650-9393110 Hillcrest Way Okemah, OK 74859
Ridgeview Place
amended corp. name (fkaProdetik, Inc.)
eff 02-05-08
Operating Entity
P.O. Box 217 Weleetka, OK 74880
The Reach Corporation
Non-Profit Board President of The Reach
Corporation 1-8-08
Officers Who Do Not Hold Stock
P.O. Box 790 Uniontown, KY 42461
Welsh Richard
Non-Profit Board VP of The Reach
Corporation 1-8-08
Officers Who Do Not Hold Stock
PO Box 790 UnionTown, KY 42461
Bailey M. Geoffry
Non-Profit Board Sec/Treas of The Reach
Corporation
Stockholders/partners -- Not Officers
PO Box 790 Uniontown, KY 42461
Pyle William "Bill"
authorized agent for The Reach
Corporation
Officers Who Do Not Hold Stock
1201 West Trudgeon Place Henryetta, OK 74437
Bentley Roy
eff. 8-15-07
Lessor Or Real Estate Owner
P.O. Box 409 Sturgis, KY 42459
Maricopa Properties, LLC
100% of RE
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Maricopa Partners, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Rock River, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
MMB, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Lovenest, LLC
30.959% of Rock River, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gary
16.025% of Rock River, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Lisa
16.025% of Rock River, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Lisa
32.88% of MMB, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Tim
17.455% of MMB, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Vicki
29.421% of Lovenest, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Robert
Page 204 of 265
Owner NameFacilities Owned
13.957% of Lovenest, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Laura
53.016% of Rock River, LLC - 4 children
w/13.254% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
4 Irrevocable Trusts
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O.Box 409 Sturgis, KY 42459
Ervin Mallory
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Jade
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Luke
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gabe
49.665% of MMB, LLC - 5 children
w/9.933% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
3 Irrevocable Trusts
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Max
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box Sturgis, KY 42459
Linenger Jessica
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mitch
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Linenger Jennifer
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Brock
56.623% of Lovenest, LLC - 7 children
w/8.089% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
7 Irrevocable Trusts
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Thea
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugris, KY 42459
Ervin Issac
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugis, KY 42459
Ervin Samuel
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Elijah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Saul
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Micah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mathias
Page 205 of 265
Owner NameFacilities Owned
NH4003 918-875-31071008 Arkansas Street Arkoma, OK 74901
Riverside Health Services
33 1/3% Member OP/RE
Stockholders/partners -- Not Officers
P.O. Box 749 Warner, OK 74469
Rogers Justin Todd
33 1/3% Member OP/RE
Stockholders/partners -- Not Officers
P. O. box 749 Warner, OK 74469
Three Oaks LLC Rogers Jack
33 1/3% Sole Manager OP/RE
Stockholders/partners Who Are Officers
P.O. Box 749 Warner, OK 74469
Three Oaks Rogers John Eric
EFF 8/15/2016
Operating Entity
312 Cary Place Musckogee, OK 74403
Riverside Health Services, LLC
EFF 8/15/2016
Lessor Or Real Estate Owner
212 Cary Place Musckogee, OK 74403
Riverside Property Holdings, LLC
NH2414 580-548-26992501 Northeast Delaware Enid, OK 73701
Robert M Greer Center
Operating Entity
P.O. Box 25352 Oklahoma City, OK 73075
Oklahoma Department Of Human Services
MGR
Contracted Management
3073 Horseshoe Dr. South Naples, FL 34104
Liberty Healthcare of Oklahoma, Inc.
Parent Mgmt Corp of Liberty of
Oklahoma Corporation
Contracted Management
2501 N.E. Delaware Enid, OK 73701-9410
Liberty Healthcare Corporation
100% & President of Liberty of
Oklahoma Corp
Stockholders/partners Who Are Officers
401 East City Ave. 820 Bala Cynwyd, PA 19004
Caskey, M.D. Herbert T.
Director, DHS Eff 11/1/2012
Officers Who Do Not Hold Stock
P.O. Box 25352 Oklahoma City, OK 73125
OKDHS Lake Ed
NH6604 918-266-5500801 North 193 East Avenue Catoosa, OK 74015
Rolling Hills Care Center
OP/RE 100% President
Stockholders/partners Who Are Officers
PO Box 768 Sallisaw, OK 74955
Sullivan, Jr. Frank
Eff - 12/10/2010
Contracted Management
PO BOX 768 Sallisaw, OK 74955
Comprehensive Management Services Inc.
Page 206 of 265
Owner NameFacilities Owned
Eff 12/10/2010
Lessor Or Real Estate Owner
P.O. Box 768 Sallisaw, OK 74955
Requip of Catoosa, LLC
Eff 12/10/2010
Operating Entity
P.O. Box 768 Sallisaw, OK 74955
ConHold of Catoosa, LLC
NH6301 405-275-90041610 North Bryan Avenue Shawnee, OK 74804
Rose Manor Nursing Center
Manager eff 06-10-2013
Contracted Management
4415 Highline Blvd., P.O. Box 23017 Oklahoma City, OK 73123
Amity Care Corporation
OP, RE & Manager (Manager/Trustee)
eff 06-12-2013
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Greiner Don
Manager of OP, RE & Manager eff
06-12-2013
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Dimond Mike
99% of OP, 78% Amity Care eff
06-12-2013
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Don Greiner Trustee Kenneth D.Greiner III Revocable Trust, Don Greiner
Benef/Trustee
100% of Clarity Prop & 48% of Renew
eff 06-12-2013
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Okc, OK 73108
Don Greiner Trust
OP Eff 06-12-2013
Operating Entity
4350 Will Rogers Parkway 380 Oklahoma City, OK 73108
Opshaw, LLC
100% RE
Lessor Or Real Estate Owner
4350 Will Rogers PKWY 300 Oklahoma City, OK 73018
Reshaw, LLC
58% of RE Company - eff 06-12-2013
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Clarity Properties, LLC
42% of RE Company eff 06-12-2013
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Renew, LLC
52% of Renew - Mike Dimond, Trustee
eff 06-12-2013
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Stalwort Trust
NH1501 580-927-23777 North Covington Coalgate, OK 74538-0326
Ruth Wilson Hurley Manor
Treasurer OP
Officers Who Do Not Hold Stock
114 S. Arno Coalgate, OK 74538
Owen Tom
Chairman RE
Officers Who Do Not Hold Stock
Rt. 4, Box 510 Coalgate, OK 74538
Servais Jean Neal
Page 207 of 265
Owner NameFacilities Owned
Member RE
Officers Who Do Not Hold Stock
Rt. 1 Box 1535 Coalgate, OK 74538
Thomas Bobby Zane
Lessor Or Real Estate Owner
7 N. Covington Coalgate, OK 74538
Coal County General Hospital Holding Company
ViceChairman RE
Officers Who Do Not Hold Stock
Queen Avenue Coalgate, OK 74538
Sandmann Louis
Secretary OP
Officers Who Do Not Hold Stock
105 W. Ivy Coalgate, OK 74538
Watkins Gerry
Member RE/OP
Stockholders/partners -- Not Officers
PO Box 253 Coalgate, OK 74538
Mixon Phyllis
Member RE/OP
Stockholders/partners -- Not Officers
Route 1, Box 1310 Coalgate, OK 74538
Chaney Rick
eff 7/29/2006
Operating Entity
7 N. Covington Coalgate, OK 745338
Coal County Extended Care, Incorporated
NH0912 405- 263-4658644 West Texas Okarche, OK 73762
Saint Andre Bessette
Eff 08/10/16
Operating Entity
6th And Texas Okarche, OK 73762
Center Of Family Love
Secretary, eff 08/10/16
Officers Who Do Not Hold Stock
12111 NE 164th Street Jones, OK 73049
Pierce John
Executive Director, eff 08/10/16
Officers Who Do Not Hold Stock
635 W Texas Okarche, OK 73762
Espinosa Debbie
President eff 08/10/16
Officers Who Do Not Hold Stock
3129 Pine Ridge Rd Oklahoma City, OK 73120
Fleckinger Joseph
Vice-President, eff 08/10/16
Officers Who Do Not Hold Stock
2113 N.W. 59th PL Oklahoma City, OK 73112
Dolan Robert
Treasurer, eff 08/10/16
Officers Who Do Not Hold Stock
P.O. Box 21000 Oklahoma City, OK 73156
Krittenbrink Gerald
NH0910 405-263-4658645 West Texas Okarche, OK 73762
Salatka Hall
100%
Operating Entity
6th And Texas Okarche, OK 73762
Center Of Family Love
Secretary of OP
Officers Who Do Not Hold Stock
12111 NE 164th Street Jones, OK 73049
Pierce John
Page 208 of 265
Owner NameFacilities Owned
Treasurer EFF 06/01/2012
Officers Who Do Not Hold Stock
P.O. Box 21000 Oklahoma City, ok 73156
Krittenbrink Jerry
VP EFF 06/01/2012-7/1/13; Pres. eff
7/1/13
Officers Who Do Not Hold Stock
2516 Somerset PL Oklahoma City, OK 73116
Cooper Steve
VP eff 7/1/13
Officers Who Do Not Hold Stock
2113 NW 59th Place okc, OK 73112
Dolin Robert (Bob)
Executive Director
Officers Who Do Not Hold Stock
635 W Texas Okarche, OK 73762
Espinosa Debbie
NH7217 918-245-59081025 North Adams Sand Springs, OK 74063
Sand Springs Nursing and Rehabilitation
Lessor Or Real Estate Owner
980 N. Michigan 1080 Chicago, IL 60611
H. A. Sand Springs, LLC
55% of Tenant One, LLC, Trustee of
SSSTrust
Stockholders/partners -- Not Officers
PO Box 768 Sallisaw, OK 74955
Sullivan, Jr. Frank
Management Co.
Contracted Management
24641 US Highway 19 N Clearwater, FL 33763
Traditions Senior Management, Inc.
100% of the RE eff 08/29/2013
Lessor Or Real Estate Owner
1025 North Adams Sand Springs, OK 74063
Requip of Sand Springs
OP eff 08/29/2013
Operating Entity
1025 North Adams Sand Springs, OK 74063
ConHold of Sand Springs
100% of ConHold SS (OP) & Requip SS
(RE) eff 08/29/2013
Stockholders/partners -- Not Officers
111 East Chicksaw Sallisaw, OK 74955
Tenant One, LLC
45% of Tenant One, LLC
Stockholders/partners -- Not Officers
111 East Chickasaw Sallisaw, OK 74955
Sullivan Sand Springs Trust
NH1415 405-793-16431000 B S. Santa Fe Moore, OK 73160
Santa Fe Cheyenne House
Lessor Or Real Estate Owner
6619 S. Western Oklahoma City, OK 73139
Forrest White Great-West, L.L.C.
90%
Managing Member
6619 S. Western Okla. City, OK 73139
White Wm. Forrest
5%
Stockholders/partners -- Not Officers
6619 S. Western Okla. City, OK 73139
Talley Janice
5%
Stockholders/partners -- Not Officers
PO Box 281 Vinita, OK 74301
Jones De Nellda
Page 209 of 265
Owner NameFacilities Owned
Operating Entity
6619 South Western Oklahoma City, OK 73139
Santa Fe Place, L.L.C.
NH1416 405-912-53771000 A South Santa Fe Moore, OK 73160
Santa Fe Sierra House
Lessor Or Real Estate Owner
6619 S. Western Oklahoma City, OK 73139
Forrest White Great-West, L.L.C.
90%
Managing Member
6619 S. Western Okla. City, OK 73139
White Wm. Forrest
5%
Stockholders/partners -- Not Officers
6619 S. Western Okla. City, OK 73139
Talley Janice
5%
Stockholders/partners -- Not Officers
PO Box 281 Vinita, OK 74301
Jones De Nellda
Op Ent eff 5/23/2007
Operating Entity
6619 South Western Oklahoma City, OK 73139
Santa Fe Place, L.L.C.
NH2201 580-922-4433914 NE Highway 60 Seiling, OK 73663
Seiling Nursing Center
Seling Vice Mayor-Board Member
Seiling Nursing Facility Authorty
Officer
PO Box 702 Seiling, OK 73663
Nichols Michael
Seiling Mayor - Board Member Seiling
Nursing Fac Authority
Officer
PO Box 875 Seiling, OK 73663
Louthan Micky
Board Member/Trustee Seiling Nursing
Facility Authorty
Officer
Rt 1 Box 20D Seiling, OK 73663
Adair Wanda
Trustee/Board Member Seiling Nursing
Fac Authority
Officer
HC60 Box 168 Fairview, OK 73737
Case Rodger
Trustee/Board Member Seiling Nursing
Fac Authority
Officer
P.O. Box 292 Seiling, OK 73663
McCurley Brandon
Vice-Pres Seiling Nursing Facility
Authority
Officer
P.O. Box 274 Seiling, OK 73663
Cooley Karen
Vice-Mayor eff 4/19/11 end 12/15/16
Board Member Seiling NF Auth
Officer
Rt 1 Box 826 Mutual, OK 73853
Bensch Starley
Trustee/Board Member Seiling Nursing
Fac Authority
Officer
Seiling, OK 73663
Biggs Amy
Page 210 of 265
Owner NameFacilities Owned
Board Member Seiling Nursing Facility
Authority
Officer
PO Box 214 Seiling, OK 73663
Daugherty Pat
Board Member Seiling Nursing Fac
Authority
Officer
310 North Main Street Seiling, OK 73663
Goodman Gayla
OP eff 02/14/2017
Operating Entity
315 North Main Street Seiling, OK 73663
Seiling Nursing Facility Authority
NH6706 405-382-11271200 Wrangler Blvd Seminole, OK 74868
Seminole Care and Rehabilitation Center
100% of Sabra Health Care Holdings III
Stockholders/partners -- Not Officers
18831 Von Karman Ave 400 Irvine, CA 92612
Sabra Health Care Limited Partnership
1% Limited Partner of Sabra Health Care
LP
Stockholders/partners -- Not Officers
18831 Von Karman Ave 400 Irvine, CA 92612
Sabra Health Care, LLC
99% GP of Sabra Health Care Limited
Partnership
Stockholders/partners -- Not Officers
18831 Von Karman Ave. 400 Irvine, CA 92612
Sabra Health Care REIT, Inc.
Contracted Management eff 09-09-2016
Contracted Management
2 City Place Drive 200 St. Louis, MO 63141
Midwest Geriatric Management, LLC
7% (Manager) of Seminole Health Care
eff 11-09-2016
Stockholders/partners -- Not Officers
14447 Chellington Ct. 430 Chesterfield, MO 63017
Bienstock Judah
Manager of Okla Acqu & 50% MGM and
Trustee of Nationalwide Trust
Stockholders/partners -- Not Officers
8 Primrose Dr. Lakewood, NJ 08701
Jeremias Baruch
eff12-19-2011
Lessor Or Real Estate Owner
18831 Von Karman Ave 400 Irvine, CA 92612
Sabra Health Care Holdings III, LLC
10% Seminole Health Care eff
11-09-2016
Stockholders/partners -- Not Officers
1111 Marcus Ave 107 Lake Success, NY 11042
Fensterman Howard
37% of Seminole Health Care eff
11-09-2016
Stockholders/partners -- Not Officers
1111 Marcus Ave. 107 Lake Success, NY 11042
Landa Benjamin
EFF 03/15/2013
Operating Entity
477 North Lindergh Blvd 310 St. Louis, MO 63141
Seminole Health Care, LLC
13% of Seminole Health Care eff
11-09-2016
Stockholders/partners -- Not Officers
59 Causeway Lawrence, NY 11559
Taub Miriam
33% of Seminole Health Care, LLC eff
11-09-2016
Stockholders/partners -- Not Officers
8 Primrose Drive Lakewood, NJ 08701
Oklahoma Acquisitions, LLC
84.85% of Oklahoma Acquisitions eff
11-2016
Stockholders/partners -- Not Officers
8 Primrose Drive Lakewood, NJ 08701
10-26 Nationwide Trust
Page 211 of 265
Owner NameFacilities Owned
15.15% of Oklahoma Acquisitions eff
11-2016 no members have 5%
Stockholders/partners -- Not Officers
445 Central Ave 304 Cedarhurst, NY 11516
MACB Resources, LLC
NH6704 405-382-12701705 Boren Blvd Seminole, OK 74868
Seminole Pioneer Nursing Home
100% Pres/OP & 100% RE Seminole
Property Holding, LLC eff 6-1-12
Stockholders/partners Who Are Officers
P.O. Box 582 Sulphur, OK 73086
Jewell Samuel
eff 1-31-03
Operating Entity
1705 Boren Boulevard Seminole, OK 74868
Seminole Nursing Home, Inc.
100% Real Estate eff 06/01/2012
Lessor Or Real Estate Owner
110 West Muskogee Ave Sulphur, OK 73086
Seminole Property Holdings, LLC
NH5406 918/650-9393202 East 5th Street Weleetka, OK 74880
Seminole Place
amended corp. name (fkaProdetik, Inc.)
eff 02-05-08
Operating Entity
P.O. Box 217 Weleetka, OK 74880
The Reach Corporation
Non-Profit Board President of The Reach
Corporation 1-8-08
Officers Who Do Not Hold Stock
P.O. Box 790 Uniontown, KY 42461
Welsh Richard
Non-Profit Board VP of The Reach
Corporation 1-8-08
Officers Who Do Not Hold Stock
PO Box 790 UnionTown, KY 42461
Bailey M. Geoffry
Non-Profit Board Sec/Treas of The Reach
Corporation
Officers Who Do Not Hold Stock
PO Box 790 Uniontown, KY 42461
Pyle William "Bill"
authorized agent for The Reach
Corporation
Officers Who Do Not Hold Stock
1201 West Trudgeon Place Henryetta, OK 74437
Bentley Roy
eff. 8-15-07
Lessor Or Real Estate Owner
P.O. Box 409 Sturgis, KY 42459
Maricopa Properties, LLC
100% of RE
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Maricopa Partners, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Rock River, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
MMB, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Lovenest, LLC
Page 212 of 265
Owner NameFacilities Owned
30.959% of Rock River, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gary
16.025% of Rock River, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Lisa
32.88% of MMB, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Tim
17.455% of MMB, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Vicki
29.421% of Lovenest, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Robert
13.957% of Lovenest, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Laura
53.016% of Rock River, LLC - 4 children
w/13.254% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
4 Irrevocable Trusts
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O.Box 409 Sturgis, KY 42459
Ervin Mallory
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Jade
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Luke
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gabe
49.665% of MMB, LLC - 5 children
w/9.933% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
3 Irrevocable Trusts
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Max
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box Sturgis, KY 42459
Linenger Jessica
20% of 3 Irrevocable Trusts
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mitch
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Linenger Jennifer
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Brock
56.623% of Lovenest, LLC - 7 children
w/8.089% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
7 Irrevocable Trusts
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Thea
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugris, KY 42459
Ervin Issac
Page 213 of 265
Owner NameFacilities Owned
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugis, KY 42459
Ervin Samuel
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Elijah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Saul
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Micah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mathias
NH7214 918-250-54053501 West Washington Broken Arrow, OK 74012
Senior Suites Healthcare
Pres 50% RE/OP end 03/17/11; Presi
100% RE/OP eff 03/17/11
Stockholders/partners Who Are Officers
6271 East 120th Court 100 Tulsa, OK 74137
Cox Steve
Operating Entity
2552 E. 21st Street Tulsa, OK 74114
Cox Building Company, Inc.
NH4403 405-485-33151100 North Madison Blanchard, OK 73010
Senior Village Nursing Home
100% Real Estate eff 07/29/2016
Lessor Or Real Estate Owner
1413 North Crewford Norman, OK 73069
Simmons Real Estate, LLC
OP eff 07-29-2016
Operating Entity
1413 North Crawford Norman, OK 73069
Senior Village, LLC
100% Simmons RE & Senior Village eff
10-31-2016
Stockholders/partners -- Not Officers
115 South Peters Ave 6 Norman, OK 73069
Estate of Bob Simmons, Personal Representative Zachary Simmons
Manager of Senior Village eff 12-28-2016
Officers Who Do Not Hold Stock
115 South Peters Ave 6 Norman, OK 73069
Simmons Zachary
NH6802 918-427-7401701 S. Taylor Road Roland, OK 74954
Sequoyah East Nursing Center, LLC
12.5% Pres
Stockholders/partners Who Are Officers
PO Box 568 Sallisaw, OK 74955
Estate of Bob G Mitchell - deceased, Marcinda Mitchell, Personal
Page 214 of 265
Owner NameFacilities Owned
9.096%
Stockholders/partners Who Are Officers
1500 East Downing 110 Tahlequah, OK 74464
Pointer Ed
100% of OP
Stockholders/partners -- Not Officers
P.O. Box 427 Sallisaw, OK 74955
Sequoyah House, Inc.
Lessor Or Real Estate Owner
P.O. Box 427 Sallisaw, OK 74955
Sequoyah House, Inc.
8.4%
Stockholders/partners Who Are Officers
104 S. Oak Sallisaw, OK 74955
Corley Bert N. M. III
6.08% Sequoyah House inc
Stockholders/partners Who Are Officers
1603 Fryar Dr. Sallisaw, OK 74955
Fred B. Oliver Family Trust, Virginia Kaye Ronk, Trustee
18.920% Sequoyah House inc
Stockholders/partners -- Not Officers
P. O. Box 338 Sallisaw, OK 74955
Oliver Family Trust Fred B.
12.5
Stockholders/partners -- Not Officers
412 South Dogwood Sallisaw, OK 74955
Mitchell Delores O.
Corp. Sec.
Officers Who Do Not Hold Stock
Rt. 1, Box 165 Sallisaw, OK 74955
Qualls Wava Sue
eff 4-1-02
Operating Entity
Rt. 1 Taylor Road Roland, OK 74954
Sequoyah East Nursing Center, L.L.C.
8.33%
Stockholders/partners -- Not Officers
PO Box 370 Adair, OK 74330
Dr. William R. VanDeLinder Trust (DWVT)
8.334% Sequoyah House inc
Stockholders/partners -- Not Officers
PO Box 370 Adair, OK 74330
VanDeLinder Dr. William R.
8.333% Sequoyah House inc
Stockholders/partners -- Not Officers
1500 West Elm Stroud, OK 74079
Bivin Julie K.
8.333% Sequoyah House
Stockholders/partners -- Not Officers
3808 NW Marquess Drive Bentonville, AR 72712
Yowell Lynn M.
NH6803 918-775-4881615 East Redwood Sallisaw, OK 74955
Sequoyah Manor, LLC
12.5% Pres
Stockholders/partners Who Are Officers
PO Box 568 Sallisaw, OK 74955
Estate of Bob G Mitchell - deceased, Marcinda Mitchell, Personal
9.096%
Stockholders/partners Who Are Officers
1500 East Downing 110 Tahlequah, OK 74464
Pointer Ed
100% of OP
Stockholders/partners -- Not Officers
P.O. Box 427 Sallisaw, OK 74955
Sequoyah House, Inc.
100% of LLC
Lessor Or Real Estate Owner
P.O. Box 427 Sallisaw, OK 74955
Sequoyah House, Inc.
Page 215 of 265
Owner NameFacilities Owned
8.4%
Stockholders/partners Who Are Officers
104 S. Oak Sallisaw, OK 74955
Corley Bert N. M. III
18.92% Director
Stockholders/partners Who Are Officers
1603 Fryar Dr. Sallisaw, OK 74955
Fred B. Oliver Family Trust, Virginia Kaye Ronk, Trustee
12.5
Stockholders/partners -- Not Officers
412 South Dogwood Sallisaw, OK 74955
Mitchell Delores O.
Corp. Sec.
Officers Who Do Not Hold Stock
Rt. 1, Box 165 Sallisaw, OK 74955
Qualls Wava Sue
eff 4-3-02
Operating Entity
615 East Redwood Sallisaw, OK 74955
Sequoyah Manor, L.L.C.
8.33%
Stockholders/partners -- Not Officers
PO Box 370 Adair, OK 74330
Dr. William R. VanDeLinder Trust (DWVT)
NH7242 918-272-51518515 North 123rd East Avenue Owasso, OK 74055
Sequoyah Pointe Living Center
100% OP, RE Mgr
Stockholders/partners Who Are Officers
PO Box 768 Sallisaw, OK 74955
Sullivan, Jr. Frank
Eff. 12/10/2010
Lessor Or Real Estate Owner
P.O.Box 768 Sallisaw, OK 74955
Requip of Owasso, LLC
Eff. 12/10/2010
Operating Entity
PO Box 768 Sallisaw, OK 74955
ConHold of Owasso, LLC
Eff. 12/10/2010
Contracted Management
PO BOX 768 Sallisaw, OK 74955
Comprehensive Management Services Inc.
NH2702 580-395-2105616 South Front Street Medford, OK 73759
Servant Living Center - Medford
100% of Op Entity and Real Estate
Entity,eff12-03-16
Stockholders/partners -- Not Officers
PO Box 990 Edmond, OK 73013
Diakonos Group, LLC
Managing Member and 99% owner of
Diakonos Group
Stockholders/partners -- Not Officers
PO Box 990 Edmond, OK 73013
Pilgrim Scott
Eff 12-03-16
Operating Entity
616 S. Front Medford, OK 73759
Servant Living Center-Medford, LLC
Eff 12-03-16
Lessor Or Real Estate Owner
P.O. Box 990 Edmond, OK 73083
Servant Living Center Holding Company-Medford, LLC
1% Mbr of Diakonos Grp ,LLC, Eff
12-03-16
Stockholders/partners -- Not Officers
P.O. Box 990 Edmond, OK 73083
Servant Holding Corporation
Page 216 of 265
Owner NameFacilities Owned
NH4907 918-825-4455210 South Adair Pryor, OK 74361
Shady Rest Care Center
25% BGM Estate, LLC Eff 9-16-2016
Stockholders/partners -- Not Officers
P.O. Box 330 Muldrow, OK 74948
Tabor Angela
25% BGM Estate, LLC eff 9-16-2016
Stockholders/partners -- Not Officers
111522 S. 4740 Rd. Muldrow, OK 74948
Mitchell Robert Michael
25% BGM Estate, LLC Eff 9-16-16
Stockholders/partners -- Not Officers
412 S. Dogwood Sallisaw, OK 74955
Mitchell Marcinda
Operating Entity
201 N. Elm A Sallisaw, OK 74955
Shady Rest Care Center, L. L. C.
12.5% OP and 25% BGM Estate, LLC
9-16-2016
Stockholders/partners -- Not Officers
7240 Chase Oaks Blvd 121 Plano, TX 75025
Mitchell Kelly O.
Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Green Reba
Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Ellis, fka Seay Tiffany Renee
Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Thurman Bronson Owen
25% OP
Stockholders/partners -- Not Officers
P.O. Box 1454 Sallisaw, OK 74955
Philip M. Green Revocable Trust
25 % OP Eff 02-20-2014
Stockholders/partners -- Not Officers
P.O. Box 1090 Sallisaw, OK 74955
Gilbert F. Green Trust
bene Gilbert F. Green Trust Trustee Philip
M. Green Revocable Tr
Trustee
P.O. Box 1090 Sallisaw, OK 74955
Green Philip M.
Gilbert F. Green Trust
Trustee
P.O. Box 1090 Sallisaw, OK 74955
Green Gilbert F.
Philip M. Green Revocable Trust
Beneficiary
P.O. box 1090 Sallisaw, OK 74955
Stewart Lori Green
Philip M. Green Revocable Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Green Philip R.
Manager end 12/31/2015
Officers Who Do Not Hold Stock
210 S. Adair Pryor, OK 74362
Carson Jonathan
37.50% OP eff 9-16-16
Stockholders/partners -- Not Officers
,
BGM Estate, LLC
Manager of OP eff7/25/2016
Officers Who Do Not Hold Stock
1320 NE. 1st Place Pryor, OK 74362
Cree Robert
Page 217 of 265
Owner NameFacilities Owned
NH2604 405-224-13972500 South 12th Street Chickasha, OK 73023-0969
Shanoan Springs Nursing and Rehabilitation Center
34% N&R Chickasha & Health Systems
of Oklahoma eff 01/01/2017
Stockholders/partners Who Are Officers
329 Townepark Circle 100 Louisville, KY 40243
Vinson John
eff 08/24/2011
Contracted Management
329 Townepark Circle 100 Louisville, KY 40243
Health Systems of Oklahoma, L.L.C.
eff 08/24/2011 RE mem 49%; OP/Mngr
mem 4%;
Stockholders/partners Who Are Officers
329 Townepark Circle 100 Louisville, KY 40243
Vinson Cathy
eff 08/24/2011
Lessor Or Real Estate Owner
329 Townepark Circle Louisville, KY 40243
Cambridge Investments, LLC
eff 08/24/2011
Operating Entity
2500 S. 12th Street Chickasha, OK 73018
N&R of Chickasha, LLC
33% N&R Chickasha & Health Systems
of Oklahoma eff 01/01/2017
Stockholders/partners -- Not Officers
329 Townepark Circle Louisville, KY 40243
Vinson, Jr John
33% N&R Chickasha & Health Systems
of Oklahoma eff 01/1/2017
Stockholders/partners -- Not Officers
329 Towepark Circle Louisville, KY 40243
Trumbo Jay H.
NH7602 580-430-3383730 Share Drive Alva, OK 73717
Share Medical Center
Operating Entity
730 Share Drive Alva, OK 73717
Alva Hospital Authority
Vice-Chairman
Officers Who Do Not Hold Stock
722 Logan Alva, OK 73717
Sanderson Darlene
Chairman
Officers Who Do Not Hold Stock
1030 Church Alva, OK 73717
Gaisford Jason
Secretary
Officers Who Do Not Hold Stock
1029 Center Alva, OK 73717
Simon Halah
NH2301 580-938-2501201 North Alfalfa Shattuck, OK 73858
Shattuck Nursing Center
1% Treas Stock
Operating Entity
201 N. Alfalfa Shattuck, OK 73858
Shattuck Nursing Center, Inc.
Page 218 of 265
Owner NameFacilities Owned
99% President
Stockholders/partners Who Are Officers
3434 S.E. Kentucky Place Bartlesville, OK 74006
Brown Jim
NH3607 580-765-33642024 Turner Road Ponca City, OK 74604
Shawn Manor Nursing Home
100% OP/RE and Manager eff
12/10/2010
Stockholders/partners Who Are Officers
PO Box 768 Sallisaw, OK 74955
Sullivan, Jr. Frank
100% owner Manager eff 12/10/2010
Contracted Management
PO BOX 768 Sallisaw, OK 74955
Comprehensive Management Services Inc.
100% Owner RE eff 12/10/2010
Lessor Or Real Estate Owner
P.O.Box 768 Sallisaw, OK 74955
Requip of Ponca, LLC
100% Owner OP eff. 12/10/2010
Operating Entity
P.O.Box 768 Sallisaw, OK 74955
Conhold of Ponca, LLC
NH6304 405-273-80431202 West Gilmore Shawnee, OK 74804
Shawnee Care Center
25% BGM Estate, LLC Eff 9-16-16
Stockholders/partners -- Not Officers
P.O. Box 330 Muldrow, OK 74948
Tabor Angela
25% BGM Estate, LLC eff 9-16-16
Stockholders/partners -- Not Officers
111522 S. 4740 Rd. Muldrow, OK 74948
Mitchell Robert Michael
25% BGM Estate, LLC eff 9-16-16
Stockholders/partners -- Not Officers
412 S. Dogwood Sallisaw, OK 74955
Mitchell Marcinda
12.5% and 25% BGM Estate, LLC eff
9-16-16
Stockholders/partners -- Not Officers
7240 Chase Oaks Blvd 121 Plano, TX 75025
Mitchell Kelly O.
UPL Manager Eff 6/30/2017
Contracted Management
1202 W. Gilmore Sallisaw, OK 74804
Shawnee Care Center, L.L.C.
Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Green Reba
Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Ellis, fka Seay Tiffany Renee
Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Thurman Bronson Owen
25%
Stockholders/partners -- Not Officers
P.O. Box 1454 Sallisaw, OK 74955
Philip M. Green Revocable Trust
25%
Stockholders/partners -- Not Officers
P.O. Box 1090 Sallisaw, OK 74955
Gilbert F. Green Trust
Page 219 of 265
Owner NameFacilities Owned
Trustee Philip M Green Revocable Trust
Ben-Gilbert F Green Trust
Trustee
P.O. Box 1090 Sallisaw, OK 74955
Green Philip M.
Gilbert F. Green Trust
Trustee
P.O. Box 1090 Sallisaw, OK 74955
Green Gilbert F.
Philip M. Green Revocable Trust
Beneficiary
P.O. box 1090 Sallisaw, OK 74955
Stewart Lori Green
Philip M. Green Revocable Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Green Philip R.
Sole Manager
Manager
1202 W Gilmore Shawnee, OK 74804
Chappell Kathy
37.50% OP eff 9-16-16
Stockholders/partners -- Not Officers
,
BGM Estate, LLC
UPL Owner eff. 6/30/2017
Operating Entity
201 S. 2nd Street Hugo, OK 74743
City of Hugo
NH6311 405-273-7661535 West Federal Street Shawnee, OK 74804
Shawnee Colonial Estates Nursing Home
34% of N&R Shawnee & Health Systems
of Oklahoma eff 01/01/2017
Stockholders/partners Who Are Officers
329 Townepark Circle 100 Louisville, KY 40243
Vinson John
Contracted Management
329 Townepark Circle 100 Louisville, KY 40243
Health Systems of Oklahoma, L.L.C.
eff 10/01/03
Operating Entity
535 W. Federal Shawnee, OK 74804
N & R of Shawnee, L.L.C.
Lessor Or Real Estate Owner
200 International Circle 3500 Hunt Valley, MD 21030
CSE Shawnee, LLC
CEO of CSE/RE
Stockholders/partners Who Are Officers
,
Pickett Taylor
COO of CSE/RE
Stockholders/partners Who Are Officers
,
Booth Daniel J.
Senior VP of CSE/RE
Stockholders/partners Who Are Officers
,
Crabill, Jr R. Lee
100% Owner of CSE Shawnee LLC
Stockholders/partners -- Not Officers
200 International Circle 3500 Hunt Valley, MD 21030
Omega Healthcare Investors, Inc.
33% of N&R Shawnee & Health Systems
of Oklahoma eff 01/01/2017
Stockholders/partners Who Are Officers
329 Townepark Circle Louisville, KY 40243
Vinson, Jr John
33% of N&R Shawnee & Health Systems
of Oklahoma eff 01/01/2017
Stockholders/partners Who Are Officers
329 Towepark Circle Louisville, KY 40243
Trumbo Jay H.
Page 220 of 265
Owner NameFacilities Owned
NH7225 918-446-42842416 West 51st South Tulsa, OK 74107
Sherwood Manor Nursing Home
25% Member of RE
Stockholders/partners -- Not Officers
P.O. Box 638 Gore, OK 74435
Montgomery Schuyler
25% Member of RE
Stockholders/partners -- Not Officers
P.O. Box 638 Gore, OK 74435
Montgomery Bobbie
EFF 9/3/2014
Lessor Or Real Estate Owner
P.O. Box 638 Gore, OK 74435
Ponderosa Holdings, LLC
25% Managing Member RE/ 50%
Managing Member OP
Stockholders/partners -- Not Officers
101042 South 4450 Rd. Gore, OK 74435
Holland Vernie Mathew
25% Managing Member RE/ 50%
Managing Member OP
Stockholders/partners -- Not Officers
101042 South 4450 Rd Gore, OK 74435
Holland Whitney J.
EFF 9/3/2014
Operating Entity
P.O. Box 638 Gore, OK 74435
Sherwood Health Services. LLC
NH5507 405-869-07009221 Harmony Drive Midwest City, OK 73130
Sienna Extended Care & Rehab
Lessor Or Real Estate Owner
208 East Fifth Street Gore, OK 74435
Mulberry Properties, L.L.C.
Operating Entity
P.O. Box 638 Gore, Ok 74435
Sienna Extended Care & Rehab, LLC
100% RE/OP
Stockholders/partners Who Are Officers
P.O. Box 638 Gore, OK 74435
Montgomery Bobbie
NH0805 405-247-3346300 West Washington Anadarko, OK 73005
Silvercrest Manor Nursing Home
100% Real Estate end 07-01-2016
Lessor Or Real Estate Owner
10100 Santa Monica Blvd. Las Angeles, CA 90067
Ok-an Associates, L.P.
eff 5-16-05
Operating Entity
110 West Muskogee Sulphur, OK 73086
Silvercrest Manor Nursing Home, Inc.
100% & Managing Member of
Interhealth, LLC eff 02/17/2017
Stockholders/partners -- Not Officers
9 Professional Drive Bella Vista, AR 72715
Montgomery Bradford
100% Real Estate eff 07/01/2016
Lessor Or Real Estate Owner
P.O. Box 130 Newport, AR 72112
Trinik Holdings, LLC
Page 221 of 265
Owner NameFacilities Owned
Receiver CJ-2016-3346 Lindsay Manor
eff 01/25/2017
Court Appointed Receiver
419886 East 1080 Road Checotah, OK 74426
Cockrell Travis
Contracted Management eff 02-17-2017
Contracted Management
9 Professional Drive Bella Vista, AR 72715
Interhealth, LLC
NH5705 918-396-2149318 South Cherry Skiatook, OK 74070
Skiatook Nursing Home, LLC
Successor Trustee/Ben-WBTeff 5/24/12
Beneficiary
P.O. Box 2230 Waldron, AR 72958
Watts Fred
9.61494% Oklahoma Nursing Home, Ltd,
Manager
Contracted Management
210 E. Choctaw, P.O. Box 429 Sallisaw, OK 74955-0429
Oklahoma Nursing Homes, Ltd. (ONH,Ltd.)
8.4112%RE 8.314%P 9.401287% mgmt
Stockholders/partners -- Not Officers
P.O. Box 40 Sallisaw, OK 74955
Cheek Barnie J.
OP/MANAGEMENT 8.314% / RE
8.4112%
Stockholders/partners -- Not Officers
3520 East 110th Place Tulsa, OK 74137
Sandra Cheek Farmer Trust (SCFT)
5.834% OP & Mgmt/5.9190% mgr
RE/6.597394% Okla. Nurs.Homes,Inc.
Stockholders/partners -- Not Officers
4814 S. 164th East Ave. Tulsa, OK 74134
Haskins Lloyd
5.192% OP & Mgmt. / 5.2626% RE/
12.535047% Okla.Nurs.Homes,Inc.
Stockholders/partners -- Not Officers
51 green acre village #51 Sallisaw, OK 74955
Watts Cleo
RE 5.9746% 5.893OP/ONH,Ltd
Stockholders/partners -- Not Officers
51 Green Acre Village Sallisaw, OK 74955
Watts Beneficiaries Trust (WBT)
RE 14.022%OP/ONH,Ltd- 21.936335%
mgmt
Stockholders/partners -- Not Officers
Box 856 Miami, OK 74355
Tubbs Steven
OP/MANAGEMENT 5.376% RE
5.4406%
Stockholders/partners -- Not Officers
3910 Cherry Forest Drive Houston, TX 77088
Tubbs, Jr. Stanley I.
5.542% OP & Mgr./ 5.6186% RE/
6.267525% Okla Nurs Homes, Inc.
Stockholders/partners -- Not Officers
416 Fairway Dr. Athens, TX 75751
Estep Pat
OP/MANAGEMENT 2.771% RE
2.8037%
Stockholders/partners -- Not Officers
1500 West Elm Stroud, OK 74079
Julie Kay Bivin Revocable Trust (JKBRT)
5.2207%RE 5.135%
OP/MANAGEMENT
Stockholders/partners -- Not Officers
6708 South 256th East Avenue Broken Arrow, OK 74014
Caroyln D. Leaverton Revocable Trust
OP/MANAGEMENT 2.771% / RE
2.8037%
Stockholders/partners -- Not Officers
PO Box 370 Adair, OK 74330
Dr. William R. VanDeLinder Trust (DWVT)
OP/MANAGEMENT 2.771% RE
2.8037%
Stockholders/partners -- Not Officers
3808 NW Marquess Drive Bentonville, AR 72712
Lynn M. Yowell Trust
Page 222 of 265
Owner NameFacilities Owned
9.7298% of Midwest Nursing Home, LLC
Eff 4-25-16
Lessor Or Real Estate Owner
210 East Choctaw Sallisaw, OK 74955
Midwest Nursing Homes, LLC (MNHLLC)
OP/MANAGEMENT 2.771% / RE
2.8038%
Stockholders/partners -- Not Officers
2802 West Country Club Drive Oklahoma City, OK 73116
Richard Armstrong Trust (RAT)
9.61494% Skiatook Nursing Home.LLC
Eff 4-25-16
Operating Entity
P.O. box 400 Sallisaw, OK 74955
Skiatook Nursing Home, LLC
1.219% mgr OP & Mgmt.
Contracted Management
P.O. Box 400 Sallisaw, OK 74955
Oklahoma Nursing Homes, Inc. General Partner (ONH,Inc)
9.401287% Oklahoma Nursing Homes,
Inc.
Stockholders/partners -- Not Officers
2802 W. Country Club Dr. Oklahoma City, OK 73116
Armstrong Richard James
Trustee-SCFT/9.401287% Oklahoma
Nursing Homes, Inc.
Stockholders/partners -- Not Officers
3520 East 110th Place Tulsa, OK 74137
Farmer Sandra
1.28306% OP & Mgmt./ 1.3156%
RE/9.401287% Okla.Nurs. Homes,Inc.
Stockholders/partners -- Not Officers
20852 South Shannon Drive Claremore, OK 74017
Wilson James G.
OP/MANAGEMENT 2.079% RE
2.1028%
Stockholders/partners -- Not Officers
P.O. Box 173 Gore, OK 74435
Ferguson Debra M.
5.556% OP & Mgmt./5.5630% RE/
5.657265% i& Treas ONH,Inc.
Stockholders/partners Who Are Officers
607 Mayo Street Sallisaw, OK 74955
McGrew Justin
OP/MANAGEMENT 2.771% RE
2.8038%
Stockholders/partners -- Not Officers
HCR 68 Box 1260 Vian, OK 74962
Armstrong Sally
9.401287% Okla. Nursing Homes,Inc.
President
Stockholders/partners Who Are Officers
PO Box 370 Adair, OK 74330
VanDeLinder Dr. William R.
Trustee-Carolyn D. Leaverton Rev. Trust
eff 05/24/12
Trustee
6708 South 256th East Ave Broken Bow, OK 74014
Leaverton Carolyn
Trustee-Carolyn D. Leaverton Rev. Trust
eff 05/24/12
Trustee
6708 South 256th East Ave Broken Arrow, OK 74014
Leaverton Ronald
Succ.Trustee & Benf-Carolyn D.
Leaverton Rev. Trust eff 05/24/12
Beneficiary
6708 South 256th East Ave Broken Arrow, OK 74014
Johnson Karen Diane
Successor Trustee/Ben-WBTeff 5/24/12
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Byers Karen
Successor Trustee/Ben-WBTeff 5/24/12
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Rhodes Sharon
Beneficiary - WTB eff 5/24/12
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Rhodes Grant
Beneficiary - WTB eff 5/24/12
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Miles Sydney
Beneficiary - WTB eff 5/24/12
Beneficiary
51 Green Acre Village Sallisaw, OK 74955
Cameron Amber
Page 223 of 265
Owner NameFacilities Owned
Sucessor Trustee-SCFT EFF 05/24/2012
Beneficiary
3520 east 110th Place Tulsa, OK 74137
Farmer Frederick Sinclair
Beneficiary - SCFT eff 5/24/12
Beneficiary
3520 East 110th Place Tulsa, OK 74137
Farmer Cassandra C.
Beneficiary - SCFT eff 5/24/12
Beneficiary
3520 East 110th Place Tulsa, OK 74137
Farmer Alexandra C.
Registered Agent317 N.W. 12th St. Oklahoma City, OK 73103
Burnsed (C. Craig Cole & Assoc.) Carrie
NH5539 405-942-38842200 Coltrane Road Oklahoma City, OK 73121
Skyview Nursing Center
100%
Stockholders/partners -- Not Officers
3714 N. Portland Oklahoma City, OK 73112
Crane Judy M.
eff 6-19-2006
Operating Entity
3714 North Portland Oklahoma City, OK 73112
Skyview Nursing Center, Inc.
100% of the Real Estate eff 3/28/2012
Lessor Or Real Estate Owner
3126 South Boulevard Edmond, OK 73103
R&B Lynch, LLC
25% of R&B Lynch, LLC eff 3/28/2012
Stockholders/partners -- Not Officers
3203 North Coltrane Road Oklahoma City, OK 73121
Chambers Phyills
25% of R&B Lynch, LLC eff 3/28/2012
Stockholders/partners -- Not Officers
1212 Cedar Pointe Drive Wylie, TX 75098
Lynch Terry
25% of R&B Lynch, LLC eff 3/28/2012
Stockholders/partners -- Not Officers
4208 NE 19th Street Oklahoma City, OK 73121
Lynch Irish
25% of R&B Lynch, LLC eff 3/28/2012
Stockholders/partners -- Not Officers
3201 North Coltrane Road Oklahoma City, OK 73121
Burden Brenda
NH5534 405-631-7444225 Southwest 35th Street Oklahoma City, OK 73109
South Park East
33.33%
Stockholders/partners Who Are Officers
P.O. Box 3669 Tulsa, OK 74101
Buford Stephen
33.33%
Stockholders/partners -- Not Officers
P.O. Box 3669 Tulsa, OK 74101
Buford Sam
33.34%
Stockholders/partners -- Not Officers
P.O. Box 3669 Tulsa, OK 74101
fka Buford Linsenmeyer Sharon B.
Operating Entity
1563 Riverside Drive Tulsa, OK 74119
Court Appointed Receiver, Larry Cain/Phoenix Healthcare, L.L.C.,
Page 224 of 265
Owner NameFacilities Owned
NH5532 405-685-47915725 South Ross Oklahoma City, OK 73119
South Pointe Rehabilitation and Care Center
Contracted Management Company eff
03-2017
Contracted Management
2 City Place Drive 200 St. Louis, MO 63141
Midwest Geriatric Management, LLC
7% South Park Health Care- 50%
Midwest Geriatric Mgmt 03-2017
Managing Member
14447 Chellington Ct. 430 Chesterfield, MO 63017
Bienstock Judah
Mgr Okla Acquisitions & 50% Midwest
Geriatric Mgmt eff 03-2017
Stockholders/partners -- Not Officers
8 Primrose Dr. Lakewood, NJ 08701
Jeremias Baruch
50% Benhow,LL (03/15/13) 10% S Park
Health Care eff 03-2017
Stockholders/partners -- Not Officers
1111 Marcus Ave 107 Lake Success, NY 11042
Fensterman Howard
50% Benhow,LLC (03/15/13) & 37% S
Park Health Care eff 03-2017
Stockholders/partners -- Not Officers
1111 Marcus Ave. 107 Lake Success, NY 11042
Landa Benjamin
EFF 03/15/2013
Lessor Or Real Estate Owner
1111 Marcus Ave., Suite 107 Lake Success, NY 11042
Benhow,LLC
EFF 03/15/2013
Operating Entity
477 North Lindergh Blvd 310 St. Louis, MO 63141
South Park Health Care,LLC
13% South Park Health Care eff 03-2017
Stockholders/partners -- Not Officers
59 Causeway Lawrence, NY 11559
Taub Miriam
33% of South Park Health Care eff
03-2017
Stockholders/partners -- Not Officers
8 Primrose Drive Lakewood, NJ 08701
Oklahoma Acquisitions, LLC
84.85% of Oklahoma Acquisitions eff
03-2017
Stockholders/partners -- Not Officers
8 Primrose Drive Lakewood, NJ 08701
10-26 Nationwide Trust
15.15% of Oklahoma Acquisitions eff
03-2017 no members have 5%
Stockholders/partners -- Not Officers
445 Central Ave 304 Cedarhurst, NY 11516
MACB Resources, LLC
NH1006 580-223-5901832 Isabel Southwest Ardmore, OK 73401
Southbrook Healthcare, Inc.
Lessor Or Real Estate Owner
832 Isabel S W Ardmore, OK 73401
Lu-ken Manor Inc.
50%
Stockholders/partners -- Not Officers
815 Ridgecrest Ardmore, OK 73401
Kenaga James A.
President
Officers Who Do Not Hold Stock
815 Ridgecrest Ardmore, OK 73401
Kenaga Judith R.
Operating Entity
1811 9th Nw Ardmore, OK 83401
Southbrook Healthcare, Inc.
Page 225 of 265
Owner NameFacilities Owned
President 65% EFF 7/17/2012
Stockholders/partners Who Are Officers
1908 12th Ave N.W. E Ardmore, OK 73401
Coble Tom C.
VP/SEC/TRES 35% EFF 7/17/2012
Stockholders/partners Who Are Officers
1908 12th Ave NW Ardmore, OK 73401
Jackson Don N.
100% OpEnt
Stockholders/partners Who Are Officers
1908 12th Avenue, N W E Ardmore, OK 73401
Elmbrook Properties, Inc.
NH7227 918-496-39635170 South Vandalia Tulsa, OK 74135
Southern Hills Rehabilitation Center
Eff 2-1-2015
Operating Entity
401 South Boston 2200 Tulsa, OK 74103
Healthcare Management of Oklahoma, LLC
100% of Southern Tulsa TLC, LLC,
[Publicly Traded Co. (GBCS)]
Stockholders/partners -- Not Officers
8480 East Orchard Road 3600 Greenwood Villa, GA 80111
Global Healthcare Reit
CJ2016-01781 - Healthcare Management
Oklahoma eff 05/10/2016
Court Appointed Receiver
401 South Boston 2200 Tulsa, OK 74103
Turnaround Professionals C. David Rhoades Court Appointed Receiver
CJ2016-01781
100% RE Eff 10-30-2014
Lessor Or Real Estate Owner
6800 North 79th Street 200 Niwot, CO 80503
Southern Tulsa TLC, LLC
NH5902 918-762-25151401 4th Street Pawnee, OK 74058
Southern Oaks Care Center
Pres 33.33%
Stockholders/partners Who Are Officers
P.O. Box 3669 Tulsa, OK 74101
Buford Stephen
Sec/Trea. 33.33
Stockholders/partners Who Are Officers
P.O. Box 3669 Tulsa, OK 74101
Buford Sam
VP 33.34%
Stockholders/partners Who Are Officers
P.O. Box 3669 Tulsa, OK 74101
fka Buford Linsenmeyer Sharon B.
Lessor Or Real Estate Owner
P.O. Box 3669 Tulsa, OK 74101
Pawnee Living Center, Inc.
Operating Entity
1563 Riverside Drive Tulsa, OK 74119
Court Appointed Receiver, Larry Cain/Phoenix Healthcare, L.L.C.,
NH0707 580-296-4500101 Sherrard Drive Colbert, OK 74733
Southern Pointe Living Center
Page 226 of 265
Owner NameFacilities Owned
25%
Stockholders/partners -- Not Officers
PO Box 568 Sallisaw, OK 74955
Estate of Bob G Mitchell - deceased, Marcinda Mitchell, Personal
6.25% OP
Stockholders/partners -- Not Officers
P.O. Box 330 Muldrow, OK 74948
Tabor Angela
6.25% OP
Stockholders/partners -- Not Officers
111522 S. 4740 Rd. Muldrow, OK 74948
Mitchell Robert Michael
6.25% OP
Stockholders/partners -- Not Officers
412 S. Dogwood Sallisaw, OK 74955
Mitchell Marcinda
UPL Mgr. effective 6/30/2017
Contracted Management
101 Sherrard Colbert, OK 74733
Colbert Nursing Home, Inc.
6.25% OP
Stockholders/partners -- Not Officers
7240 Chase Oaks Blvd 121 Plano, TX 75025
Mitchell Kelly O.
Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Green Reba
Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Ellis, fka Seay Tiffany Renee
Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Thurman Bronson Owen
25% OP
Stockholders/partners -- Not Officers
P.O. Box 1454 Sallisaw, OK 74955
Philip M. Green Revocable Trust
25% OP
Stockholders/partners -- Not Officers
P.O. Box 1090 Sallisaw, OK 74955
Gilbert F. Green Trust
President/Director Eff. 05-12-2016
Officers Who Do Not Hold Stock
,
Mitchell Heather
Director/President - No longer
associated
Officers Who Do Not Hold Stock
101 Sherrard Dr. Colbert, OK 74733
Gilbert Paul
Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Green Philip M.
Philip M. Green Revocable Trust
Beneficiary
P.O. box 1090 Sallisaw, OK 74955
Stewart Lori Green
Philip M. Green Revocable Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Green Philip R.
UPL Owner eff. 6/30/2017
Operating Entity
201 S. 2nd Street Hugo, OK 74743
City of Hugo
NH7203 918-366-621076 West Rachel Street Bixby, OK 74008
Southtown Nursing and Ventilator Care
Page 227 of 265
Owner NameFacilities Owned
owner/lessor to Southtown Holding
Company, LLC
Stockholders/partners -- Not Officers
76 West Rachel Street Bixby, OK 74008
15600 South Memorial Drive, Inc.
99% managing member of southtown
asset management, llc 100%SNLLC
Stockholders/partners -- Not Officers
PO Box 990 Edmond, OK 73013
Pilgrim Scott
effective 3/31/2016
Operating Entity
129 W. 1st B Edmond, OK 73008
Southtown Nursing, LLC
100%
Lessor Or Real Estate Owner
129 West 1st B Edmond, OK 73003
Southtown Holding Company, LLC
100% Man Member Southtown Holding,
Co. LLC/Southtown Nursing LL
Stockholders/partners -- Not Officers
129 W. 1st B Edmond, OK 73003
Southtown Asset Management, LLC
1% of Southtown Asset Management,
LLC
Stockholders/partners -- Not Officers
P.O Box 990 Edmond, OK 73034
Servent Holding Corporation
NH4005 918-962-2308401 South Main Spiro, OK 74959
Spiro Nursing Home, Inc.
42.9% Pres&VP Removed Mr. Gary
McClure due to death 8/24/10
Stockholders/partners Who Are Officers
401 S. Main Spiro, OK 74959
McClure Rhonda
40% Sec/Treas
Stockholders/partners Who Are Officers
5735 Worskey Rd. Charleston, AR 72933
McKean Linda
Operating Entity
401 S. Main Spiro, OK 74959
Spiro Nursing Home, Inc.
2.10% Director
Stockholders/partners -- Not Officers
401 S. Main Spiro, OK 74959
Wilson Happy
10%
Stockholders/partners -- Not Officers
P.O. Box 346 Spiro, Ok 74959
Odom Patsy
5% OP EFF 02/01/2016
Stockholders/partners -- Not Officers
401 S. Main Spiro, OK 74959
McClure Garon & Kerry
NH5529 405-728-78889400 Saint Ann Drive Oklahoma City, OK 73162
St. Anns Home
Operating Entity
9400 St. Ann Dr. Oklahoma City, OK 73162
St. Anns Home
Archbishop eff 11-17-2011
Officers Who Do Not Hold Stock
7501 NW Expressway Oklahoma City, OK 73132
Coakley Paul S.
Page 228 of 265
Owner NameFacilities Owned
NH2413 580-233-6100305 South 5th Street Enid, OK 73701
St. Marys Regional Medical Center
Operating Entity
367 South Gulph Road King of Prussia, PA 19406
UHS of Oklahoma, Inc.
NH0101 918-696-7715422 West Locust Street Stilwell, OK 74960
Stilwell Nursing Home, LLC
7%Mbr HMLC, LLC
Stockholders/partners -- Not Officers
P.O. Box 1095 Guthrie, OK 73044
Golden Age Nursing Home Of Guthrie, Inc.(GAN)
Trustee-MLC Trust eff 04/18/2012 100%
owner SNH, PGV, GAN
Trustee
Box 1095 Guthrie, OK 73044
Chappell Mary Lou
3%Mbr HMLC, LLC EFF 04/15/16
Stockholders/partners -- Not Officers
P.O. Box 1095 Guthrie, OK 73044
Perry Green Valley Nursing Home, Inc.(PGV)
3% Mbr HMLC,LLC
Stockholders/partners -- Not Officers
PO Box 1095 Guthrie, OK 73044
Stilwell Nursing Home, Inc.(SNH)
Beneficiary- Chappell 2012 Succession
Trust dated 1/3/2012
Beneficiary
P.O. Box 1095 Guthrie, OK 73044
Chappell Jeff
Real Estate
Lessor Or Real Estate Owner
PO Box 1095 Guthrie, OK 73044
CC&G Rentals, LLC
Mrg of RE/OP & HMLC,LLC
Manager
P.O. Box 1095 Guthrie, OK 73044
Hastings Tandie
eff 07/01/07
Operating Entity
P.O.Box 1095 Guthrie, OK 73044
Stilwell Nursing Home, LLC
100% Mmbr OP; 33.3% Mmbr RE, eff
04/18/12
Stockholders/partners -- Not Officers
PO Box 1095 Guthrie, OK 73044
HMLC, LLC
Trustee Chappell 2012 Succession Trust;
Mngr OP & HMLC
Trustee
PO Box 1095 Guthrie, OK 73044
Chappell Hollie "Joe"
72% member HMLC, LLC 4/15/16 Benef
MLC Trust Eff 6/1/16
Stockholders/partners -- Not Officers
P.O. Box 1095 Guthrie, OK 73044
Chappell 2012 Succession Trust dated 1/3/2012
Trustee & Beneficiary of Cook Family
Revocable Trust
Trustee
P.O. Box 1418 Ponca City, OK 74602
Cook Dr. William Z.
33%Mbr of RE
Stockholders/partners -- Not Officers
P.O. Box 16427 Oklahoma City, OK 73113
Burdge Green Family Ltd. Partnership
15 % mbr HMLC, LLC
Stockholders/partners -- Not Officers
P.O. Box 1095 Guthrie, OK 73044
Mary Lou Chappell Trust
Page 229 of 265
Owner NameFacilities Owned
Beneficiary- Chappell 2012 Succession
Trust dated 1/3/2012
Beneficiary
,
Chappell Jon D.
Beneficiary - Chappell 2012 Succession
Trust dated 1/3/2012
Beneficiary
,
Crockett Mary Janice
33.3% Mem RE eff 08-28-2013
Stockholders/partners -- Not Officers
P.O. Box 1418 Ponca City, OK 74602
Cook Family Revocable Living Trust
25% Burdge Green Family Ltd
Partnership Eff 6/1/2016
Stockholders/partners -- Not Officers
PO Box 1095 Guthrie, OK 73044
Burdge Green Family Ltd Partnership Counts-Ellis Beverly
25% Burdge Green Family Ltd
Partnership Eff 6/1/2016
Stockholders/partners -- Not Officers
PO Box 1095 Guthrie, OK 73044
Bollenback Barbara Ruth
25% Burdge Green Family Ltd
Partnership Eff 6/1/2016
Stockholders/partners -- Not Officers
PO Box 1095 Guthrie, OK 73044
Morrison Marion DeCell
25% Burdge Green Family Ltd
Partnership Eff 6/1/2016
Stockholders/partners -- Not Officers
PO Box 1095 Guthrie, OK 73044
Green-Elder Catherine
Trustee Cook Family Revocable Trust
Trustee
PO Box 1095 Guthrie, 73044
Cook Norma Lee
NH4101 918-968-2075721 West Olive Stroud, OK 74079
Stroud Health Care Center South
Operating Entity
P.O. Box 680 Stroud, OK 74079
Contemporary Enterprises, Ltd.
President 100% OpEnt and Real Estate
Stockholders/partners Who Are Officers
P.O. Box 680 Stroud, OK 74079
Garrett Debbie Jo
VP
Officers Who Do Not Hold Stock
P.O. Box 680 Stroud, Ok 74079
Keim Jason
Sec/Treas
Officers Who Do Not Hold Stock
P.O.Box 680 Stroud, OK 74079
Keim Vicki
100%
Lessor Or Real Estate Owner
720 S Old Stroud Rd. Stroud, OK 74079
GK Properties Management, L.L.C.
NH0601 580-822-4441119 North 6th Street Okeene, OK 73763
Summers Health Services,LLC
60% RE Autumn Health Care
LLC/60%OP Summers Health Care LLC
Managing Member
2801 Redbird Lane Enid, OK 73703
Miller Michael
Page 230 of 265
Owner NameFacilities Owned
EFF 03/31/2014
Lessor Or Real Estate Owner
2801 Redbird Lane Enid, OK 73703
Autumn Health Care LLC
40%RE Autumn HealthCare,LLC/40%OP
Summers Health Care, LLC
Contracted Management
1402 Indian DamRoad Lahoma, OK 73754
Heinen Tyanne
Eff 03/31/2014
Operating Entity
119 North 6th Street Okeene, OK 73763
Summers Health Services LLC
EFF 04/1/2012
Contracted Management
2801 Redbird Lane Enid, OK 73703
Autumn Health Care LLC
NH6307 405-598-2167201 West Walnut Tecumseh, OK 74873
Sunset Estates
Manager eff 06-12-2013
Contracted Management
4415 Highline Blvd., P.O. Box 23017 Oklahoma City, OK 73123
Amity Care Corporation
OP, RE & Manager (Manager/Trustee)
eff 06-12-2013
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Greiner Don
Manager of OP, RE & Manager eff
06-10-2013
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Dimond Mike
99% of OP, 78% Amity Care eff
06-12-2013
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Don Greiner Trustee Kenneth D.Greiner III Revocable Trust, Don Greiner
Benef/Trustee
100% of Clarity Prop & 48% of Renew
eff 06-12-2013
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Okc, OK 73108
Don Greiner Trust
100% RE ended June 10, 2013
Lessor Or Real Estate Owner
201 South Rangeline Tecumseh, OK 74873
Sunset Estates of Tecumseh, LLC
58% of RE Company - eff 06-12-2013
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Clarity Properties, LLC
42% of RE Company eff 06-12-2013
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Renew, LLC
52% of Renew - Mike Dimond, Trustee
eff 06-12-2013
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Stalwort Trust
UPL Mgr. eff 6/30/2017
Contracted Management
4350 Will Rogers Parkway 380 Oklahoma City, OK 73108
Tecumseh Operations, LLC
RE Owner eff 06/12/2013
Lessor Or Real Estate Owner
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Tecumseh Real Estate, LLC
UPL Owner eff. 6/30/2017
Operating Entity
100 W. Paul Avenue Pauls Valley, OK 73075
City of Pauls Valley
Page 231 of 265
Owner NameFacilities Owned
NH4401 405-527-2122915 North 7th Avenue Purcell, OK 73080
Sunset Estates Of Purcell
Operating Entity
915 1015 N 7th Purcell, OK 73080
Sunset Estates Of Purcell, Inc.
100% PresSecTre
Stockholders/partners Who Are Officers
Rt. 1 Purcell, OK 73080
Baird Tony
Lessor Or Real Estate Owner
5801 Broadway Ext. 301 Okla. City, OK 73118
Jiles Brothers & Associates, an Oklahoma Ltd Partnership
NH5612 918-650-9393404 South Taft Okmulgee, OK 74447
Taft Place
amended corp. name (fkaProdetik, Inc.)
eff 02-05-08
Operating Entity
P.O. Box 217 Weleetka, OK 74880
The Reach Corporation
Non-Profit Board President of The Reach
Corporation 1-8-08
Officers Who Do Not Hold Stock
P.O. Box 790 Uniontown, KY 42461
Welsh Richard
Non-Profit Board VP of The Reach
Corporation 1-8-08
Officers Who Do Not Hold Stock
PO Box 790 UnionTown, KY 42461
Bailey M. Geoffry
Non-Profit Board Sec/Treas of The Reach
Corporation
Officers Who Do Not Hold Stock
PO Box 790 Uniontown, KY 42461
Pyle William "Bill"
authorized agent for The Reach
Corporation
Officers Who Do Not Hold Stock
1201 West Trudgeon Place Henryetta, OK 74437
Bentley Roy
eff. 8-15-07
Lessor Or Real Estate Owner
P.O. Box 409 Sturgis, KY 42459
Maricopa Properties, LLC
100% of RE
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Maricopa Partners, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Rock River, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
MMB, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Lovenest, LLC
30.959% of Rock River, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gary
16.025% of Rock River, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Lisa
32.88% of MMB, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Tim
Page 232 of 265
Owner NameFacilities Owned
17.455% of MMB, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Vicki
29.421% of Lovenest, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Robert
13.957% of Lovenest, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Laura
53.016% of Rock River, LLC - 4 children
w/13.254% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
4 Irrevocable Trusts
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O.Box 409 Sturgis, KY 42459
Ervin Mallory
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Jade
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Luke
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gabe
49.665% of MMB, LLC - 5 children
w/9.933% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
3 Irrevocable Trusts
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Max
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box Sturgis, KY 42459
Linenger Jessica
20% of 3 Irrevocable Trusts
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mitch
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Linenger Jennifer
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Brock
56.623% of Lovenest, LLC - 7 children
w/8.089% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
7 Irrevocable Trusts
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Thea
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugris, KY 42459
Ervin Issac
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugis, KY 42459
Ervin Samuel
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Elijah
14.286% of 7 Irrevocable Trust
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Saul
Page 233 of 265
Owner NameFacilities Owned
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Micah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mathias
NH4006 918-567-2279First & Emmert Street Talihina, OK 74571
Talihina Manor
25% BGM Estate, LLC Benef- Delores
O. Mitchell Revocab Trust
Stockholders/partners -- Not Officers
P.O. Box 330 Muldrow, OK 74948
Tabor Angela
25% BGM Estate Benef- Delores O.
Mitchell Revocab Trust
Stockholders/partners -- Not Officers
111522 S. 4740 Rd. Muldrow, OK 74948
Mitchell Robert Michael
25% BGM Benef- Delores O. Mitchell
Revocab Trust
Stockholders/partners -- Not Officers
412 S. Dogwood Sallisaw, OK 74955
Mitchell Marcinda
UPL Manager Eff 06/30/2017
Contracted Management
First & Emmert Talihina, OK 74571
Talihina Manor, LLC
25% BGM Estate Benef- Delores O.
Mitchell Revocab Trust
Beneficiary
7240 Chase Oaks Blvd 121 Plano, TX 75025
Mitchell Kelly O.
Trustee of Delores O. Mitchell Revocable
Trust
Trustee
412 S. Dogwood Sallisaw, OK 74955
Mitchell Delores
20% of GIlbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Green Reba
5% of Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Ellis, fka Seay Tiffany Renee
5% of Gilbert F. green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Thurman Bronson Owen
50%
Stockholders/partners -- Not Officers
P.O. Box 1090 Sallisaw, OK 74955
Gilbert F. Green Trust
manager/administrator
Managing Member
First & Emmert Street Talihina, OK 74571
Hibdon Nikki
10% of Gilbert F. Green Trust
Beneficiary
P.O. Box 1090 Sallisaw, OK 74955
Green Philip M.
55.6% of Gilbert F. Green Trust
Trustee
P.O. Box 1090 Sallisaw, OK 74955
Green Gilbert F.
25%
Stockholders/partners Who Are Officers
412 S. Dogwood Sallisaw, OK 74955
Delores O. Mitchell Revocable Trust
25.00% OP eff 9-16-16
Stockholders/partners -- Not Officers
,
BGM Estate, LLC
Page 234 of 265
Owner NameFacilities Owned
UPL Owner eff. 6/30/2017
Operating Entity
201 S. 2nd Street Hugo, OK 74743
City of Hugo
Mayor of City of Hugo 6/30/2017
Officers Who Do Not Hold Stock
,
Frazier Darren
NH1702 580-825-6336100 West Green Avenue Temple, OK 73568
Temple Manor Nursing Home
Indirect Owner 25% RE/OP
Stockholders/partners -- Not Officers
1633 North Campbell Avenue Chicago, IL 60647
Birchwood Health Care Properties, LLC
Indirect Owner 25% RE/OP
Stockholders/partners -- Not Officers
1633 North Campbell Avenue Chicago, IL 60647
Dole Isaac
contracted management since 09/01/2015
Contracted Management
1518 Legacy Dr. #110 Frisco, TX 75034
Southwest LTC Management Services, LLC
Indirect owner 54.46% RE/OP & Indirect
80% Mgt
Stockholders/partners -- Not Officers
1518 Legacy Drive 110 Frisco, TX 75034
Payne Ronald
Indirect Owner 7.13% RE/OP & Direct
Owner 20% Mgt
Stockholders/partners -- Not Officers
1518 Legacy Drive 110 Frisco, TX 75034
Brashier Craig
RE 12/1/2015
Lessor Or Real Estate Owner
1518 Legacy Drive 110 Frisco, TX 75034
Temple LTC Land, LLC
direct owner 75% RE/OP
Stockholders/partners -- Not Officers
1518 Legacy Drive 110 Frisco, OK 75034
Southwest LTC Oklahoma Holdings,LLC
Indirect owner 75% RE/OP
Stockholders/partners -- Not Officers
1518 Legacy Dr. 110 Frisco, TX 75034
Southwest LTC, LTD
Indirect Owner 54.46% RE/OP & Direct
Owner 80% Mgt
Stockholders/partners -- Not Officers
1518 Legacy Drive 110 Frisco, TX 75034
Ronald R. Payne, P.C.
Indirect Owner 8.99% RE/OP
Stockholders/partners -- Not Officers
5731 Jackson St. Ext C Alexandria, LA 71303
Quality Care Givers, Inc.
Direct Owner 25% RE/OP
Stockholders/partners -- Not Officers
1633 N. Campbell ave Chicago, IL 60647
BHCP OK 3 Sponsor, LLC
EFF 12/1/2015
Operating Entity
,
Southwest LTC-Temple, LLC
NH7234 918-250-85717707 South Memorial Drive Tulsa, OK 74133
The Cottage at Woodland Hills
90% 76th St. Land & Woodland
Retirement Co. eff 06-26-2017
Managing Member
6271 East 120th Court 100 Tulsa, OK 74137
Cox Steve
Page 235 of 265
Owner NameFacilities Owned
100% of Real Estate eff 06-26-2017
Lessor Or Real Estate Owner
6271 East 120th Court 100 Tulsa, OK 74137
Woodland Retirment Company, LLC
OP eff 06-26-2017
Operating Entity
6271 East 120th Court 100 Tulsa, OK 74137
76th Street Land Company, LLC
10% 76th St. Land & Woodland
Retirement Co. eff 06-26-2017
Stockholders/partners -- Not Officers
6271 East 120th Court 100 Tulsa, OK 74137
Cox Melissa
NH7253 918/742-70802552 East 21st Street Tulsa, OK 74114
The Cottage Extended Care
100%
Stockholders/partners Who Are Officers
6271 East 120th Court 100 Tulsa, OK 74137
Cox Steve
Operating Entity
2552 E. 21st Street Tulsa, OK 74114
Cox Retirement Properties, Inc.
NH1906 918-224-06001165 South Brenner Road Sapulpa, OK 74066
The Gardens
Pres 33.33%
Stockholders/partners Who Are Officers
P.O. Box 3669 Tulsa, OK 74101
Buford Stephen
S/tres 33.33%
Stockholders/partners Who Are Officers
P.O. Box 3669 Tulsa, OK 74101
Buford Sam
V/pres 33.34%
Stockholders/partners Who Are Officers
P.O. Box 3669 Tulsa, OK 74101
fka Buford Linsenmeyer Sharon B.
Lessor Or Real Estate Owner
P. O. Box 3669 Tulsa, OK 74101
Midwest Land And Investment Company
Operating Entity
1563 Riverside Drive Tulsa, OK 74119
Court Appointed Receiver, Larry Cain/Phoenix Healthcare, L.L.C.,
NH6308 405-273-710638801 Hardesty Road Shawnee, OK 74801
The Golden Rule Home
51% OP/RE, managing member eff
09/01/11
Stockholders/partners Who Are Officers
PO Box 1831 Ocean Springs, MS 39566
fax 601-510-9727 Daves, Jr. William E. (Billy)
49% OP/RE, managing member eff
09/01/11
Stockholders/partners Who Are Officers
PO Box 17888 Hattiesburg Hattiesburg, MS 39404
Johnson Christopher W.
Page 236 of 265
Owner NameFacilities Owned
Thru 09/01/11
Operating Entity
129 W. 1st Street B Edmond, OK 73003
Golden Rule Senior Properties, LLC
100% GRSP, LLC. RE eff 09/01/11,
Stockholders/partners -- Not Officers
129 W. 1st Street B Edmond, OK 73003
Shawnee Asset Management, LLC
NH7259 918-928-480010098 N. 123rd E. Ave. Owasso, OK 74055
The Highlands at Owasso
100% OP President
Stockholders/partners Who Are Officers
6271 East 120th Court 100 Tulsa, OK 74137
Cox Steve
Operating Entity
3501 West Washington Street Broken Arrow, OK 74012
Golf Course Property, Inc.
NH0705 580-924-04961223 West Baltimore Durant, OK 74701
The Kings Daughters & Sons Nursing Home
President
Officers Who Do Not Hold Stock
947 N. 10th Durant, OK 74701
Haynie Lena
Treasurer
Officers Who Do Not Hold Stock
P.O. Box 831 Durant, OK 74701
Intolubbe Velman
Secretary
Officers Who Do Not Hold Stock
118 N. 11th Durant, OK 74701
Mason Minnah Leah
Chairman
Officers Who Do Not Hold Stock
1945 W. Elm Durant, OK 74701
Swearengin Rector
Member
Officers Who Do Not Hold Stock
2302 W. Wilson Durant, OK 74701
Morton Bill
Member
Officers Who Do Not Hold Stock
508 W. Main Durant, OK 74701
Haynie Dr. W. K.
100% / Pres.
Stockholders/partners Who Are Officers
Rt 1, Box 140-5 Durant, OK 73449
K.D.&S. Homes, Inc. Seay Gregory w.
100%
Operating Entity
1223 Baltimore Durant, OK 74701
K.D.&S. Homes, Inc.
Lessor Or Real Estate Owner
1026 Radio Road Durant, OK 74701
Greg Seay Enterprises, LLC
Page 237 of 265
Owner NameFacilities Owned
NH5519 405-773-89005701 West Britton Road Oklahoma City, OK 73132
The Lakes
Pres 33.33%
Stockholders/partners Who Are Officers
P.O. Box 3669 Tulsa, OK 74101
Buford Stephen
S/tres 33.33%
Stockholders/partners Who Are Officers
P.O. Box 3669 Tulsa, OK 74101
Buford Sam
V/pres 33.34%
Stockholders/partners Who Are Officers
P.O. Box 3669 Tulsa, OK 74101
fka Buford Linsenmeyer Sharon B.
Lessor Or Real Estate Owner
P. O. Box 3669 Tulsa, OK 74101
Midwest Land And Investment Company
Operating Entity
1563 Riverside Drive Tulsa, OK 74119
Court Appointed Receiver, Larry Cain/Phoenix Healthcare, L.L.C.,
NH2401 580-234-14111409 North 17th Street Enid, OK 73701
The Living Center
100% OP & RE eff 07/28/2011
Operating Entity
593 Atlanta Street Roswell, GA 30075
Living Center, LLC
100% of Living Center, LLC
Stockholders/partners -- Not Officers
593 Atlanta Street Roswell, GA 30075
Brogdon Connie
Mngr of Living Center, LLC eff 07/28/11
100% Marsh Pointe Mngmt
Stockholders/partners -- Not Officers
3050 Peachtree Rd 355 Atlanta, GA 30305
Brogdon Christopher
Eff 03/01/2014
Contracted Management
Two Buckhead Plaza, 3050 Peachtree Road NW 355 Atlanta, GA 30305
Marsh Pointe Managment, LLC
NH0909 405-263-4658635 West Texas Okarche, OK 73762
The Loosen Center
Operating Entity
6th And Texas Okarche, OK 73762
Center Of Family Love
Secretary EFF 07/30/2012
Officers Who Do Not Hold Stock
12111 NE 164th Street Jones, OK 73049
Pierce John
Treasurer EFF 07/30/2012
Officers Who Do Not Hold Stock
P.O. Box 21000 Oklahoma City, ok 73156
Krittenbrink Jerry
President EFF. 7-1-2013
Officers Who Do Not Hold Stock
2516 Somerset PL Oklahoma City, OK 73116
Cooper Steve
Vice President EFF 7/1/2013
Officers Who Do Not Hold Stock
2113 NW 59th Place okc, OK 73112
Dolin Robert (Bob)
Page 238 of 265
Owner NameFacilities Owned
Executive Director Eff 2-1-2012
Officers Who Do Not Hold Stock
635 W Texas Okarche, OK 73762
Espinosa Debbie
NH5553 405-348-6682330 West Danforth Edmond, OK 73003
The Nova Centre
Treasurer eff 07/28/11
Secretary/Treasurer
7501 N. Classen Oklahoma City, OK 73116
Musgrave Chuck
Operating Entity
330 West Danforth Edmond, OK 73034
Edmond Association Of Retarded Citizens, Inc.
Vice Pres
Officers Who Do Not Hold Stock
PO BOX 925 PROSPER, TX 75708
BAILEY CLARENCE
Pres 07/1/2012
Officers Who Do Not Hold Stock
2600 SOMERSET OKC, OK 73116
Cooper Catherine
Stockholders/partners Who Are Officers
1104 CHESTNUT LANE EDMOND, OK 73034
DREW JR. GEORGE M.
Secretary
Officers Who Do Not Hold Stock
713 NW 19th OKC, OK 73103
Holloway Kenny
NH4009 918-647-82361501 Clayton Avenue Poteau, OK 74953
The Oaks Healthcare Center
50% of OP (Poteau Nursing Center, LLC)
Stockholders/partners -- Not Officers
3216 Shiloh Creek Stillwater, OK 74074
Young Jeffrey
50% of OP (Poteau Nursing Center, LLC)
Stockholders/partners -- Not Officers
46487 E. 1040 Rd. Sallisaw, OK 74955
Rhodes Johnathan Grant
eff 4-15-02
Operating Entity
217 East 9th Avenue Stillwater, OK 74074
Poteau Nursing Center, L.L.C.
COO of OP eff.07-01-09
Managing Member
614 West Harrison McAlester, OK 74501
Harper Pamela G.
CEO of OP (Poteau Nursing Center, LLC)
eff. 07-01-09
Officers Who Do Not Hold Stock
9017 N. Yale Ave Sperry, OK 74073
Lietzke Mark
NH5106 918-683-29145800 West Okmulgee Muskogee, OK 74401
The Springs, A Grace Living Center Community
Page 239 of 265
Owner NameFacilities Owned
President/Manag.Member of
OP/RE/Manager
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Greiner Don
Lessor Or Real Estate Owner
2200 NW 50th 126 Oklahoma City, OK 73112
Azaleabrook, L. L. C.
Contracted Management
4350 Will Rogers Parkway 300 Okc, OK 73108
Amity Care, L.L.C.
78% OP & Amity Care, LLC eff.
10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Oklahoma City, OK 73108
Don Greiner Trustee Kenneth D.Greiner III Revocable Trust, Don Greiner
Benef/Trustee
22% OP & Amity Care, LLC
eff.10-21-03
Stockholders/partners -- Not Officers
4350 Will Rogers Parkway 300 Okc, OK 73108
Don Greiner Trust
Secretary
Officers Who Do Not Hold Stock
4350 Will Rogers Parkway 300 Okc, OK 73108
Diamond Mike
Operating Entity
4359 Will Rogers Parkway 300 Oklahoma City, OK 73108
Azalea Park Manor, L.L.C.
NH5548 405-454-140018501 Northeast 63rd Street Harrah, OK 73045
The Wolfe Living Center at Summit Ridge
Lessor Or Real Estate Owner
4735 NW 63rd Harrah, OK 73132
Summit Ridge Retirement Center
President
Officers Who Do Not Hold Stock
P.O. Box 32098 Oklahoma City, OK 73123
Moyer Jr. John H.
Vice Chairman
Officers Who Do Not Hold Stock
P.O. Box 32098 Oklahoma City, OK 73123
Thompson Trevor W.
Operating Entity
P.O. Box 32098 Oklahoma City, OK 73123
Wolfe Living Center Association
NH5408 918/650-9393125 East 3rd Street Weleetka, OK 74880
Third (3rd) Place
amended corp. name (fkaProdetik, Inc.)
eff 02-05-08
Operating Entity
P.O. Box 217 Weleetka, OK 74880
The Reach Corporation
Non-Profit Board President of The Reach
Corporation 1-8-08
Officers Who Do Not Hold Stock
P.O. Box 790 Uniontown, KY 42461
Welsh Richard
Non-Profit Board VP of The Reach
Corporation 1-8-08
Officers Who Do Not Hold Stock
PO Box 790 UnionTown, KY 42461
Bailey M. Geoffry
Page 240 of 265
Owner NameFacilities Owned
Non-Profit Board Sec/Treas of The Reach
Corporation
Officers Who Do Not Hold Stock
PO Box 790 Uniontown, KY 42461
Pyle William "Bill"
authorized agent for The Reach
Corporation
Officers Who Do Not Hold Stock
1201 West Trudgeon Place Henryetta, OK 74437
Bentley Roy
eff. 8-15-07
Lessor Or Real Estate Owner
P.O. Box 409 Sturgis, KY 42459
Maricopa Properties, LLC
100% of RE
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Maricopa Partners, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Rock River, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
MMB, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Lovenest, LLC
30.959% of Rock River, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gary
16.025% of Rock River, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Lisa
32.88% of MMB, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Tim
17.455% of MMB, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Vicki
29.421% of Lovenest, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Robert
13.957% of Lovenest, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Laura
53.016% of Rock River, LLC - 4 children
w/13.254% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
4 Irrevocable Trusts
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O.Box 409 Sturgis, KY 42459
Ervin Mallory
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Jade
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Luke
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gabe
49.665% of MMB, LLC - 5 children
w/9.933% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
3 Irrevocable Trusts
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Max
Page 241 of 265
Owner NameFacilities Owned
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box Sturgis, KY 42459
Linenger Jessica
20% of 3 Irrevocable Trusts
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mitch
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Linenger Jennifer
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Brock
56.623% of Lovenest, LLC - 7 children
w/8.089% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
7 Irrevocable Trusts
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Thea
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugris, KY 42459
Ervin Issac
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugis, KY 42459
Ervin Samuel
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Elijah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Saul
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Micah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mathias
NH3903 918-465-5020900 West Ranchwood Drive Wilburton, OK 74578
Tidwell Living Center
OP eff 12/15/2013 - (Manager
10/01/13-12-15-13)
Operating Entity
225 W. Main Wilburton, OK 74578
Tidwell HealthCare, LLC
RE Owner eff 09/30/2013
Lessor Or Real Estate Owner
225 West Main Wilburton, OK 74578
ICP HealthCare, LLC
50% IPC Healthcare & Tidwell
Healthcare eff 09/30/2013
Stockholders/partners -- Not Officers
900 Ranchwood Dr Wilburton, OK 74578
Tidwell Melissa
50% of IPC Healthcare & Tidwell
Healthcare eff 09/30/2013
Stockholders/partners -- Not Officers
225 W Main St Wilburton, OK 74578
Tidwell Darren
Page 242 of 265
Owner NameFacilities Owned
NH2202 580-995-4216619 Speck Vici, OK 73859
Town Of Vici Nursing Home
Operating Entity
619 Speck Vici, OK 73859
Town Of Vici
Officers Who Do Not Hold Stock
P.O. Box 217 Vici, OK 73859
Town of Vici Nursing Home Trimble David
Officers Who Do Not Hold Stock
Vici, OK 73859
Butler Kim
eff 7/27/2012
Officers Who Do Not Hold Stock
619 Speck Vici, OK 73859
Longhofer, Mayor Carey
eff 7/19/2013
Officers Who Do Not Hold Stock
619 Speck Vici, OK 73859
Atland Gary
board member EFF 4/1/2015
Officers Who Do Not Hold Stock
,
Worsencroft Brad
NH7230 972-899-434410912 East 14th Street Tulsa, OK 74128
Tulsa Nursing Center
45.806% of WR Invest,LP, 100% WR GP
eff 02/10/2014
Stockholders/partners Who Are Officers
1500 Waters Ridge Dr 200 Lewisville, TX 75077
Taylor John F.
30.323% of WR Investments, LP Eff
02/10/2014
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, TX 75057
Lake Creek Capital Partners, LP
10.7090% of WR Investment, LP eff
02/10/2014
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, TX 75057
Fisher James (Jim)
10.0650% WR Investment, LP eff
02-2014- Authorized Officer
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, TX 75057
Pierce Paula
0.1% general partner in Lake Creek
Captial Partners, LP
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, TX 75057
LC General Partner, LLC
20% limited partner in Lake Creek
Capital Partners, LP
Stockholders/partners -- Not Officers
1500 WatersRidge Lewisville, TX 75057
Taylor John Paul & Casey
20% limited partner in Lake Creek
Capital Partners, LP
Stockholders/partners -- Not Officers
1500 Waters Ridge Lewisville, TX 75057
Campbell Scott & Syndney
Lessor Or Real Estate Owner
1500 Waters Ridge Drive 200 Lewisville, TX 75077
TNC Realty, LLC
Subcontracted Managment EFF
6/30/2017
Contracted Management
1500 Waters Ridge Drive 200 Lewisville, TX 75057
Stonegate Senior Living, LLC
Page 243 of 265
Owner NameFacilities Owned
UPL Manager Eff 6/30/2017
Contracted Management
1500 Waters Ridge Drive 200 Lewisville, TX 75077
TNC Operations, LLC
3.0970% of WR Investment, LP, Lake
Creek 20% eff 12-2013
Stockholders/partners -- Not Officers
1500 Waters Ridge Dt Lewisville, TX 75057
Taylor John P.
100% of TNC Operations, LLC eff
02/10/2014
Stockholders/partners -- Not Officers
1500 Waters Ridge Dr. 200 Lewisville, TX 75057
Southwest SNF Holdings, LLC (SW SNFH)
100% of Southwest SNF Holdings, LLC
& SW Post Acute Prop 02/2013
Stockholders/partners -- Not Officers
1500 Waters Ridge Dirve 200 Lewisville, TX 75057
WR Investments, LP (WRI, LP)
General Partner of WR Investments, LP
eff 02/10/2014
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, TX 75057
WR Investments GP, Inc.
20% of Lake Creek Capital Partners, LP
eff 12-2013
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, TX 75057
Campbell Scott
100% of TNC Realty, LLC
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, TX 75057
SW Post Acute Properties, LLC (SW PAP)
100% of Stonegate Senior Living, LLC
02/10/2014
Stockholders/partners -- Not Officers
1500 Waters Ridge Drive 200 Lewisville, OK 75057
SGSL Management Holdings, LLC
UPL Owner eff. 6/30/2017
Operating Entity
100 W. Paul Avenue Pauls Valley, OK 73075
City of Pauls Valley
NH5542 405-286-08352333 Tuscany Blvd Oklahoma City, OK 73120
Tuscany Village Nursing Center
60% Southwest Healthcare Management,
Inc.
Stockholders/partners -- Not Officers
9813 S. Penn OKC, OK 73159
McCormick Denver
Contracted Management
9813 S. Penn Okla. City, OK 73159
Southwest Health Care Management, Inc.
40% Southwest Healthcare Management,
Inc.
Stockholders/partners -- Not Officers
5413 NW 107th Street Oklahoma City, OK 73162
Dunbar Arlena
25% OP eff. 12-20-06 Denver
McCormick, Beneficiary & Trustee
Stockholders/partners -- Not Officers
9813 S. Penn Oklahoma City, OK 73159
Denver McCormick Revocable Trust
25% OP eff. 12-20-06 Linda McCormick,
Trustee & Beneficiary
Stockholders/partners -- Not Officers
9813 S. Penn Oklahoma City, OK 73159
Linda McCormick Revocable Trust
25% OP eff. 12-20-06 Arlena Dunbar,
Trustee & Beneficiary
Stockholders/partners -- Not Officers
5413 N.W. 107th Okla. City, OK 73162
Arlena Dunbar Revocable Trust
25% OP eff. 12-20-06 Donald Nevard,
Beneficiary & Trustee
Stockholders/partners -- Not Officers
5 S.W. 9th Okla. City, OK
Donald Nevard, Revocable Trust
Page 244 of 265
Owner NameFacilities Owned
Beneficiary Donald Nevard Revocable
Trust
Trustee
4800 N. Lincoln Blvd. Okla. City, OK 73105
Nevard Debra
Donald Nevard Revocable Trust
Trustee
4800 N. Lincoln Blvd. Okla. City, OK 73105
Nevard Lisa
Donald Nevard Revocable Trust
Trustee
4800 N. Lincoln Blvd. Okla. City, OK 73105
Nevard Michael
Beneficiary of Linda & Denver
McCormicks Revocable Trusts
Trustee
4108 Opus Ct. Flower Mound, TX 75022
Pennington Amy
Beneficiary of Linda & Denver
McCormicks Revocable Trusts
Beneficiary
2433 Glenoak Dr. Norman, OK 73071
Petrone Alison
Beneficiary of Linda & Denver
McCormicks Revocable Trusts
Beneficiary
8594 D East 133 Holdenville, OK 74850
Jones Joshua
Linda McCormick Revocable
Trust/Denver McCormick Revocable
Trust
Beneficiary
8594 D East 133 Holdenville, OK 74850
Jones Tanner
Benficiary - Arlena Dunbar Revocable
Trust
Trustee
5413 NW 107th Okla. City, OK 73159
Dunbar William
Arlena Dunbar Revocable Trust
Trustee
3913 Spyglass Rd. Okla. City, OK 73162
Nard Charlotte
Arlena Dunbar Revocable Trust
Trustee
12204 N. Kimberlyn Rd. Okla. City, OK 73162
Dunbar Teresa
Mayor, City of Pauls Valley, eff
6/30/2017
Officers Who Do Not Hold Stock
PO Box 778 Pauls Valley, OK 73075
Alfred Gary
Vice Mayor/Vice Chair, City of Pauls
Valley, eff 6/30/17
Officers Who Do Not Hold Stock
PO Box 778 Pauls Valley, OK 73075
Rushing Jocelyn
Member, City of Pauls Valley, eff 6/30/17
Member
PO Box 778 Pauls Valley, OK 73075
Grimmett Patrick
Member, City of Pauls Valley, eff 6/30/17
Member
PO Box 778 Pauls Valley, Ok 73075
Parrish Michael
Member, City of Pauls Valley, eff 6/30/17
Member
PO Box 778 Pauls Valley, OK 73075
Montgomery Shirley
UPL Owner eff. 6/30/2017
Operating Entity
100 W. Paul Avenue Pauls Valley, OK 73075
City of Pauls Valley
UPL Manager, eff 6/30/17
Manager
1500 Waters Ridge Dr. Lewisville, TX 75057
Tuscany SNF OPCO, LLC
Page 245 of 265
Owner NameFacilities Owned
NH2601 405-381-3363104 Southeast 4th Street Tuttle, OK 73089
Tuttle Care Center
Direct Owner 25% OP/RE
Stockholders/partners -- Not Officers
1633 North Campbell Avenue Chicago, IL 60647
Birchwood Health Care Properties, LLC
Indirect Owner 25% OP/RE
Stockholders/partners -- Not Officers
1633 North Campbell Avenue Chicago, IL 60647
Dole Isaac
managment 09/01/2015
Contracted Management
1518 Legacy Dr. #110 Frisco, TX 75034
Southwest LTC Management Services, LLC
Indirect Owner 54.46% RE/OP,Indirect
Owner MGT80%
Stockholders/partners -- Not Officers
1518 Legacy Drive 110 Frisco, TX 75034
Payne Ronald
Indirect Owner 7.13% RE/OP & Direct
Owner 20% Mgt
Stockholders/partners -- Not Officers
1518 Legacy Drive 110 Frisco, TX 75034
Brashier Craig
direct Owner 75% OP/RE
Stockholders/partners -- Not Officers
1518 Legacy Drive 110 Frisco, OK 75034
Southwest LTC Oklahoma Holdings,LLC
Indirect Owner 75% OP/RE
Stockholders/partners -- Not Officers
1518 Legacy Dr. 110 Frisco, TX 75034
Southwest LTC, LTD
Direct Owner 80% MGT/Indirect Owner
54.46% RE/OP
Stockholders/partners -- Not Officers
1518 Legacy Drive 110 Frisco, TX 75034
Ronald R. Payne, P.C.
Indirect Owner 8.99% OP/RE
Stockholders/partners -- Not Officers
5731 Jackson St. Ext C Alexandria, LA 71303
Quality Care Givers, Inc.
Direct Owner 25% OP/RE
Stockholders/partners -- Not Officers
1633 N. Campbell ave Chicago, IL 60647
BHCP OK 3 Sponsor, LLC
RE EFF 12/01/2015
Lessor Or Real Estate Owner
1518 Legacy Drive 110 Frisco, TX 75034
Tuttle LTC Land, LLC
OP EFF 12/1/2015
Operating Entity
1518 Legacy Drive 110 Frisco, TX 75034
Southwest LTC-Tuttle, LLC
NH2003 580-323-09122316 Modelle Clinton, OK 73601
United Methodist Health Care Center, Inc.
Chairman
Officers Who Do Not Hold Stock
108 Rolling Hills Clinton, OK 73601
Cornell Pat
Treasurer - eff 07/01/2012
Officers Who Do Not Hold Stock
P.O. Box 1224 Clinton, OK 73601
Carpenter Yvonne
Operating Entity
2316 Modelle Clinton, OK 73601
The United Methodist Retirement & Health Care Center, Inc.
Secretary eff 07/01/2014
Officers Who Do Not Hold Stock
Custer City, OK
Covey Yvonne
Page 246 of 265
Owner NameFacilities Owned
Vice Chairman - eff 07/01/2013
Officers Who Do Not Hold Stock
518 Hayes Clinton, OK 73601
Graves Charles
NH7706 918-650-93931635 East 2nd Street Okmulgee, OK 74447
University Place
amended corp. name (fkaProdetik, Inc.)
eff 02-05-08
Operating Entity
P.O. Box 217 Weleetka, OK 74880
The Reach Corporation
Non-Profit Board President of The Reach
Corporation 1-8-08
Officers Who Do Not Hold Stock
P.O. Box 790 Uniontown, KY 42461
Welsh Richard
Non-Profit Board VP of The Reach
Corporation 1-8-08
Officers Who Do Not Hold Stock
PO Box 790 UnionTown, KY 42461
Bailey M. Geoffry
Non-Profit Board Sec/Treas of The Reach
Corporation
Officers Who Do Not Hold Stock
PO Box 790 Uniontown, KY 42461
Pyle William "Bill"
authorized agent for The Reach
Corporation
Officers Who Do Not Hold Stock
1201 West Trudgeon Place Henryetta, OK 74437
Bentley Roy
eff. 8-15-07
Lessor Or Real Estate Owner
P.O. Box 409 Sturgis, KY 42459
Maricopa Properties, LLC
100% of RE
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Maricopa Partners, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Rock River, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
MMB, LLC
33.33% of Maricopa Partners, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Lovenest, LLC
30.959% of Rock River, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gary
16.025% of Rock River, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Lisa
32.88% of MMB, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Tim
17.455% of MMB, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Vicki
29.421% of Lovenest, LLC
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Robert
13.957% of Lovenest, LLC
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Laura
Page 247 of 265
Owner NameFacilities Owned
53.016% of Rock River, LLC - 4 children
w/13.254% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
4 Irrevocable Trusts
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O.Box 409 Sturgis, KY 42459
Ervin Mallory
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Jade
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Luke
25% of 4 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Gabe
49.665% of MMB, LLC - 5 children
w/9.933% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
3 Irrevocable Trusts
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Max
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box Sturgis, KY 42459
Linenger Jessica
20% of 3 Irrevocable Trusts
Stockholders/partners Who Are Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mitch
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Linenger Jennifer
20% of 3 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Brock
56.623% of Lovenest, LLC - 7 children
w/8.089% each
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
7 Irrevocable Trusts
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Thea
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugris, KY 42459
Ervin Issac
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Stugis, KY 42459
Ervin Samuel
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Elijah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Saul
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Micah
14.286% of 7 Irrevocable Trusts
Stockholders/partners -- Not Officers
P.O. Box 409 Sturgis, KY 42459
Ervin Mathias
Page 248 of 265
Owner NameFacilities Owned
NH7231 918-299-26618555 South Lewis Avenue Tulsa, OK 74137
University Village Retirement Community
RE 38%/OP 385/ Managmnt 51% start
0729/2011
Managing Member
2021 S. Lewis Ave. 300 Tulsa, OK 74104
Fail Blake N.
RE 38%/OP 38%/ Managmnt 49% start
0729/2011
Managing Member
2021 S. Lewis Ave. 300 Tulsa, OK 74104
Gawey Matthew R.
RE 23%/OP 24% start 07/29/2011
Stockholders/partners -- Not Officers
8555 S. Lewis Ave Tulsa, OK 74137
Roberts Keith A.
start 07/29/2011
Operating Entity
8555 S. Lewis Ave Tulsa, OK 74137
University Village Retirement Community, LLC
start 07/29/2011
Contracted Management
8555 S. Lewis Ave Tulsa, OK 74137
Triad Aspen Partners, LLC
NH6804 918-773-5258305 North Thornton Vian, OK 74962
Vian Nursing & Rehab
50% RE/OP
Managing Member
P.O. Box 638 Gore, OK 74435
Montgomery Schuyler
50% RE/OP
Managing Member
P.O. Box 638 Gore, OK 74435
Montgomery Bobbie
Operating Entity
208 East Fifth Street Gore, OK 74435
Vian Nursing & Rehab, LLC
Lessor Or Real Estate Owner
208 East Fifth Street Gore, OK 74435
Vian Health Services, LLC
NH7228 918-251-26261709 South Main Broken Arrow, OK 74012
Village Health Care Center
100% RE/OP
Stockholders/partners -- Not Officers
124 S. Elm Place Broken Arrow, OK 74012
Ross LaDonna
100% RE/OP
Stockholders/partners -- Not Officers
124 S. Elm Place Broken Arrow, OK 74012
Ross LaDonna
Sec/tres
Officers Who Do Not Hold Stock
124 S. Elm Broken Arrow, OK 74012
Owen Jacquelyn D.
Operating Entity
1709 S. Main Broken Arrow, OK 74012
The Village Health Care Center, Inc.
Page 249 of 265
Owner NameFacilities Owned
LaDonna Ross Managing Member 100%
Lessor Or Real Estate Owner
124 South Elm Place Broken Arrow, OK 74012
The Village Care Center, LLC
NH7302 918-378-2562205 North Lincoln Avenue Wagoner, OK 74467
Wagoner Health & Rehab
50% Managing Member of Wagoner Care
Center,LLC
Stockholders/partners -- Not Officers
P.O. Box 1009 Gore, OK 74435
Montgomery John B.
Lessor Or Real Estate Owner
P. O. Box 547 Sallisaw, OK 74955
S.M.K. of Oklahoma, Inc.
100% sole stockholder
Stockholders/partners -- Not Officers
P.O. Box 726 Stigler, OK 74462
Wagoner Care Center, L.L.C.
Pres of S.M.K of OK,Inc, 50%
WCC,LLC, 100% MM OP Eff 10-1-15
Stockholders/partners -- Not Officers
9 Professional Drive Bella Vista, AR 72715
Montgomery Bradford
EFF 10-1-2015
Operating Entity
,
Wagoner Health & Rehab, LLC
NH6110 918-423-73731001 South George Nigh Expressway McAlester, OK
74502
Walnut Grove Living Center
60% BHCP GP JV 2015, LLC, 7/1/16
Stockholders/partners -- Not Officers
1633 North Campbell Avenue Chicago, IL 60647
Birchwood Health Care Properties, LLC
Manager & 100% Mbr, Birchwood HCP
LLC& OK4 Manager, LLC 7/1/16
Stockholders/partners Who Are Officers
1633 North Campbell Avenue Chicago, IL 60647
Dole Isaac
Manager 7/1/16
Manager
415 US Hwy377 S 200 Argyle, TX 76226
Transition Health Services-OK, LLC
100% Lessor (Real Estate) & Lessee (OP)
7/1/16
Stockholders/partners -- Not Officers
1633 N. Campbell Ave Chicago, IL 60647
OK4 SNF HoldCo, LLC
100% OK4 SNF HoldCo, LLC, 7/1/16
Stockholders/partners -- Not Officers
1633 N. Campbell Ave Chicago, IL 60647
OK4 HH/H Master HoldCo, LLC
75%-100% OK4 HH/H Master HoldCo,
LLC 7/1/16
Stockholders/partners -- Not Officers
1633 N. Campbell Ave Chicago, IL 60647
BHCP OK4 HH/H JV, LLC
5% BHCP OK4 HH/H JV, LLC 7/1/16
Stockholders/partners -- Not Officers
1633 N. Campbell Ave Chicago, IL 60647
BHCP OK4 HH/H Sponsor, LLC
95% BHCP OK4 HH/H JV, LLC,7/1/16
Stockholders/partners -- Not Officers
1633 N. Campbell Ave Chicago, IL 60647
BHCP OK4 HH/H Investors, LLC
Page 250 of 265
Owner NameFacilities Owned
Will own greater percent BHCP OK4
HH/H Sponsor,LLC 7/1/16
Stockholders/partners -- Not Officers
1633 N. Campbell Ave Chicago, IL 60647
BHCP GP JV 2015, LLC
Mgr-Applicant,Lessor, OK4 SNF
HoldCo,LLC,OK4HH/H Master 7/1/16
Manager
1633 N. Campbell Ave Chicago, IL 60647
OK4 Manager, LLC
0-25% OK4 HH/H Master HoldCo, LLC,
7/1/16
Stockholders/partners -- Not Officers
415 US Hwy 377 S 200 Argyle, TX 76226
SBS of OK, LLC
33.33% Member & Manager SBSof
OK,LLC&THS-OK,LLC,7/1/16
Stockholders/partners Who Are Officers
415 US Hwy 377 S 200 Argyle, TX 76226
Bates Josh
33.33% Member & Manager SBSof
OK,LLC&THS-OK,LLC,7/1/16
Stockholders/partners Who Are Officers
415 US Hwy 377 S 200 Argyle, TX 76226
Shelton Chana
33.33% Member & Manager SBSof
OK,LLC&THS-OK,LLC,7/1/16
Stockholders/partners Who Are Officers
415 US Hwy 377 S 200 Argyle, TX 76226
Sims Debra
7/1/16
Lessor Or Real Estate Owner
1633 N. Campbell Ave Chicago, IL 60647
OK4 McAlester RealCo, LLC
Eff 7/1/16
Operating Entity
1633 N. Campbell Ave Chicago, IL 60647
OK4 McAlester OpCo, LLC
NH5515 405-721-54446501 North MacArthur Oklahoma City, OK 73132
Warr Acres Nursing Center
12% Director for OWW,LLC EFF
06/01/2013
Stockholders/partners Who Are Officers
303 W Madison 2400 Chicago, IL 60606
Bernfield Craig
authorized agent for OWW,LLC EFF
06/01/2013303 W Madison 2400 Chicago, IL 60606
Kovitz Samuel H.
44% Director of OWW, L.L.C. EFF
06/01/2013
Stockholders/partners Who Are Officers
630 5th Ave, 30th floor New York, NY 10111
Goldberg Alan E.
44% Director of OWW, L.L.C. EFF
06/01/2013
Stockholders/partners Who Are Officers
630 5th Ave, 30th floor New York, NY 10111
Lindsay Robert D.
99%-Manager of GP EFF 06/01/2013
Stockholders/partners Who Are Officers
5420 W. Plano Pkwy Plano, TX 75075
Scott Thomas D.
EFF 06/01/2013
Contracted Management
5420 W. Plano Parkway Plano, TX 75093
Preferred Care Partners Managment Group, L.P.(PCPMG)
24% PCPMG, L.P. EFF 06/01/2013
Stockholders/partners -- Not Officers
5420 Plano Parkway Plano, TX 75093
Anderson Gary
24% of PCPMG, L.P. EFF 06/01/2013
Stockholders/partners -- Not Officers
5420 W. Plano Parkway Plano, TX 75093
Lunceford Travis
Page 251 of 265
Owner NameFacilities Owned
24% of PCPMG, L.P. EFF 06/01/2013
Stockholders/partners -- Not Officers
5420 W. Plano Parkway Plano, TX 75093
Provence Mindy
24% of PCPMG, L.P. EFF 06/01/2013
Stockholders/partners -- Not Officers
5420 W. Plano Parkway Plano, TX 75093
Tennyson Michael
0% Co-Manager of the GP EFF
06/01/2013
Officers Who Do Not Hold Stock
5500 W. Plano Parkway Plano, TX 75093
Riek Robert
EFF 06/01/2013
Operating Entity
5420 W. Plano Parkway Plano, TX 75093
OKC Health Facilities,LP (OHF)
EFF 06/01/2013
Lessor Or Real Estate Owner
303 West Madison St. 2400 Chicago, IL 60606
Oklahoma Warr Wind, L.L.C. (OWW)
NH2501 405-238-5528105 Washington Pauls Valley, OK 73075-5039
Washita Valley Living Center
eff 12-20-01
Operating Entity
105 Washington Pauls Valley, OK 73075
Washita Valley Living Center, Inc.
Pres100%OpEnt/50% Member RE
Stockholders/partners Who Are Officers
105 Washington Pauls Valley, OK 73075
Justice Jack
50% RE Managing Member
Stockholders/partners -- Not Officers
110 Burr Aveneu Pauls Valley, OK 73075
Justice Julie
Effective 12/28/2007
Lessor Or Real Estate Owner
110 Burr Ave Pauls Valley, OK 73075
WVLC Properties, LLC
NH2005 580-774-12392200 North Lyle Road Weatherford, OK 73096
Weatherford Living Center
100% RE/OP Effective 05/2008
Stockholders/partners Who Are Officers
P.O. Box 638 Gore, OK 74435
Montgomery Schuyler
Schuyler Montgomery 100% President
Lessor Or Real Estate Owner
2200 N. Lyle Rd. Weatherford, OK 73096
Weatherford Living Center, Inc.
Schuyler Montgomery 100% President
Operating Entity
P.O. Box 638 Gore, OK 74435
Weatherford Health Services, L.L.C.
NH3403 580-228-23631100 North Ash Street Waurika, OK 73573
Westbrook Healthcare, Inc.
Page 252 of 265
Owner NameFacilities Owned
President 49.5% OP/ 66%President of
Elmbrook Properties. Inc
Stockholders/partners Who Are Officers
1908 12th Ave N.W. E Ardmore, OK 73401
Coble Tom C.
VPres 49.5% OP Eff 6/9/04 & 34% of
Elmbrook Properties. Inc
Stockholders/partners Who Are Officers
1908 12th Ave NW Ardmore, OK 73401
Jackson Don N.
1%
Operating Entity
1100 N. Ash Waurika, OK 73573
Westbrook Healthcare, Inc.
100% of OP
Stockholders/partners -- Not Officers
1908 12th Avenue, N W E Ardmore, OK 73401
Elmbrook Properties, Inc.
RE EFF 10/27/2014
Lessor Or Real Estate Owner
16203 Chasemore Spring, TX 77379
Covenant Care Centers, LLC
100% Owner of RE EFF 10/27/2014
Stockholders/partners -- Not Officers
16203 Chasemore Springs, TX 77379
Sanborn Ron
NH6006 405-743-11401215 South Western Stillwater, OK 74074
Westhaven Nursing Home
34% N&RWesthaven & Health Systems
of Oklahoma eff 01/01/2017
Stockholders/partners Who Are Officers
329 Townepark Circle 100 Louisville, KY 40243
Vinson John
Contracted Management
329 Townepark Circle 100 Louisville, KY 40243
Health Systems of Oklahoma, L.L.C.
eff 10-01-02
Operating Entity
1215 S. Western Stillwater, OK 74074
N & R of Westhaven, L.L.C.
Lessor Or Real Estate Owner
200 International Circle 3500 Hunt Valley, MD 21030
CSE Stillwater LLC
CEO of CSE/RE
Stockholders/partners Who Are Officers
,
Pickett Taylor
COO of CSE/RE
Stockholders/partners Who Are Officers
,
Booth Daniel J.
Senior VP of CSE/RE
Stockholders/partners Who Are Officers
,
Crabill, Jr R. Lee
100% Owner of CSE Stillwater LLC
Stockholders/partners -- Not Officers
200 International Circle 3500 Hunt Valley, MD 21030
Omega Healthcare Investors, Inc.
33% N&R Westhaven & Health Systems
of Oklahoma eff 01/01/2017
Stockholders/partners -- Not Officers
329 Townepark Circle Louisville, KY 40243
Vinson, Jr John
33% N&R of Westhaven & Health
Systems of Oklahoma eff 01/01/2017
Stockholders/partners -- Not Officers
329 Towepark Circle Louisville, KY 40243
Trumbo Jay H.
Page 253 of 265
Owner NameFacilities Owned
NH4206 405-282-02051900 West Harrison Guthrie, OK 73044
Westview Cottages
100% OP/RE
Stockholders/partners -- Not Officers
PO Box 990 Edmond, OK 73013
Diakonos Group, LLC
99% Diakonos Group, LLC
Stockholders/partners -- Not Officers
PO Box 990 Edmond, OK 73013
Pilgrim Scott
1% of Diakonos Group, LLC
Stockholders/partners -- Not Officers
P.O. Box 990 Edmond, OK 73083
Servant Living Center Holding Company
EFF 09/01/2015
Lessor Or Real Estate Owner
P.O. BOX 990 Edmond, OK 73083
Westview Holding, LLC
EFF 09/01/2015
Operating Entity
P.O.Box 990 Edmond, OK 73083
Westview Cottages, LLC
NH6705 405-257-33931400 West First Street Wewoka, OK 74884
Wewoka Healthcare Center
Manager OP/RE eff 10/11/2011
Stockholders/partners Who Are Officers
131 North Broadway Ada, OK 74820
Reed Bart
Bart T. Reed 100% managing Member
Stockholders/partners Who Are Officers
131 North Broadway Ada, OK 74820
BK Strategies, LLC
Bart T. Reed 100% managing Member
Stockholders/partners Who Are Officers
131 North Broadway Ada, OK 74820
BK Strategies Real Estate, LLC
UPL Mgr. eff 6/30/2017
Contracted Management
131 North Broadway Ada, OK 7820
Wewoka Healthcare Center, LLC
eff 10/11/2011
Lessor Or Real Estate Owner
131 North Broadway Ada, OK 74820
Wewoka Real Estate, LLC
UPL Owner eff. 6/30/2017
Operating Entity
100 W. Paul Avenue Pauls Valley, OK 73075
City of Pauls Valley
NH1002 580-223-4803111 13th Avenue Northwest Ardmore, OK 73401
Whispering Oaks
100%
Stockholders/partners Who Are Officers
P.O. Box 128 Ardmore, OK 73402-0128
Porter Gary L.
Operating Entity
PO Box 128 Ardmore, OK 73402-0128
Premier Health Care, L.L.C.
Contracted Management
PO Box 128 Ardmore, OK 73402-0128
LTC Management Co.
Page 254 of 265
Owner NameFacilities Owned
NH7209 918-747-80083333 East 28th Street Tulsa, OK 74114
Wildwood Care Center, Inc.
15.374%VP
Stockholders/partners Who Are Officers
66 Cedar Ridge Road Broken Arrow, OK 74011
Thomas Jack
16.135% each OP/RE
Stockholders/partners -- Not Officers
14 Woodward Blvd. Tulsa, OK 74114
Anderson Robert L.
Pres/C.E.O. 26% each OP/RE
Stockholders/partners Who Are Officers
1815 East Skelly Dr. Tulsa, OK 74105
Rucker Ed
15.116% Sec each OP/RE
Stockholders/partners Who Are Officers
2716 East 39th Place Tulsa, OK 74105
Perryman Robert G.
5.433% each OP/RE
Stockholders/partners -- Not Officers
2840 South Columbia Place Tulsa, OK 74114
Dunitz Scott E.
3.396% each OP/RE
Stockholders/partners -- Not Officers
6585 South Yale 500 Tulsa, OK 74136
Bischoff James
3.396% Treasurer each OP/RE
Stockholders/partners -- Not Officers
2452 South Peoria Tulsa, OK 74124
Garrett Robert
13.429% each OP/RE
Stockholders/partners -- Not Officers
66 Cedar Ridge Rod. Broken Arrow, OK 74011
Jack E. Thomas Trust,
9.395% each OP/RE
Stockholders/partners -- Not Officers
P.O. Box 2300 Tulsa, OK 74192
Ceylon S. Lewis, Jr., Trust A,
OP Ent eff 10/4/06
Operating Entity
3333 East 28th Street Tulsa, OK 74114
Wildwood Management Company, L.L.C.
beneficary of Genevieve K. Gary
Revocable Trust
Beneficiary
11711 South Braden Tulsa, OK 74137
Gary Richard
beneficary of Genevieve K. Gary
Revocable Trust
Beneficiary
11711 South Braden Tulsa, OK 74137
Miles Deanna
beneficary of Genevieve K. Gary
Revocable Trust
Beneficiary
11711 South Braden Tulsa, OK 74137
Hughes Jenny
beneficary of Genevieve K. Gary
Revocable Trust
Beneficiary
11711 South Braden Tulsa, OK 74137
Rucker Edward
beneficary of Ceylon S. Lewis, Jr. Trust A
Beneficiary
,
Lewis Corinne H.
beneficary of Ceylon S. Lewis, Jr. Trust A
Beneficiary
,
Lorenz Sarah Lee
beneficary of Ceylon S. Lewis, Jr. Trust A
Beneficiary
,
Lewis, III C. S.
Page 255 of 265
Owner NameFacilities Owned
beneficary of Ceylon S. Lewis, Jr. Trust A
Beneficiary
,
Kast Carol D.
beneficary of Jack E. Thomas Trust
Beneficiary
66 Cedar Ridge Road Tulsa, OK 74012
Thomas Betty J.
beneficary of Jack E. Thomas Trust
Beneficiary
66 Cedar ridge Road Tulsa, OK 74012
Meek Mary Jean
beneficary of Jack E. Thomas Trust
Beneficiary
66 Cedar Ridge Road Tulsa, OK 74012
Thomas Randall E.
beneficary of Jack E. Thomas Trust
Beneficiary
66 Cedar Ridge Road Tulsa, OK 74012
Waggenblatt Deborah Lynn
4.157%
Stockholders/partners -- Not Officers
5727 S. Lewis Tulsa, OK 74105
Genevieve K. Gary, Trust Bank of Oklahoma, Trustee
.998000% Secretary, C.O.O.
Stockholders/partners Who Are Officers
1815 E. Skelly Dr. Tulsa, OK 74105
Pope Robert
NH6905 580-252-39551205 South 4th Street Duncan, OK 73533
Wilkins Health and Rehabilitation Community
President 75%, eff. 10-1-13
Stockholders/partners Who Are Officers
2400 W. Camelback Duncan, OK 73553
Wilkins Tony
Sec/Treas
Officers Who Do Not Hold Stock
4845 Odom Duncan, OK 73553
Wilkins Melanie
5%
Stockholders/partners -- Not Officers
3612 Rolling Lane Midwest City, OK 73110
Allen David
Operating Entity
1205 South 4th Street Duncan, OK 73533
Duncan Health Care, Inc.
20% eff. 11-1-91
Stockholders/partners Who Are Officers
3434 S.E. Kentucky Place Bartlesville, OK 74006
Brown Jim
NH4201 405-282-16862300 West Noble Guthrie, OK 73044
Willow Creek Health Care
100% of OP
Stockholders/partners Who Are Officers
2300 W. Noble Guthrie, OK 73044
Coles Nursing Home, L.L.C.
7% Mbr HMLC, LLC
Stockholders/partners -- Not Officers
P.O. Box 1095 Guthrie, OK 73044
Golden Age Nursing Home Of Guthrie, Inc.(GAN)
Trustee-Mary Lou Chappell Trust; Mbr
HMLC, LLC eff 04/18/2012
Stockholders/partners Who Are Officers
Box 1095 Guthrie, OK 73044
Chappell Mary Lou
Page 256 of 265
Owner NameFacilities Owned
3% Mbr HMLC, LLC
Stockholders/partners -- Not Officers
P.O. Box 1095 Guthrie, OK 73044
Perry Green Valley Nursing Home, Inc.(PGV)
3% Mbr HMLC, LLC
Stockholders/partners -- Not Officers
PO Box 1095 Guthrie, OK 73044
Stilwell Nursing Home, Inc.(SNH)
Lessor Or Real Estate Owner
P.O. Box 1095 Guthrie, OK 73044
Bradford Square Properties, L.L.C. Bradford Square Properties, LLC
Manager of RE/OP EFF 05-20-2014
Officers Who Do Not Hold Stock
P.O. Box 1095 Guthrie, OK 73044
Chappell Jeff
President of GAN,PGV,SNH; Mrg of
HMLC,LLC
Officers Who Do Not Hold Stock
P.O. Box 1095 Guthrie, OK 73044
Hastings Tandie
eff. 01-01-2010
Operating Entity
PO Box 1095 Guthrie, Ok 73044
Willow Creek Health Care, L.L.C.
100% Coles NH LLC (OP) & RE, eff
04/18/12
Stockholders/partners -- Not Officers
PO Box 1095 Guthrie, OK 73044
HMLC, LLC
Mrg of HMCL, LLC, Trustee Chappell
2012 Succession Trust
Officers Who Do Not Hold Stock
PO Box 1095 Guthrie, OK 73044
Chappell Hollie "Joe"
72% Mbr HMLC, LLC eff 04/18/2012
Stockholders/partners -- Not Officers
P.O. Box 1095 Guthrie, OK 73044
Chappell 2012 Succession Trust dated 1/3/2012
15% Mbr HMLC, LLC
Stockholders/partners -- Not Officers
P.O. Box 1095 Guthrie, OK 73044
Mary Lou Chappell Trust
NH3602 580-628-25291301 North 5th Street Tonkawa, OK 74653
Willow Haven
Lessor Or Real Estate Owner
805 Avenue L Brooklyn, NY 11230
1340 East 9th Street Realty Corp.
50% owner in RE
Stockholders/partners Who Are Officers
805 Avenue L Brooklyn, NY 11230
Pinter Fagie
50% owner in RE
Stockholders/partners Who Are Officers
805 Avenue L Brooklyn, NY 11230
Pinter Samuel
eff 07/15/2009
Operating Entity
8627 S. 90th Street Tulsa, OK 74133
Ila Seaton, LLC, as Receiver, CJ-06-201 Sequoyah County
100% Managing Member of Illa Seaton,
LLC
Stockholders/partners Who Are Officers
8627 S. 90th Street Tulsa, OK 74133
Seaton Illa
NH1607 580-536-12797019 Northwest Cache Road Lawton, OK 73505
Willow Park Health Care Center
Page 257 of 265
Owner NameFacilities Owned
Indirect Owner 25% OP/RE
Stockholders/partners -- Not Officers
1633 North Campbell Avenue Chicago, IL 60647
Birchwood Health Care Properties, LLC
Indirect Owner 25% OP/RE
Stockholders/partners -- Not Officers
1633 North Campbell Avenue Chicago, IL 60647
Dole Isaac
managment 09/01/2015
Contracted Management
1518 Legacy Dr. #110 Frisco, TX 75034
Southwest LTC Management Services, LLC
Indirect Owner 54.46% RE/OP,Indirect
Owner MGT80%
Stockholders/partners -- Not Officers
1518 Legacy Drive 110 Frisco, TX 75034
Payne Ronald
Direct Owner 20% MGT, Indirect Owner
7.13% OP/RE
Stockholders/partners -- Not Officers
1518 Legacy Drive 110 Frisco, TX 75034
Brashier Craig
Direct owner 75% OP/RE
Stockholders/partners -- Not Officers
1518 Legacy Drive 110 Frisco, OK 75034
Southwest LTC Oklahoma Holdings,LLC
Indirect Owner 75% OP/RE
Stockholders/partners -- Not Officers
1518 Legacy Dr. 110 Frisco, TX 75034
Southwest LTC, LTD
Direct Owner 80% MGT/Indirect Owner
54.46% RE/OP
Stockholders/partners -- Not Officers
1518 Legacy Drive 110 Frisco, TX 75034
Ronald R. Payne, P.C.
Indirect Owner 8.99% OP/RE
Stockholders/partners -- Not Officers
5731 Jackson St. Ext C Alexandria, LA 71303
Quality Care Givers, Inc.
Direct Owner 25% OP/RE
Stockholders/partners -- Not Officers
1633 N. Campbell ave Chicago, IL 60647
BHCP OK 3 Sponsor, LLC
RE EFF 12/1/2015
Lessor Or Real Estate Owner
1518 Legacy Drive 110 Frisco, TX 75034
Lawton LTC Land, LLC
OP EFF 12/1/2015
Operating Entity
1518 Legacy Drive 110 Frisco, TX 75034
Southwest LTC- Lawton, LLC
NH3203 405-452-3271620 South Alabama Wetumka, OK 74883
Willow Place
President/Beneficiary of Family Trust
Trustee
P.O. Box 488 Weleetka, OK 74880
Adkins Gerrol Dean
Secretary/Beneficiary of Family Trust
Trustee
P.O. Box 488 Weleetka, OK 74880
Adkins Arbret June
Lessor Or Real Estate Owner
P.O. Box 488 Wetumka, OK 74880
Pioneer Nursing Home Of Hughes County, Inc.
Beneficiary eff.12/31/12
Beneficiary
319 West 9th St. Weleetka, OK 74880
Majors Cynthia
Beneficiary eff.12/31/12
Beneficiary
319 West 9th St Weleetka, OK 74880
Simmons Donna Renee
Page 258 of 265
Owner NameFacilities Owned
52% RE and 100% manag. member of
Business Trust
Stockholders/partners -- Not Officers
P.O. Box 488 Weleetka, OK 74880
Gerrol Dean Adkins & Arbret June Adkins Family Trust (GDA/AJA)
100% OP manag. member
Managing Member
P.O. Box 488 Weleetka, OK 74880
Willow Place Revocable Business Trust
eff. 1-1-07
Operating Entity
622 South Alabama Wetumka, OK 74883
Willow Place Living Center, LLC
16% RE eff 12/31/12
Stockholders/partners -- Not Officers
Rt 1 Box 121A Weleetka, OK 74880
Gerrol Dean Adkins II Irrevocable Trust dated 12/28/12
16% RE eff 12/31/12
Stockholders/partners -- Not Officers
Rt 1 Box 121A Weleekta, OK 74880
Cynthia Denise Majors Irrevocable Trust dated 12/28/12
16% RE eff 12/31/12
Stockholders/partners -- Not Officers
Rt 1 Box 121A Weleetka, OK 74880
Donna Renee Simmons Irrevocable Trust dated 12/28/12
Trustee eff 12/31/12
Trustee
523 W. Main Henryetta, OK 74437
Palmer, C.P.A. Reginald
NH1007 580-668-2337867 US Highway 70A Wilson, OK 73463
Wilson Nursing Center
50%Pres
Lessor Or Real Estate Owner
203 Thomas Healdton, OK 73438
McNeill Glyn
50%SecTreas
Lessor Or Real Estate Owner
203 Thomas Healdton, OK 73438
McNeill Ruth Ann
eff 4/20/04
Operating Entity
8 N.W. 8th Street Healdton, OK 73438
Court Appointed Receiver, Tom McNeill/Equity Funding, LLC
Lessor Or Real Estate Owner
PO Box 856 Healdton, OK 73438
Tricare, LLC
NH5804 972-931-38002530 North Elm Street Miami, OK 74354
Windridge Nursing and Rehabilitation Center
99% limtd prtnr
MHF,LP/100%MHFGP,LLC EFF
04/01/13
Stockholders/partners Who Are Officers
5420 W. Plano Pkwy Plano, TX 75075
Scott Thomas D.
EFF 04/01/2013
Lessor Or Real Estate Owner
10960 Wilshire Blvd.,5th floor Los Angeles, CA 90024
Tri-State Miami, LLC
EFF 04/01/2013
Operating Entity
5420 W. Parkway Plano, TX 75093
Miami Health Facilities, L.P.
Page 259 of 265
Owner NameFacilities Owned
EFF 04/01/2013
Contracted Management
5420 W. Plano Parkway Plano, TX 75093
Preferred Care Partners Managment Group, L.P.(PCPMG)
manager of Tri-State Miami, LLC
Contracted Management
10960 Wilshire Blvd. 5th Floor Los Angeles, CA 90024
Tri-State GPM, LLC, A Delaware limited liability
100% Owner of Tri-State Miami, LLC
Stockholders/partners -- Not Officers
10960 Wilshire Blvd. 5th Floor Los Angeles, CA 90024
Tri-State Associates, a California limited partnership
49% owner Tri-state Miami, limtd
partner of Tri-state Assoc
Stockholders/partners -- Not Officers
10960 Wilshire Blvd. 5thFloor Los Angeles, CA 90024
Gary S. Kading,Trustee of the Gary S. Kading Trust of 1994
49% owner Tri-state Miami, limtd
partner of Tri-state Assoc
Stockholders/partners Who Are Officers
10960 Wilshire Blvd. 5th Floor Los Angeles, CA 90024
Jacqueline Yellin,Trustee of the Jacqueline Yellen Trust of 1992
24% PCPMG, L.P./25%PCPMG,LLC
EFF 4/1/13
Stockholders/partners -- Not Officers
5420 Plano Parkway Plano, TX 75093
Anderson Gary
24% of PCPMG, L.P./25% PCPMG,LLC
EFF 04/1/13
Stockholders/partners -- Not Officers
5420 W. Plano Parkway Plano, TX 75093
Lunceford Travis
24% of PCPMG, L.P./25% PCPMG,LLC
EFF 04/1/13
Stockholders/partners -- Not Officers
5420 W. Plano Parkway Plano, TX 75093
Provence Mindy
24% of PCPMG, L.P./25% PCPMG,LLC
EFF 04/1/2013
Stockholders/partners -- Not Officers
5420 W. Plano Parkway Plano, TX 75093
Tennyson Michael
0% Co-Manager of Miami Health
Facilities GP,LLC eff 4/1/13
Officers Who Do Not Hold Stock
5500 W. Plano Parkway Plano, TX 75093
Riek Robert
1% GP of Miami Health Fac.,LP
Stockholders/partners -- Not Officers
,
Miami Health Facilities GP, LLC
4% PCPMG,LP general partner
Stockholders/partners -- Not Officers
,
Preferred Care Partners Management Group,LLC(PCPMG)
NH5516 405-942-85662416 North Ann Arbor Oklahoma City, OK 73127
Windsor Hills Nursing Center
12% Director for OWW,LLC EFF
06/01/2013
Stockholders/partners Who Are Officers
303 W Madison 2400 Chicago, IL 60606
Bernfield Craig
authorized agent for OWW,LLC EFF
06/01/2013303 W Madison 2400 Chicago, IL 60606
Kovitz Samuel H.
44% Director of OWW, L.L.C. EFF
06/01/2013
Stockholders/partners Who Are Officers
630 5th Ave, 30th floor New York, NY 10111
Goldberg Alan E.
44% Director of OWW, L.L.C. EFF
06/01/2013
Stockholders/partners Who Are Officers
630 5th Ave, 30th floor New York, NY 10111
Lindsay Robert D.
Page 260 of 265
Owner NameFacilities Owned
99%-Manager of GP EFF 06/01/2013
Stockholders/partners Who Are Officers
5420 W. Plano Pkwy Plano, TX 75075
Scott Thomas D.
EFF 06/01/2013
Contracted Management
5420 W. Plano Parkway Plano, TX 75093
Preferred Care Partners Managment Group, L.P.(PCPMG)
24% PCPMG, L.P. EFF 06/01/2013
Stockholders/partners -- Not Officers
5420 Plano Parkway Plano, TX 75093
Anderson Gary
24% PCPMG, L.P. EFF 06/01/2013
Stockholders/partners -- Not Officers
5420 W. Plano Parkway Plano, TX 75093
Lunceford Travis
24% PCPMG, L.P. EFF 06/01/2013
Stockholders/partners -- Not Officers
5420 W. Plano Parkway Plano, TX 75093
Provence Mindy
24% PCPMG, L.P. EFF 06/01/2013
Stockholders/partners -- Not Officers
5420 W. Plano Parkway Plano, TX 75093
Tennyson Michael
0% Co-Manager of the GP EFF
06/01/2013
Officers Who Do Not Hold Stock
5500 W. Plano Parkway Plano, TX 75093
Riek Robert
EFF 06/01/2013
Operating Entity
5420 W. Plano Parkway Plano, TX 75093
OKC Health Facilities,LP (OHF)
EFF 06/01/2013
Lessor Or Real Estate Owner
303 West Madison St. 2400 Chicago, IL 60606
Oklahoma Warr Wind, L.L.C. (OWW)
NH6603 918-341-43652800 North Hickory Street Claremore, OK 74017
Wood Manor Nursing Center
42.5% member of ESH & Manager
Stockholders/partners Who Are Officers
PO Box 2107 Brentwood, TN 37024
Coates Christopher J.
RE 100% Eff 08/30/2013
Lessor Or Real Estate Owner
3232 Mckinney Ave 890 Dallas, TX 75204
RSF AS Wood Manor Realty V, LP
OP eff 08/30/2013
Operating Entity
3232 McKinney Ave 890 Dallas, TX 75204
Wood Manor Opco, LLC
GP RSFAS WoodManorRealtyV, LP &
100%RSFASTRSV,Inc
Stockholders/partners -- Not Officers
3232 McKinney Ave 890 Dallas, TX 75204
RSF REIT VB GP, LLC
100% of RFS AS Wood Manor, Realty V,
LP
Stockholders/partners -- Not Officers
3232 McKinney Ave 890 Dallas, TX 75204
RSF REIT VB, LLC
Manager of RSF REIT VB, LLC
Stockholders/partners -- Not Officers
3232 McKinney Ave 890 Dallas, TX 75204
RSF Gen Par V, LLC
Manager of RSF Gen Par V, LLC
Stockholders/partners -- Not Officers
3232 McKinney Ave 890 Dallas, TX 75204
Mahowald Group V, LLC
98.4% of Mahowald Group V, LLC
Stockholders/partners Who Are Officers
3232 McKinney Ave 890 Dallas, TX 75204
Mahowald Christopher
Page 261 of 265
Owner NameFacilities Owned
95% of Wood Manor Opco (OP) eff
8/30/2013
Stockholders/partners -- Not Officers
3232 McKinney Ave 890 Dallas, OK 75204
RSF AS TRS V, Inc.
5% of WMOpco eff 8/30/2013
Stockholders/partners -- Not Officers
8500 West 110th 510 Overland Park, KS 66210
Arbor Spings of Claremore, LLC
Sole member of Manager
Contracted Management
1 Village Dr. Suite 400 Abilene, TX 79606
ER Senior Management, LLC
Sole member of ER Senior Management,
LLC
Member
PO Box 2107 Brentwood, TN 37024
ESLP Management, LLC
Sole member of ESLP Mgmt LLC
Member
,
Evergreen Senior Holdings, LLC
42.5% member of ESH and Manager
Stockholders/partners Who Are Officers
PO Box 2107 Brentwood, TX 37024
Dowd Brian E.
15% member of Evergreen Senior
Holdings & Manager
Managing Member
3899 Maple Avenue 250 Dallas, TX 75219
RSF Partners VI, LP
Its General Partner
General Partner
3899 Maple Avenue 250 Dallas, TX 75219
RSF GenPar VI, LP
General Partner of RSF GenPar of RSF
GEnPar VI, LP
General Partner
3899 Maple Avenue 250 Dallas, TX 75219
McKinney VI, LLC
Vice Pres. of McKinney VI, LLC
Vice President
3899 Maple Avenue 250 Dallas, TX 75219
Read Kurt C.
NH7232 918-252-25215707 South Memorial Tulsa, OK 74145
Woodland Park Home, Inc.
Trustee of Jack Thomas Trust & VP of
Woodland Park Management Co
Officer
66 Cedar Ridge Road Broken Arrow, OK 74011
Thomas Jack
9.818%
Stockholders/partners -- Not Officers
2300 Riverside Dr. 8F Tulsa, OK 74114
C.S. Lewis Living Trust, Bank of Oklahoma
Pres/C.E.O. Woodland Park Management
Co.
Stockholders/partners Who Are Officers
1815 East Skelly Dr. Tulsa, OK 74105
Rucker Ed
Sec 14.289% each OP/RE
Stockholders/partners Who Are Officers
2716 East 39th Place Tulsa, OK 74105
Perryman Robert G.
3.755% each OP/RE
Stockholders/partners -- Not Officers
2840 South Columbia Place Tulsa, OK 74114
Dunitz Scott E.
2.261% each OP/RE
Stockholders/partners -- Not Officers
6585 South Yale 500 Tulsa, OK 74136
Bischoff James
Treasurer 2.261% each OP/RE
Stockholders/partners -- Not Officers
2452 South Peoria Tulsa, OK 74124
Garrett Robert
Page 262 of 265
Owner NameFacilities Owned
9.387% each OP/RE
Stockholders/partners -- Not Officers
6733 South Gary Tulsa, OK 74136
Alexander Marjorie
9.817% Woodland Park Management Co
eff 11-18-2016
Stockholders/partners -- Not Officers
66 Cedar Ridge Rod. Broken Arrow, OK 74011
Jack E. Thomas Trust,
9.817% each OP/RE
Stockholders/partners -- Not Officers
P.O. Box 2300 Tulsa, OK 74192
Ceylon S. Lewis, Jr., Trust A,
Op Ent /RE eff 07/1/2014
Operating Entity
5707 South Memorial Drive Tulsa, OK 74145
Woodland Park Management Company, L.L.C.
beneficary of Genevieve K. Gary
Revocable Trust
Beneficiary
11711 South Braden Tulsa, OK 74137
Gary Richard
beneficary of Genevieve K. Gary
Revocable Trust
Officers Who Do Not Hold Stock
11711 South Braden Tulsa, OK 74137
Miles Deanna
beneficary of Genevieve K. Gary
Revocable Trust
Beneficiary
11711 South Braden Tulsa, OK 74137
Hughes Jenny
beneficary of Genevieve K. Gary
Revocable Trust
Beneficiary
11711 South Braden Tulsa, OK 74137
Rucker Edward
beneficary of Ceylon S. Lewis, Jr. Trust A
Beneficiary
,
Lewis Corinne H.
beneficary of Ceylon S. Lewis, Jr. Trust A
Beneficiary
,
Lorenz Sarah Lee
beneficary of Ceylon S. Lewis, Jr. Trust A
Beneficiary
,
Lewis, III C. S.
beneficary of Ceylon S. Lewis, Jr. Trust A
Beneficiary
,
Kast Carol D.
beneficary of Jack E. Thomas Trust
Beneficiary
66 Cedar Ridge Road Tulsa, OK 74012
Thomas Betty J.
beneficary of Jack E. Thomas Trust
Beneficiary
66 Cedar ridge Road Tulsa, OK 74012
Meek Mary Jean
beneficary of Jack E. Thomas Trust
Beneficiary
66 Cedar Ridge Road Tulsa, OK 74012
Thomas Randall E.
beneficary of Jack E. Thomas Trust
Beneficiary
66 Cedar Ridge Road Tulsa, OK 74012
Waggenblatt Deborah Lynn
Ceylon S.Lewis, Jr. Trust A, eff. 10/4/06
Trustee
PO Box 23000 Tulsa, OK 74192
Bank of Oklahoma, N.A.
1% & Secretary/COO Woodland Park
Management Co
Stockholders/partners Who Are Officers
1815 E. Skelly Dr. Tulsa, OK 74105
Pope Robert
35.798% Woodland Park Management
Co, LLC
Stockholders/partners -- Not Officers
1815 East Skellly Drive Tulsa, OK 74105
ED & Kim Rucker Trust 06/30/2014
Page 263 of 265
Owner NameFacilities Owned
8.982% Woodland Park Management Co,
LLC
Stockholders/partners -- Not Officers
16221 Wynncrest Ridge Court Wildwood, MO 63005
Jenny A. Hughes Rev. Trust
Beneficiary of ED and Kim Rucker Trust
Beneficiary
1815 East Skelly Drive Tulsa, OK 74105
Rucker Benjamin
Beneficiary of Ed & Kim Rucker Trust
Beneficiary
1815 East Skelly Drive Tulsa, OK 74105
Rucker Sarah
Beneficiary Jenny A. Hughes Rev. Trust
Beneficiary
16221 Wynncrest Ridge Court Wildwood, MO 63005
Reichardt Diane
Beneficiary Jenny A. Hughes Rev. Trust
Beneficiary
16221 Wynncrest Ridge Court Wildwood, MO 63005
Rainey Kathleen
NH1008 580-226-54541630 3rd Avenue Northeast Ardmore, OK 73401
Woodview Home, Inc.
Operating Entity
1630 3rd N.E. Ardmore, OK 73401
Woodview Home, Inc.
President 65% EFF 7/17/2012
Stockholders/partners Who Are Officers
1908 12th Ave N.W. E Ardmore, OK 73401
Coble Tom C.
VP/SEC/TRES 35% EFF 7/17/2012
Stockholders/partners Who Are Officers
1908 12th Ave NW Ardmore, OK 73401
Jackson Don N.
100% OpEnt
Stockholders/partners -- Not Officers
1908 12th Avenue, N W E Ardmore, OK 73401
Elmbrook Properties, Inc.
NH2506 405-665-2330810 East California Wynnewood, OK 73098
Wynnewood Care Center
Pres 100% IHS Holding, Inc. & IHS
Management Consultants,Inc.
Stockholders/partners Who Are Officers
131 North Broadway Ada, OK 74820
Reed Bart
100% RE
Stockholders/partners -- Not Officers
131 North Broadway Ada, OK 74820
Epecho Associates, Inc.
100% UPL Manager
Stockholders/partners -- Not Officers
131 North Broadway Ada, OK 74820
IHS Holding, Inc.
UP Manager Eff 6-30-2017
Contracted Management
131 North Broadway Ada, OK 74820
IHS Wynnewood Care Center, L.L.C.
100% Member IHS Wynnewood Care
Center, LLC
Stockholders/partners Who Are Officers
131 North Broadway Ada, OK 74820
BK Strategies, LLC
Bart T. Reed 100% Managing Member
Stockholders/partners Who Are Officers
131 North Broadway Ada, OK 74820
BK Strategies, LLC
Page 264 of 265
Owner NameFacilities Owned
Lessor Or Real Estate Owner
131 North Broadway Ada, OK 74820
IHS Wynnewood Real Estate, LLC
Bart T. Reed 100% managing Member
Stockholders/partners Who Are Officers
131 North Broadway Ada, OK 74820
BK Strategies Real Estate, LLC
Bart T. Reed 100% managing Member
Stockholders/partners Who Are Officers
131 North Broadway Ada, OK 74820
BK Strategies Real Estate, LLC
UPL Owner eff. 6/30/2017
Operating Entity
100 W. Paul Avenue Pauls Valley, OK 73075
City of Pauls Valley
NH5112 918-682-6724500 South York Muskogee, OK 74403
York Manor Nursing Home
Operating Entity
1305 Southeast Adams Street Idabel, OK 74745
Heartway Corporation
Secretary Board of Directors eff 11-5-14
Officers Who Do Not Hold Stock
2202 Sunset Ridge Muskogee, OK 74403
Black Vletta (Kathy)
VP Board of Directors
Officers Who Do Not Hold Stock
1302 S. Lynn Lane Idabel, OK 74745
Salyer Dr. Thomas W.
Director, Board of Directors
Officers Who Do Not Hold Stock
810 W. Adams Street Broken Arrow, OK 74728
Darby, Jr Pastor Charles L. (Chuck)
President, Board of Directors eff 11-5-14
Officers Who Do Not Hold Stock
13490 Old Livingston Road Naples, FL 34109-3855
Carter Daniel E.
Treasurer, Board of Directors Eff
11-5-2014
Officers Who Do Not Hold Stock
13490 Old Livingston Road Naples, FL 34109
Barton Blaine
Page 265 of 265