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California CDPH state citations and administrative penalties, 1997 to early 2024 (archived dataset). Separate from federal CMS deficiencies.
| Severity | Isolated | Pattern | Widespread |
|---|---|---|---|
| Immediate jeopardy | J· | K· | L· |
| Actual harm | G4 | H· | I· |
| Potential harm | D54 | E11 | F25 |
| Minimal | A· | B1 |
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 23, 2026 | Health | Health Complaint | 3 | Actual harm | — | Open → |
| Jan 29, 2026 | Fire safety | Fire Safety Standard | 6 | Potential harm | — | Open → |
| Jan 29, 2026 | Health | Health Complaint, Health Standard | 19 | Actual harm | — | Open → |
| Sep 11, 2025 | Health | Health Complaint | 1 | Potential harm | — | Open → |
| Jul 2, 2025 | Health | Health Complaint | 1 | Potential harm | — | Open → |
| Jul 1, 2025 | Health | Health Complaint | 1 | Potential harm | — | Open → |
| Jun 3, 2025 | Health | Health Complaint | 1 | Potential harm | — | Open → |
| Mar 27, 2025 | Fire safety | Fire Safety Standard | 9 | Potential harm | — | Open → |
| Mar 27, 2025 | Health | Health Standard | 9 | Potential harm | — | Open → |
| Jan 21, 2025 | Health | Health Complaint | 1 | Potential harm | — | Open → |
| Oct 15, 2024 | Health | Health Complaint | 2 | Potential harm | — | Open → |
| May 28, 2024 | Health | Health Complaint | 1 | Potential harm | — | Open → |
| May 15, 2024 | Health | Health Complaint | 2 | Actual harm | — | Open → |
| May 6, 2024 | Health | Health Complaint | 1 | Potential harm | — | Open → |
| Apr 23, 2024 | Health | Health Complaint | 2 | Potential harm | — | Open → |
| Mar 28, 2024 | Fire safety | Fire Safety Standard | 7 | Potential harm | — | Open → |
| Mar 28, 2024 | Health | Health Complaint, Health Standard | 27 | Actual harm | — | Open → |
| Feb 16, 2024 | Health | Health Complaint | 1 | Potential harm | — | Open → |
| Dec 5, 2023 | Health | Health Complaint | 1 | Potential harm | — | Open → |
| Oct 26, 2023 | Health | Health Complaint | 1 | Potential harm | — | Open → |
| Oct 12, 2023 | Health | Health Complaint | 1 | Potential harm | — | Open → |
| Oct 3, 2023 | Health | Health Complaint | 1 | Potential harm | — | Open → |
| Date | Type | Amount | Payment denial | Record |
|---|---|---|---|---|
| Jul 23, 2026 | Civil money penalty (fine) | $13,870 | — | 555229|Fine|145833 |
| Jan 29, 2026 | Civil money penalty (fine) | $31,535 | — | 555229|Fine|137766 |
| Mar 28, 2024 | Civil money penalty (fine) | $59,660 | — | 555229|Fine|130864 |
| Issued | Class | Type | Category | Final amount | Flags | Record |
|---|---|---|---|---|---|---|
| Jun 5, 2024 violation Mar 25, 2024 | Class B | Citation Citation B (HSC 1424) | Patient Care | $3,000 | Closed | 120020246 |
| Jun 13, 2023 violation Oct 1, 2020 | AP NHPPD | Administrative Penalty AP - 3.2 Nursing-Hours-per-Patient-Day AP (HSC 1276.5) | DHPPD: 12 - 24 Days | $50,000 | Open | 810018829 |
| Oct 17, 2022 violation Aug 5, 2022 | Class B | Citation Citation B (HSC 1424) | Abuse/Facility Not Self Reported | $3,000 | Closed | 120018041 |
| Severity | Isolated | Pattern | Widespread |
|---|---|---|---|
| Immediate jeopardy | J· | K· | L· |
| Actual harm | G4 | H· | I· |
| Potential harm | D54 | E11 | F25 |
| Minimal | A· | B1 | C3 |
| Date | Tag | Deficiency | Scope / severity | Correction | Flags |
|---|---|---|---|---|---|
| Jul 23, 2026 | 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 | G · Actual harm Isolated | Corrected Aug 13, 2026 | Complaint |
| Jul 23, 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 | D · Potential harm Isolated | Corrected Aug 13, 2026 | Complaint |
“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 |
|---|---|---|---|---|---|
| Vpr Ops, LLC | Organization | Direct owner | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 50% | Jun 1, 2023 |
| Rush Melliti | Individual | Direct owner | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 25% | Jun 1, 2023 |
| Nathan Pease | Individual | Direct owner | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 25% | Jun 1, 2023 |
| Moishe Frankel | Individual | Indirect owner | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 25% | Jun 1, 2023 |
| David Levy | Individual | Indirect owner | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 25% | Jun 1, 2023 |
| Name | Type | Role (Carefield group) | CMS role text | Share | Since |
|---|---|---|---|---|---|
| Vpr Ops, LLC | Organization | Direct owner | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 50% | Jun 1, 2023 |
| Rush Melliti | Individual | Direct owner | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 25% | Jun 1, 2023 |
| Nathan Pease | Individual | Direct owner | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 25% | Jun 1, 2023 |
| Moishe Frankel | Individual | Indirect owner | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | 25% | Jun 1, 2023 |
| David Levy | Individual |
Coordinates as published by CMS.
| Facility | Distance | Beds | CMS overall | Last inspection | Citations (window) | Fines |
|---|---|---|---|---|---|---|
| The Orchards Post-Acute 730 34 Street, Bakersfield, CA 93301 CCN 5557027 state class AA/A | 2.4 km | 150 | Jun 18, 2026 | 1182 harm | $19k | |
| San Joaquin Nursing Center and Rehabilitation Cent 3601 San Dimas, Bakersfield, CA 93301 CCN 0562945 state class AA/A | 3.2 km | 99 | Aug 4, 2026 | 811 harm | $47k | |
| Rosewood Health Facility 1401 New Stine Road, Bakersfield, CA 93309 CCN 5551162 state class AA/A | 4.4 km | 79 | Feb 12, 2026 | 531 harm | $8,278 | |
| Parkview Julian Healthcare Center 1801 Julian Avenue, Bakersfield, CA 93304 CCN 0556014 state class AA/A | 4.6 km | 99 | Aug 11, 2026 | 1042 harm | $60k | |
| The Rehabilitation Center of Bakersfield 2211 Mount Vernon Avenue, Bakersfield, CA 93306 CCN 5552569 state class AA/A | 5.2 km | 160 | Jan 16, 2026 | 1255 harm | $24k | |
| Height Street Skilled Care 1611 Height Street, Bakersfield, CA 93305 CCN 5559025 state class AA/A | 5.6 km | 99 | Apr 27, 2026 | 934 harm | $13k | |
| Kern River Transitional Care 5151 Knudsen Drive, Bakersfield, CA 93308 CCN 555912 | 5.7 km | 140 | Apr 29, 2026 | 1091 harm | $78k | |
| Bakersfield Post Acute 6212 Tudor Way, Bakersfield, CA 93306 CCN 5552604 state class AA/A | 8.8 km | 99 | Aug 26, 2026 | 1302 harm | $26k |
| Source | Record | Facts | Evidence | Source release | Retrieved |
|---|---|---|---|---|---|
| CMS Provider Information US-CMS | 555229 | name, address, phone, certification, certified_beds, ownership_type, legal_business_name, chain | Verified | Oct 1, 2026 | Nov 7, 2026 |
| CMS Provider Information US-CMS | 555229 | 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 |
| California CDPH Licensed Facility Listing CA | 120000355 | state_license, licensed_beds, licensee Linked to the CMS record by exact CCN. | Verified | Oct 16, 2026 | Nov 7, 2026 |
First seen by Carefield Nov 7, 2026 · last changed Nov 7, 2026. This record as JSON · Report a correction
| Aug 26, 2022 violation Dec 27, 2021 | Class A | Citation Citation A (HSC 1424) | Patient Care | $20,000 | Closed | 120017799 |
| Aug 12, 2022 violation Jan 28, 2022 | Class A | Citation Citation A (HSC 1424) | Patient Care | $25,000 | Closed | 120017666 |
| Dec 5, 2019 violation Sep 14, 2019 | Class B | Citation Citation B (HSC 1424) | Abuse/Facility Not Self Reported | $2,000 | Closed | 120015519 |
| Dec 5, 2019 violation Aug 6, 2019 | Class B | Citation Citation B (HSC 1424) | Abuse/Facility Not Self Reported | $2,000 | Closed | 120015517 |
| Dec 5, 2019 violation Aug 6, 2019 | Class B | Citation Citation B (HSC 1424) | Patient Rights | $2,000 | Closed | 120015516 |
| Jul 17, 2018 violation Apr 14, 2018 | Class B | Citation Citation B (HSC 1424) | Abuse/Facility Not Self Reported | $2,000 | Closed | 120014233 |
| Jul 7, 2017 violation Feb 21, 2017 | Class AA | Citation Citation AA (HSC 1424) | Patient Care | $100,000 | Death related Closed | 120013119 |
| Jan 28, 2014 violation Jun 22, 2013 | Class B | Citation Citation B (HSC 1424) | Patient Care | $2,000 | Closed | 120010409 |
| Jan 28, 2014 violation Jun 11, 2013 | Class B | Citation Citation B (HSC 1424) | Patient Rights | $2,000 | Closed | 120010405 |
| Apr 13, 2011 violation Jun 27, 2009 | Class B | Citation Citation A (HSC 1424) | Patient Care | $7,200 initial $10,000 | Appealed Closed | 120006445 |
| Jul 7, 2009 violation Jul 16, 2008 | Class B | Citation Citation B (HSC 1424) | Patient Rights | $650 initial $1,000 | Appealed Closed | 120005521 |
| Dec 11, 2007 violation Sep 27, 2007 | Class B | Citation Citation B (HSC 1424) | Patient Rights | $0 initial $1,000 | Appealed Closed | 120004413 |
| Dec 11, 2007 violation Sep 27, 2007 | Class B | Citation Citation B (HSC 1424) | Patient Care | $650 initial $1,000 | Appealed Closed | 120004357 |
| Nov 7, 2007 violation Jun 26, 2007 | Class B | Citation Citation B (HSC 1424) | Patient Care | $650 initial $1,000 | Appealed Closed | 120004192 |
| Nov 7, 2007 violation Jul 16, 2007 | Class A | Citation Citation A (HSC 1424) | Patient Care | $0 initial $20,000 | Appealed Closed | 120004186 |
| Nov 7, 2007 violation Jun 26, 2007 | Class A | Citation Citation A (HSC 1424) | Patient Care | $13,000 initial $20,000 | Appealed Closed | 120004185 |
| Oct 31, 2007 violation Feb 3, 2007 | Class B | Citation Citation B (HSC 1424) | Patient Care | $1,000 | Closed | 120004358 |
| Feb 15, 2006 violation Feb 28, 2004 | Class B | Citation Citation B (HSC 1424) | Patient Care | $1,000 | Closed | 120001846 |
| Jan 20, 2005 violation Nov 8, 2003 | Class B | Citation Citation B (HSC 1424) | Patient Care | $500 | Closed | 120001817 |
| Jan 20, 2005 violation Nov 8, 2003 | Class B | Citation Citation B (HSC 1424) | Patient Care | $500 | Closed | 120001816 |
| Nov 8, 2004 violation Oct 9, 2003 | Class A | Citation Citation A (HSC 1424) | Patient Care | $5,000 | Closed | 120001797 |
| Dec 31, 2003 violation Jul 5, 2003 | Class B | Citation Citation B (HSC 1424) | Patient Care | $1,000 | Closed | 120001763 |
| Oct 19, 2001 violation Sep 24, 2001 | Class B | Citation Citation B (HSC 1424) | Patient Rights | $1,000 | Closed | 120001537 |
| Jul 23, 2026 | F-0658 | Ensure services provided by the nursing facility meet professional standards of quality. Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Aug 13, 2026 | Complaint |
| Jan 29, 2026 | F-0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. Quality of Life and Care Deficiencies · Clinical care | G · Actual harm Isolated | Corrected Feb 26, 2026 |
| Jan 29, 2026 | K-0345 | Have approved installation, maintenance and testing program for fire alarm systems. Smoke Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected Feb 17, 2026 |
| Jan 29, 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 | F · Potential harm Widespread | Corrected Feb 24, 2026 |
| Jan 29, 2026 | K-0920 | Ensure proper usage of power strips and extension cords. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Feb 24, 2026 |
| Jan 29, 2026 | K-0923 | Have proper medical gas storage and administration areas. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Feb 24, 2026 |
| Jan 29, 2026 | F-0580 | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Resident Rights Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Feb 26, 2026 |
| Jan 29, 2026 | F-0605 | 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 Feb 26, 2026 |
| Jan 29, 2026 | F-0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Feb 26, 2026 |
| Jan 29, 2026 | F-0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Feb 26, 2026 | Complaint |
| Jan 29, 2026 | F-0658 | Ensure services provided by the nursing facility meet professional standards of quality. Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Feb 26, 2026 | Complaint |
| Jan 29, 2026 | F-0679 | Provide activities to meet all resident's needs. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Feb 26, 2026 |
| Jan 29, 2026 | 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 Feb 26, 2026 |
| Jan 29, 2026 | F-0726 | Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. Nursing and Physician Services Deficiencies · Staffing & supervision | D · Potential harm Isolated | Corrected Feb 26, 2026 |
| Jan 29, 2026 | F-0728 | Ensure that nurse aides who have worked more than 4 months, are trained and competent; and nurse aides who have worked less than 4 months are enrolled in appropriate training. Nursing and Physician Services Deficiencies · Staffing & supervision | E · Potential harm Pattern | Corrected Feb 26, 2026 |
| Jan 29, 2026 | F-0755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. Pharmacy Service Deficiencies · Medication management | E · Potential harm Pattern | Corrected Feb 26, 2026 |
| Jan 29, 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 Feb 26, 2026 |
| Jan 29, 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 | D · Potential harm Isolated | Corrected Feb 26, 2026 |
| Jan 29, 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 | D · Potential harm Isolated | Corrected Feb 26, 2026 |
| Jan 29, 2026 | F-0880 | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention | D · Potential harm Isolated | Corrected Feb 26, 2026 |
| Jan 29, 2026 | F-0908 | Keep all essential equipment working safely. Environmental Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected Feb 26, 2026 |
| Jan 29, 2026 | F-0912 | Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms. Environmental Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Feb 26, 2026 |
| Jan 29, 2026 | F-0919 | Make sure that a working call system is available in each resident's bathroom and bathing area. Environmental Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected Feb 26, 2026 | Complaint |
| Jan 29, 2026 | F-0921 | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. Environmental Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected Feb 26, 2026 |
| Jan 29, 2026 | E-0015 | Address subsistence needs for staff and patients. Emergency Preparedness Deficiencies · Emergency preparedness | C · Minimal Widespread | Corrected Feb 24, 2026 |
| Jan 29, 2026 | E-0030 | List the names and contact information of those in the facility. Emergency Preparedness Deficiencies · Emergency preparedness | C · Minimal Widespread | Corrected Feb 24, 2026 |
| Sep 11, 2025 | F-0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Oct 1, 2025 | Complaint |
| Jul 2, 2025 | 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 Aug 1, 2025 | Complaint |
| Jul 1, 2025 | F-0692 | Provide enough food/fluids to maintain a resident's health. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Jul 10, 2025 | Complaint |
| Jun 3, 2025 | 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 1, 2025 | Complaint |
| Mar 27, 2025 | K-0161 | Use approved construction type or materials. Construction Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Apr 28, 2025 |
| Mar 27, 2025 | K-0291 | Install emergency lighting that can last at least 1 1/2 hours. Egress Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected Apr 28, 2025 |
| Mar 27, 2025 | K-0293 | Have properly located and lighted "Exit" signs. Egress Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected Apr 9, 2025 |
| Mar 27, 2025 | K-0345 | Have approved installation, maintenance and testing program for fire alarm systems. Smoke Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected Apr 14, 2025 |
| Mar 27, 2025 | K-0363 | Install corridor and hallway doors that block smoke. Smoke Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Apr 9, 2025 |
| Mar 27, 2025 | K-0511 | Have properly installed electrical wiring and gas equipment. Services Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Apr 7, 2025 |
| Mar 27, 2025 | K-0521 | Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions. Services Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected Apr 14, 2025 |
| Mar 27, 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 Apr 7, 2025 |
| Mar 27, 2025 | F-0580 | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Resident Rights Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Apr 18, 2025 |
| Mar 27, 2025 | F-0698 | Provide safe, appropriate dialysis care/services for a resident who requires such services. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Apr 18, 2025 |
| Mar 27, 2025 | 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 | E · Potential harm Pattern | Corrected Apr 18, 2025 |
| Mar 27, 2025 | 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 | D · Potential harm Isolated | Corrected Apr 18, 2025 |
| Mar 27, 2025 | F-0865 | Have a plan that describes the process for conducting QAPI and QAA activities. Administration Deficiencies · Administration & records | F · Potential harm Widespread | Corrected Apr 18, 2025 |
| Mar 27, 2025 | F-0880 | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention | E · Potential harm Pattern | Corrected Apr 18, 2025 |
| Mar 27, 2025 | F-0912 | Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms. Environmental Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected Apr 18, 2025 |
| Mar 27, 2025 | F-0919 | Make sure that a working call system is available in each resident's bathroom and bathing area. Environmental Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected Apr 18, 2025 |
| Mar 27, 2025 | K-0353 | Inspect, test, and maintain automatic sprinkler systems. Smoke Deficiencies · Environment & life safety | C · Minimal Widespread | Corrected Apr 9, 2025 |
| Jan 21, 2025 | 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 | D · Potential harm Isolated | Corrected Feb 3, 2025 | Complaint |
| Oct 15, 2024 | F-0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Nov 11, 2024 | Complaint |
| Oct 15, 2024 | F-0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Nov 11, 2024 | Complaint |
| May 28, 2024 | F-0576 | Ensure residents have reasonable access to and privacy in their use of communication methods. Resident Rights Deficiencies · Resident rights & abuse/neglect | E · Potential harm Pattern | Corrected Jun 21, 2024 | Complaint |
| May 15, 2024 | F-0837 | Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility. Administration Deficiencies · Administration & records | G · Actual harm Isolated | Corrected Jun 12, 2024 | Complaint |
| May 15, 2024 | F-0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Jun 12, 2024 | Complaint |
| May 6, 2024 | F-0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Resident Rights Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Jun 21, 2024 | Complaint |
| Apr 23, 2024 | 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 Jun 12, 2024 | Complaint |
| Apr 23, 2024 | F-0908 | Keep all essential equipment working safely. Environmental Deficiencies · Environment & life safety | E · Potential harm Pattern | Corrected Jun 12, 2024 | Complaint |
| Mar 28, 2024 | F-0687 | Provide appropriate foot care. Quality of Life and Care Deficiencies · Clinical care | G · Actual harm Isolated | Corrected Apr 28, 2024 |
| Mar 28, 2024 | E-0039 | Conduct testing and exercise requirements. Emergency Preparedness Deficiencies · Emergency preparedness | F · Potential harm Widespread | Corrected Apr 26, 2024 |
| Mar 28, 2024 | K-0291 | Install emergency lighting that can last at least 1 1/2 hours. Egress Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected Apr 26, 2024 |
| Mar 28, 2024 | K-0293 | Have properly located and lighted "Exit" signs. Egress Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected Apr 26, 2024 |
| Mar 28, 2024 | K-0347 | Properly provide smoke detection systems in areas open to corridors. Smoke Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected Apr 26, 2024 |
| Mar 28, 2024 | K-0363 | Install corridor and hallway doors that block smoke. Smoke Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Apr 26, 2024 |
| Mar 28, 2024 | 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 Apr 26, 2024 |
| Mar 28, 2024 | K-0926 | Ensure that personnel concerned with handling of medical gases and cylinders are trained on the risk. Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected Apr 26, 2024 |
| Mar 28, 2024 | F-0552 | Ensure that residents are fully informed and understand their health status, care and treatments. Resident Rights Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Apr 28, 2024 | Complaint |
| Mar 28, 2024 | F-0558 | Reasonably accommodate the needs and preferences of each resident. Resident Rights Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Apr 28, 2024 |
| Mar 28, 2024 | F-0580 | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Resident Rights Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Apr 28, 2024 |
| Mar 28, 2024 | F-0624 | Prepare residents for a safe transfer or discharge from the nursing home. Resident Rights Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Apr 28, 2024 |
| Mar 28, 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 | F · Potential harm Widespread | Corrected Apr 28, 2024 |
| Mar 28, 2024 | F-0638 | Assure that each resident’s assessment is updated at least once every 3 months. Resident Assessment and Care Planning Deficiencies · Clinical care | E · Potential harm Pattern | Corrected Apr 28, 2024 |
| Mar 28, 2024 | F-0655 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Apr 28, 2024 | Complaint |
| Mar 28, 2024 | F-0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Apr 28, 2024 |
| Mar 28, 2024 | F-0658 | Ensure services provided by the nursing facility meet professional standards of quality. Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Apr 28, 2024 | Complaint |
| Mar 28, 2024 | F-0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Apr 28, 2024 | Complaint |
| Mar 28, 2024 | F-0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Apr 28, 2024 |
| Mar 28, 2024 | 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 | D · Potential harm Isolated | Corrected Apr 28, 2024 | Complaint |
| Mar 28, 2024 | F-0700 | Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Apr 28, 2024 |
| Mar 28, 2024 | F-0726 | Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. Nursing and Physician Services Deficiencies · Staffing & supervision | F · Potential harm Widespread | Corrected Apr 28, 2024 |
| Mar 28, 2024 | F-0727 | Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis. Nursing and Physician Services Deficiencies · Staffing & supervision | D · Potential harm Isolated | Corrected Apr 28, 2024 |
| Mar 28, 2024 | F-0756 | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. Pharmacy Service Deficiencies · Medication management | E · Potential harm Pattern | Corrected Apr 28, 2024 |
| Mar 28, 2024 | F-0759 | Ensure medication error rates are not 5 percent or greater. Pharmacy Service Deficiencies · Medication management | D · Potential harm Isolated | Corrected Apr 28, 2024 |
| Mar 28, 2024 | 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 Apr 28, 2024 |
| Mar 28, 2024 | 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 | D · Potential harm Isolated | Corrected Apr 28, 2024 |
| Mar 28, 2024 | F-0808 | Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law. Nutrition and Dietary Deficiencies · Food, nutrition & hydration | D · Potential harm Isolated | Corrected Apr 28, 2024 |
| Mar 28, 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 Apr 28, 2024 |
| Mar 28, 2024 | F-0880 | Provide and implement an infection prevention and control program. Infection Control Deficiencies · Infection prevention | F · Potential harm Widespread | Corrected Apr 28, 2024 |
| Mar 28, 2024 | F-0883 | Develop and implement policies and procedures for flu and pneumonia vaccinations. Infection Control Deficiencies · Infection prevention | F · Potential harm Widespread | Corrected Apr 28, 2024 |
| Mar 28, 2024 | F-0887 | Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status. Infection Control Deficiencies · Infection prevention | F · Potential harm Widespread | Corrected Apr 28, 2024 |
| Mar 28, 2024 | F-0949 | Provide behavior health training consistent with the requirements and as determined by a facility assessment. Administration Deficiencies · Administration & records | F · Potential harm Widespread | Corrected Apr 28, 2024 |
| Mar 28, 2024 | F-0912 | Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms. Environmental Deficiencies · Environment & life safety | B · Minimal Pattern | Corrected Apr 28, 2024 |
| Feb 16, 2024 | F-0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Feb 23, 2024 | Complaint |
| Dec 5, 2023 | 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 Jan 4, 2024 | Complaint |
| Oct 26, 2023 | F-0655 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Nov 19, 2023 | Complaint |
| Oct 12, 2023 | F-0660 | Plan the resident's discharge to meet the resident's goals and needs. Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Nov 2, 2023 | Complaint |
| Oct 3, 2023 | F-0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Oct 23, 2023 | Complaint |
Reported from Payroll-Based Journal (PBJ) data, as published by CMS. Case-mix adjusted total: 3.85 (case-mix index 1.40).
| Indirect owner |
| 5% OR GREATER INDIRECT OWNERSHIP INTEREST |
| 25% |
| Jun 1, 2023 |
| Moishe Frankel | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | Jun 1, 2023 |
| Sarah Keeney | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | Jul 22, 2024 |
| Melvin Leonidas | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | Apr 24, 2024 |
| David Levy | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | Jun 1, 2023 |
| Rush Melliti | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | Jun 1, 2023 |
| Nathan Pease | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | Jun 1, 2023 |
| Sarabjeet Singh | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | May 1, 2024 |
| Dio Telmo | Individual | Operational / managerial control | OPERATIONAL/MANAGERIAL CONTROL | not provided | Aug 16, 2024 |
| Moishe Frankel | Individual | Corporate officer / director | CORPORATE OFFICER | not provided | Jun 1, 2023 |
| David Levy | Individual | Corporate officer / director | CORPORATE OFFICER | not provided | Jun 1, 2023 |
| Nathan Pease | Individual | Corporate officer / director | CORPORATE OFFICER | not provided | Jun 1, 2026 |
| Moishe Frankel | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Jun 1, 2023 |
| Sarah Keeney | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Jul 22, 2024 |
| Melvin Leonidas | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Apr 24, 2024 |
| David Levy | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Jun 1, 2023 |
| Rush Melliti | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Jun 1, 2023 |
| Nathan Pease | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Jun 1, 2023 |
| Sarabjeet Singh | Individual | Additional disclosable party | ADP OF THE SNF | not provided | May 1, 2024 |
| Dio Telmo | Individual | Additional disclosable party | ADP OF THE SNF | not provided | Aug 16, 2024 |