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| Severity | Isolated | Pattern | Widespread |
|---|---|---|---|
| Immediate jeopardy | J· | K· | L2 |
| Actual harm | G· | H· | I1 |
| Potential harm | D8 | E46 | F46 |
| Minimal | A· | B· | C3 |
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 | |
|---|---|---|---|---|---|---|
| May 21, 2026 | Fire safety | Fire Safety Standard | 9 | Potential harm | — | Open → |
| May 21, 2026 | Health | Health Standard | 9 | Immediate jeopardy | — | Open → |
| Dec 6, 2024 | Fire safety | Fire Safety Standard | 26 | Potential harm | — | Open → |
| Dec 6, 2024 | Health | Health Standard | 8 | Potential harm | — | Open → |
| Apr 9, 2024 | Fire safety | Fire Safety Standard | 36 | Immediate jeopardy | — | Open → |
| Apr 9, 2024 | Health | Health Standard | 18 | Potential harm | — | Open → |
| Date | Type | Amount | Payment denial | Record |
|---|---|---|---|---|
| Apr 9, 2024 | Civil money penalty (fine) | $29,997 | — | 405025|Fine|16237 |
| Severity | Isolated | Pattern | Widespread |
|---|---|---|---|
| Immediate jeopardy | J· | K· | L2 |
| Actual harm | G· | H· | I1 |
| Potential harm | D8 | E46 | F46 |
| Minimal | A· | B· | C3 |
| Date | Tag | Deficiency | Scope / severity | Correction | Flags |
|---|---|---|---|---|---|
| May 21, 2026 | F-0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · Food, nutrition & hydration | L · Immediate jeopardy Widespread | Corrected Jul 3, 2026 | |
| May 21, 2026 | 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 | I · Actual harm Widespread | Corrected Jul 3, 2026 | |
| May 21, 2026 |
“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 reports the legal business name as not available.
Not part of a CMS-reported chain.
Coordinates as published by CMS (geocoding footnote 22).
| Source | Record | Facts | Evidence | Source release | Retrieved |
|---|---|---|---|---|---|
| CMS Provider Information US-CMS | 405025 | name, address, phone, certification, certified_beds, ownership_type, legal_business_name, chain | Verified | Oct 1, 2026 | Nov 7, 2026 |
| CMS Provider Information US-CMS | 405025 | 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 |
| CMS Provider Information US-CMS | 405025 | county_fips County assigned by locating CMS coordinates in Census county boundaries (the CMS county name did not match the Census code list). | Inferred | 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
| K-0291 |
| Install emergency lighting that can last at least 1 1/2 hours. Egress Deficiencies · Environment & life safety |
| E · Potential harm Pattern |
| Corrected Jul 3, 2026 |
| May 21, 2026 | K-0345 | Have approved installation, maintenance and testing program for fire alarm systems. Smoke Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected Jul 3, 2026 |
| May 21, 2026 | K-0352 | Properly install and monitor supervisory attachments on automatic sprinkler systems. Smoke Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Jul 3, 2026 |
| May 21, 2026 | K-0353 | Inspect, test, and maintain automatic sprinkler systems. Smoke Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected Jul 3, 2026 |
| May 21, 2026 | K-0712 | Have simulated fire drills held at unexpected times. Miscellaneous Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected Jul 3, 2026 |
| May 21, 2026 | K-0907 | Ensure medical gas and vacuum systems have documented maintenance programs. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected Jul 3, 2026 |
| May 21, 2026 | K-0912 | Have power receptacles that are properly grounded. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected Jul 3, 2026 |
| May 21, 2026 | K-0918 | Have generator or other power source capable of supplying service within 10 seconds. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected Jul 3, 2026 |
| May 21, 2026 | K-0921 | Ensure that testing and maintenance of electrical equipment is performed. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected Jul 3, 2026 |
| May 21, 2026 | F-0584 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. Resident Rights Deficiencies · Resident rights & abuse/neglect | E · Potential harm Pattern | Corrected Jul 3, 2026 |
| May 21, 2026 | F-0761 | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. Pharmacy Service Deficiencies · Medication management | D · Potential harm Isolated | Corrected Jul 3, 2026 |
| May 21, 2026 | F-0802 | Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. Nutrition and Dietary Deficiencies · Food, nutrition & hydration | F · Potential harm Widespread | Corrected Jul 3, 2026 |
| May 21, 2026 | F-0803 | Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. Nutrition and Dietary Deficiencies · Food, nutrition & hydration | E · Potential harm Pattern | Corrected Jul 3, 2026 |
| May 21, 2026 | F-0838 | Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies. Administration Deficiencies · Administration & records | F · Potential harm Widespread | Corrected Jul 3, 2026 |
| May 21, 2026 | F-0880 | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention | F · Potential harm Widespread | Corrected Jul 3, 2026 |
| May 21, 2026 | F-0908 | Keep all essential equipment working safely. Environmental Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected Jul 3, 2026 |
| Dec 6, 2024 | E-0004 | Develop and maintain an Emergency Preparedness Program (EP). Emergency Preparedness Deficiencies · Emergency preparedness | E · Potential harm Pattern | Corrected Jan 20, 2025 |
| Dec 6, 2024 | E-0006 | Conduct risk assessment and an All-Hazards approach. Emergency Preparedness Deficiencies · Emergency preparedness | E · Potential harm Pattern | Corrected Jan 20, 2025 |
| Dec 6, 2024 | E-0015 | Address subsistence needs for staff and patients. Emergency Preparedness Deficiencies · Emergency preparedness | E · Potential harm Pattern | Corrected Jan 20, 2025 |
| Dec 6, 2024 | E-0018 | Establish procedures for tracking staff and patients during an emergency. Emergency Preparedness Deficiencies · Emergency preparedness | E · Potential harm Pattern | Corrected Jan 20, 2025 |
| Dec 6, 2024 | E-0020 | Establish policies and procedures including evacuation. Emergency Preparedness Deficiencies · Emergency preparedness | E · Potential harm Pattern | Corrected Jan 20, 2025 |
| Dec 6, 2024 | E-0022 | Establish policies and procedures for sheltering. Emergency Preparedness Deficiencies · Emergency preparedness | E · Potential harm Pattern | Corrected Jan 20, 2025 |
| Dec 6, 2024 | E-0023 | Establish policies and procedures for medical documentation. Emergency Preparedness Deficiencies · Emergency preparedness | E · Potential harm Pattern | Corrected Jan 20, 2025 |
| Dec 6, 2024 | E-0024 | Establish policies and procedures for volunteers. Emergency Preparedness Deficiencies · Emergency preparedness | E · Potential harm Pattern | Corrected Jan 20, 2025 |
| Dec 6, 2024 | E-0025 | Create arrangements with other facilities to receive patients. Emergency Preparedness Deficiencies · Emergency preparedness | E · Potential harm Pattern | Corrected Jan 20, 2025 |
| Dec 6, 2024 | E-0029 | Develop a communication plan. Emergency Preparedness Deficiencies · Emergency preparedness | E · Potential harm Pattern | Corrected Jan 20, 2025 |
| Dec 6, 2024 | E-0030 | List the names and contact information of those in the facility. Emergency Preparedness Deficiencies · Emergency preparedness | E · Potential harm Pattern | Corrected Jan 20, 2025 |
| Dec 6, 2024 | E-0031 | Provide emergency officials' contact information. Emergency Preparedness Deficiencies · Emergency preparedness | E · Potential harm Pattern | Corrected Jan 20, 2025 |
| Dec 6, 2024 | E-0032 | Provide primary/alternate means for communication. Emergency Preparedness Deficiencies · Emergency preparedness | E · Potential harm Pattern | Corrected Jan 20, 2025 |
| Dec 6, 2024 | E-0033 | Establish methods for sharing information. Emergency Preparedness Deficiencies · Emergency preparedness | E · Potential harm Pattern | Corrected Jan 20, 2025 |
| Dec 6, 2024 | E-0034 | Provide a means of sharing information on occupancy/needs. Emergency Preparedness Deficiencies · Emergency preparedness | E · Potential harm Pattern | Corrected Jan 20, 2025 |
| Dec 6, 2024 | E-0035 | Provide family notifications of emergency plan. Emergency Preparedness Deficiencies · Emergency preparedness | E · Potential harm Pattern | Corrected Jan 20, 2025 |
| Dec 6, 2024 | E-0036 | Establish emergency prep training and testing. Emergency Preparedness Deficiencies · Emergency preparedness | E · Potential harm Pattern | Corrected Jan 20, 2025 |
| Dec 6, 2024 | E-0037 | Establish staff and initial training requirements. Emergency Preparedness Deficiencies · Emergency preparedness | E · Potential harm Pattern | Corrected Jan 20, 2025 |
| Dec 6, 2024 | E-0039 | Conduct testing and exercise requirements. Emergency Preparedness Deficiencies · Emergency preparedness | E · Potential harm Pattern | Corrected Jan 20, 2025 |
| Dec 6, 2024 | K-0324 | Provide properly protected cooking facilities. Smoke Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected Jan 20, 2025 |
| Dec 6, 2024 | K-0345 | Have approved installation, maintenance and testing program for fire alarm systems. Smoke Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected Jan 20, 2025 |
| Dec 6, 2024 | K-0353 | Inspect, test, and maintain automatic sprinkler systems. Smoke Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected Jan 20, 2025 |
| Dec 6, 2024 | K-0355 | Properly select, install, inspect, or maintain portable fire extinguishes. Smoke Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected Dec 15, 2024 |
| Dec 6, 2024 | K-0363 | Install corridor and hallway doors that block smoke. Smoke Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected Dec 19, 2024 |
| Dec 6, 2024 | K-0761 | To conduct inspection, testing and maintenance of fire doors by qualified individuals. Miscellaneous Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected Feb 21, 2025 |
| Dec 6, 2024 | K-0908 | Ensure gas and vacuum systems are inspected and tested as part of a maintenance program. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected Jan 15, 2025 |
| Dec 6, 2024 | F-0583 | Keep residents' personal and medical records private and confidential. Resident Rights Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Jan 3, 2025 |
| Dec 6, 2024 | F-0584 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. Resident Rights Deficiencies · Resident rights & abuse/neglect | E · Potential harm Pattern | Corrected Feb 21, 2025 |
| Dec 6, 2024 | F-0636 | Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months. Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Jan 15, 2025 |
| Dec 6, 2024 | F-0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. Nutrition and Dietary Deficiencies · Food, nutrition & hydration | F · Potential harm Widespread | Corrected Feb 7, 2025 |
| Dec 6, 2024 | F-0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · Food, nutrition & hydration | F · Potential harm Widespread | Corrected Jan 15, 2025 |
| Dec 6, 2024 | F-0813 | Have a policy regarding use and storage of foods brought to residents by family and other visitors. Nutrition and Dietary Deficiencies · Food, nutrition & hydration | D · Potential harm Isolated | Corrected Dec 13, 2024 |
| Dec 6, 2024 | F-0880 | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention | F · Potential harm Widespread | Corrected Jan 3, 2025 |
| Dec 6, 2024 | F-0908 | Keep all essential equipment working safely. Environmental Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected Jan 15, 2025 |
| Apr 9, 2024 | K-0712 | Have simulated fire drills held at unexpected times. Miscellaneous Deficiencies · Environment & life safety | L · Immediate jeopardy Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | E-0004 | Develop and maintain an Emergency Preparedness Program (EP). Emergency Preparedness Deficiencies · Emergency preparedness | F · Potential harm Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | E-0006 | Conduct risk assessment and an All-Hazards approach. Emergency Preparedness Deficiencies · Emergency preparedness | F · Potential harm Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | E-0009 | Include a process for Emergency Preparedness collaboration. Emergency Preparedness Deficiencies · Emergency preparedness | F · Potential harm Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | E-0013 | Develop Emergency Preparedness policies and procedures. Emergency Preparedness Deficiencies · Emergency preparedness | F · Potential harm Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | E-0015 | Address subsistence needs for staff and patients. Emergency Preparedness Deficiencies · Emergency preparedness | F · Potential harm Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | E-0018 | Establish procedures for tracking staff and patients during an emergency. Emergency Preparedness Deficiencies · Emergency preparedness | F · Potential harm Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | E-0020 | Establish policies and procedures including evacuation. Emergency Preparedness Deficiencies · Emergency preparedness | F · Potential harm Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | E-0022 | Establish policies and procedures for sheltering. Emergency Preparedness Deficiencies · Emergency preparedness | F · Potential harm Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | E-0023 | Establish policies and procedures for medical documentation. Emergency Preparedness Deficiencies · Emergency preparedness | F · Potential harm Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | E-0024 | Establish policies and procedures for volunteers. Emergency Preparedness Deficiencies · Emergency preparedness | F · Potential harm Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | E-0025 | Create arrangements with other facilities to receive patients. Emergency Preparedness Deficiencies · Emergency preparedness | F · Potential harm Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | E-0029 | Develop a communication plan. Emergency Preparedness Deficiencies · Emergency preparedness | F · Potential harm Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | E-0030 | List the names and contact information of those in the facility. Emergency Preparedness Deficiencies · Emergency preparedness | F · Potential harm Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | E-0031 | Provide emergency officials' contact information. Emergency Preparedness Deficiencies · Emergency preparedness | F · Potential harm Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | E-0032 | Provide primary/alternate means for communication. Emergency Preparedness Deficiencies · Emergency preparedness | F · Potential harm Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | E-0033 | Establish methods for sharing information. Emergency Preparedness Deficiencies · Emergency preparedness | F · Potential harm Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | E-0034 | Provide a means of sharing information on occupancy/needs. Emergency Preparedness Deficiencies · Emergency preparedness | F · Potential harm Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | E-0035 | Provide family notifications of emergency plan. Emergency Preparedness Deficiencies · Emergency preparedness | F · Potential harm Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | E-0036 | Establish emergency prep training and testing. Emergency Preparedness Deficiencies · Emergency preparedness | F · Potential harm Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | E-0037 | Establish staff and initial training requirements. Emergency Preparedness Deficiencies · Emergency preparedness | F · Potential harm Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | E-0039 | Conduct testing and exercise requirements. Emergency Preparedness Deficiencies · Emergency preparedness | F · Potential harm Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | K-0131 | Meet requirements for sections of health care facilities separated by fire resistive construction. Construction Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected May 31, 2024 |
| Apr 9, 2024 | K-0222 | Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements. Egress Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected Jun 12, 2024 |
| Apr 9, 2024 | K-0226 | Have horizontal exits used in accordance with safety requirements. Egress Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected May 31, 2024 |
| Apr 9, 2024 | K-0281 | Install proper backup exit lighting. Egress Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected May 31, 2024 |
| Apr 9, 2024 | K-0293 | Have properly located and lighted "Exit" signs. Egress Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected May 31, 2024 |
| Apr 9, 2024 | K-0321 | Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. Smoke Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | K-0345 | Have approved installation, maintenance and testing program for fire alarm systems. Smoke Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | K-0353 | Inspect, test, and maintain automatic sprinkler systems. Smoke Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected May 31, 2024 |
| Apr 9, 2024 | K-0355 | Properly select, install, inspect, or maintain portable fire extinguishes. Smoke Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected Jun 12, 2024 |
| Apr 9, 2024 | K-0711 | Provide a written emergency evacuation plan. Miscellaneous Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | K-0751 | Have restrictions on the use of flammable curtains. Miscellaneous Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected Jun 4, 2024 |
| Apr 9, 2024 | K-0761 | To conduct inspection, testing and maintenance of fire doors by qualified individuals. Miscellaneous Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | K-0921 | Ensure that testing and maintenance of electrical equipment is performed. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected Jun 12, 2024 |
| Apr 9, 2024 | K-0932 | Meet other general requirements. Smoke Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected May 31, 2024 |
| Apr 9, 2024 | F-0578 | Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. Resident Rights Deficiencies · Resident rights & abuse/neglect | E · Potential harm Pattern | Corrected May 31, 2024 |
| Apr 9, 2024 | F-0584 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. Resident Rights Deficiencies · Resident rights & abuse/neglect | E · Potential harm Pattern | Corrected Jun 14, 2024 |
| Apr 9, 2024 | F-0692 | Provide enough food/fluids to maintain a resident's health. Quality of Life and Care Deficiencies · Clinical care | E · Potential harm Pattern | Corrected May 31, 2024 |
| Apr 9, 2024 | F-0725 | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. Nursing and Physician Services Deficiencies · Staffing & supervision | F · Potential harm Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | F-0800 | Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs. Nutrition and Dietary Deficiencies · Food, nutrition & hydration | F · Potential harm Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | 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 May 31, 2024 |
| Apr 9, 2024 | F-0802 | Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. Nutrition and Dietary Deficiencies · Food, nutrition & hydration | F · Potential harm Widespread | Corrected May 24, 2024 |
| Apr 9, 2024 | F-0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · Food, nutrition & hydration | F · Potential harm Widespread | Corrected Jun 12, 2024 |
| Apr 9, 2024 | F-0851 | Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data. Administration Deficiencies · Administration & records | F · Potential harm Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | F-0865 | Have a plan that describes the process for conducting QAPI and QAA activities. Administration Deficiencies · Administration & records | F · Potential harm Widespread | Corrected Jun 12, 2024 |
| Apr 9, 2024 | F-0867 | Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. Administration Deficiencies · Administration & records | F · Potential harm Widespread | Corrected Jun 12, 2024 |
| Apr 9, 2024 | F-0868 | Have the Quality Assessment and Assurance group have the required members and meet at least quarterly Administration Deficiencies · Administration & records | F · Potential harm Widespread | Corrected Jun 7, 2024 |
| Apr 9, 2024 | F-0880 | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention | E · Potential harm Pattern | Corrected May 31, 2024 |
| Apr 9, 2024 | F-0924 | Put firmly secured handrails on each side of hallways. Environmental Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected May 10, 2024 |
| Apr 9, 2024 | F-0925 | Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. Environmental Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | F-0577 | Allow residents to easily view the nursing home's survey results and communicate with advocate agencies. Resident Rights Deficiencies · Resident rights & abuse/neglect | C · Minimal Widespread | Corrected May 17, 2024 |
| Apr 9, 2024 | F-0679 | Provide activities to meet all resident's needs. Quality of Life and Care Deficiencies · Clinical care | C · Minimal Widespread | Corrected May 31, 2024 |
| Apr 9, 2024 | F-0838 | Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies. Administration Deficiencies · Administration & records | C · Minimal Widespread | Corrected May 17, 2024 |
Reported from Payroll-Based Journal (PBJ) data, as published by CMS. Case-mix adjusted total: 5.19 (case-mix index 1.30).