SM Foundation LLC

SM Foundation LLC was paid $2.66M by Medicaid between Oct 2022 and Nov 2024, across 3 billing codes. Its largest line is H2016, community support for mental illness or disability, billed per day — 97% of everything it billed.

33Billing provider infoSM FOUNDATION LLC
LUFKIN, TX 75904

33aNPI1265015283assigned 04/29/2021

33bProvider typeAssisted Living Facility

28Total paid$2.66M

24GClaims3,140

24DCodes billed3

24AFirst – last monthOct 2022 – Nov 2024

Compared with peers

Next to other Assisted Living Facility providers in Texas

Rank by total paid#16 of 135

Median peer was paid$558K

This provider vs. median4.8×

Peers share this provider's primary NPPES type and state. Size alone says nothing about billing quality: a big agency or a hospital system is expected to sit far above the median.

Auditor's notes

Automated statistical signals. Not evidence of fraud — how these are computed.

Single-Code Concentration97% of spending on code H2016 with only 3 total codes billed. Highly concentrated billing profile.

Box 24A · Dates of service

Paid by month

Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider

By year, as a table

Year	Claims	Paid
2022	41	$163K
2023	2,797	$1.31M
2024incomplete	302	$1.18M

Box 24 · Service lines

What it billed for

Code	Service	Share	Claims	Bene. records	Paid
H2016	Community support for mental illness or disability, billed per dayComprehensive community support services, per diem	97%	662	620	$2.59M
H2014	Skills training and development, per 15 minutes	2.2%	2,418	66	$57K
T2020	Day habilitation, waiver; per diem	<1%	60	12	$9K

Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.

From NPPES

Who's on the registration

Authorized officialMORELAND, SHANTE (PROGRAM MANAGER)