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| Severity | Isolated | Pattern | Widespread |
|---|---|---|---|
| Immediate jeopardy | J· | K· | L· |
| Actual harm | G· | H· | I· |
| Potential harm | D6 | E5 | F2 |
| Minimal | A· | B· | C· |
CMS publishes about the three most recent standard surveys plus complaint and infection-control inspections from the prior three years. Older findings leave the dataset; their absence is not evidence they never happened.
Federal certification and the state license are different records. A nursing home is licensed by the state and, separately, certified by CMS to bill Medicare and/or Medicaid. We link them by the CCN when the state publishes it; otherwise by exact address, house number and street, or exact name within the same ZIP, and label that link as inferred. Never by name alone.
| Date | Domain | Survey types | Citations | Most severe | Open | |
|---|---|---|---|---|---|---|
| Jul 24, 2025 | Fire safety | Fire Safety Standard | 1 | Potential harm | — | Open → |
| Jul 24, 2025 | Health | Health Standard | 4 | Potential harm | — | Open → |
| Jun 20, 2024 | Fire safety | Fire Safety Standard | 0 | No citations | — | Open → |
| Jun 20, 2024 | Health | Health Standard | 3 | Potential harm | — | Open → |
| Jul 19, 2023 | Fire safety | Fire Safety Standard | 1 | Potential harm | — | Open → |
| Jul 19, 2023 | Health | Health Standard | 4 | Potential harm | — | Open → |
| Severity | Isolated | Pattern | Widespread |
|---|---|---|---|
| Immediate jeopardy | J· | K· | L· |
| Actual harm | G· | H· | I· |
| Potential harm | D6 | E5 | F2 |
| Minimal | A· | B· | C· |
| Date | Tag | Deficiency | Scope / severity | Correction | Flags |
|---|---|---|---|---|---|
| Jul 24, 2025 | K-0918 | Have generator or other power source capable of supplying service within 10 seconds. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected Sep 5, 2025 | |
| Jul 24, 2025 | F-0554 | Allow residents to self-administer drugs if determined clinically appropriate. Resident Rights Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Sep 5, 2025 | |
| Jul 24, 2025 | F-0605 |
“Corrected” does not erase a citation: the historical finding stays listed with its disposition. Narrative statements of deficiencies are not part of the CMS dataset; see Care Compare for the official inspection report.
CMS ratings apply to CMS-certified nursing homes only and are relative within each state. They are not a guarantee of any individual resident’s experience.
CMS legal business name of the certified provider. Operates this facility only.
Not part of a CMS-reported chain.
| Name | Type | Role (Carefield group) | CMS role text | Share | Since |
|---|---|---|---|---|---|
| Mckenzie County Healthcare Systems Inc | Organization | Direct owner | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | Jul 1, 2004 |
| Name | Type | Role (Carefield group) | CMS role text | Share | Since |
|---|---|---|---|---|---|
| Mckenzie County Healthcare Systems Inc | Organization | Direct owner | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | Jul 1, 2004 |
| Peter Edis | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | Dec 31, 2021 |
| Gary Brown | Individual | Corporate officer / director | CORPORATE DIRECTOR | not provided | Jan 1, 2020 |
| Monty Bulzomi | Individual | Corporate officer / director | CORPORATE DIRECTOR | not provided | Jan 1, 2020 |
| Virginia Ceynar | Individual | Corporate officer / director | CORPORATE DIRECTOR | not provided | Jan 1, 2020 |
Coordinates as published by CMS.
| Source | Record | Facts | Evidence | Source release | Retrieved |
|---|---|---|---|---|---|
| CMS Provider Information US-CMS | 355072 | name, address, phone, certification, certified_beds, ownership_type, legal_business_name, chain | Verified | Oct 1, 2026 | Nov 7, 2026 |
| CMS Provider Information US-CMS | 355072 | ratings, staffing, health_survey_score Five-Star ratings and PBJ staffing apply to the CMS-certified universe only. | Verified | Oct 1, 2026 | Nov 7, 2026 |
First seen by Carefield Nov 7, 2026 · last changed Nov 7, 2026. This record as JSON · Report a correction
| Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Resident rights & abuse/neglect |
| D · Potential harm Isolated |
| Corrected Sep 5, 2025 |
| Jul 24, 2025 | F-0695 | Provide safe and appropriate respiratory care for a resident when needed. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Sep 5, 2025 |
| Jul 24, 2025 | F-0880 | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention | E · Potential harm Pattern | Corrected Sep 5, 2025 |
| Jun 20, 2024 | F-0623 | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. Resident Rights Deficiencies · Resident rights & abuse/neglect | E · Potential harm Pattern | Corrected Jul 25, 2024 |
| Jun 20, 2024 | F-0625 | Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave. Resident Rights Deficiencies · Resident rights & abuse/neglect | E · Potential harm Pattern | Corrected Jul 25, 2024 |
| Jun 20, 2024 | F-0657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Jul 25, 2024 |
| Jul 19, 2023 | K-0353 | Inspect, test, and maintain automatic sprinkler systems. Smoke Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Sep 7, 2023 |
| Jul 19, 2023 | F-0657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Aug 23, 2023 |
| Jul 19, 2023 | F-0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies · Clinical care | E · Potential harm Pattern | Corrected Aug 23, 2023 |
| Jul 19, 2023 | F-0801 | Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician. Nutrition and Dietary Deficiencies · Food, nutrition & hydration | F · Potential harm Widespread | Corrected Aug 23, 2023 |
| Jul 19, 2023 | F-0880 | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention | E · Potential harm Pattern | Corrected Aug 23, 2023 |
Reported from Payroll-Based Journal (PBJ) data, as published by CMS. Case-mix adjusted total: 5.19 (case-mix index 1.17).
| Jan Dodge |
| Individual |
| Corporate officer / director |
| CORPORATE DIRECTOR |
| not provided |
| Jan 1, 2020 |
| Cheryl Faulkner | Individual | Corporate officer / director | CORPORATE DIRECTOR | not provided | Jul 1, 2004 |
| Krista Heen | Individual | Corporate officer / director | CORPORATE DIRECTOR | not provided | Jan 30, 2024 |
| William Merkle | Individual | Corporate officer / director | CORPORATE DIRECTOR | not provided | Aug 1, 2023 |
| Randy Quale | Individual | Corporate officer / director | CORPORATE DIRECTOR | not provided | Apr 27, 2021 |
| Justin Voll | Individual | Corporate officer / director | CORPORATE DIRECTOR | not provided | Jan 1, 2020 |
| Chase Wisness | Individual | Corporate officer / director | CORPORATE DIRECTOR | not provided | Jan 1, 2022 |
| Peter Edis | Individual | Corporate officer / director | CORPORATE OFFICER | not provided | Dec 31, 2021 |
| Amanda Loughman | Individual | Corporate officer / director | CORPORATE OFFICER | not provided | Jun 9, 2025 |
| William Merkle | Individual | Corporate officer / director | CORPORATE OFFICER | not provided | Aug 1, 2023 |
| Peter Edis | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Apr 23, 2025 |
| Cheryl Faulkner | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Apr 23, 2025 |