Health inspections
Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.
Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.
Potential for minimal harm Potential for more than minimal harm Actual harm Immediate jeopardy Found on a complaint visit
Where its citations fall on CMS's grid
CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 8 health citations on file.
Severity
Isolated
Pattern
Widespread
Immediate jeopardy
0J
0K
0L
Actual harm
0G
0H
0I
Potential for more than minimal harm
7D
1E
0F
Potential for minimal harm
0A
0B
0C
February 25, 2026Standard inspection · 2 citations
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
Inspectors wroteBased on observation, interview, and record review, the facility did not ensure that a resident who is unable to carry out activities of daily living receives the necessary services to maintain good grooming and personal hygiene for 1 (R20) of 12 reviewed for ADLs (Activities of Daily Living). Surveyor observed R20 not being shaved on 2/23/26, 2/24/26, and the morning of 2/25/26. R20's care plan, wife, and R20 indicated he needs assistance with personal hygiene and grooming. Evidenced by:The facility policy, Nursing Care, Activities of Daily Living, dated 10/25, states, in part;.A program of activities of daily living is provided to residents to preserve ADL function, promote independence, self-esteem and dignity and achieve maximum level of function. Staff assist is provided as needed to complete tasks. On 2/23/26 at 4:04PM, Surveyor met R20. [...]
- D
Provide care or services that was trauma informed and/or culturally competent.
Inspectors wroteBased on record review and interview, the facility did not ensure 2 of 3 residents (R6 & R32) who are trauma survivors receive culturally competent, trauma-informed care in accordance with professional standards of practice and accounting for resident's experiences and preferences in order to eliminate or mitigate triggers that may cause re-traumatization of the resident. R6 has a diagnosis of PTSD (Post Traumatic Stress Disorder) and does not have a complete trauma assessment or a care plan addressing triggers, resident specific approaches, or interventions. The facility did not care plan R32's post-traumatic stress disorder and failed to include triggers and interventions to best support R32. This is evidenced by: Example 1: R6 was admitted to the facility on [DATE] with diagnoses that include major depressive disorder and PTSD (Post Traumatic Stress Disorder). [...]
December 23, 2025Complaint inspection · 2 citations
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Inspectors wroteBased on interview and record review, the facility did not ensure that all alleged violations involving abuse, neglect, exploitation, or mistreatment, are reported immediately to the administrator of the facility and to other officials, including the State Survey Agency, in accordance with State law through established procedures for 1 of 4 residents (R1) reviewed for abuse. An allegation of abuse was reported by staff to the facility on [DATE]. The alleged allegation of abuse had occurred 2 to 3 weeks prior. Evidenced by: The facility policy, entitled Policy and Procedure for Grievances, Mistreatment Investigations, Mistreatment Prevention and Injuries of Unknown Source, dated 12/18/25, states, in part: . Purpose: To prevent and prohibit mistreatment, abuse, neglect, involuntary seclusion, incidents of unknown source, and misappropriation of property of all residents. [...]
- D
Respond appropriately to all alleged violations.
Inspectors wroteBased on interview and record review, the facility did not ensure that in response to allegations of abuse, neglect, exploitation, or mistreatment, that all alleged violations are thoroughly investigated, and that steps were taken to prevent further abuse for 1 of 4 resident reviewed (R1). On 12/18/2025, the facility became aware of an abuse allegation regarding R1. The facility failed to provide evidence to prevent further abuse to R1 and other residents. The facility did not complete a thorough investigation of the alleged allegation of abuse. Evidenced by: The facility policy, entitled Policy and Procedure for Grievances, Mistreatment Investigations, Mistreatment Prevention and Injuries of Unknown Source, dated 12/18/25, states, in part: . Purpose: [...]
October 3, 2024Standard inspection, Complaint inspection · 4 citations
- E
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Inspectors wroteBased on interview, record review, and policy review, the facility failed to implement the facility's Abuse policy that prohibits staff to resident abuse for 1 of 1 resident (R46) reviewed for abuse in the sample of 14. Specifically, the facility did not protect R46 and other residents during the abuse investigation and failed to conduct a thorough investigation into the allegation of physical abuse as instructed in the facility's Abuse policy. This failure had the potential to negatively impact all 46 residents currently residing at the facility.
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Inspectors wroteBased on interview, record review, and policy review, the facility failed to report an allegation of staff to resident physical abuse for 1 of 1 resident (R46) reviewed in the sample of 14 residents to the State Agency (SA) immediately, but no later than 2 hours after the allegation was made when the incident involved abuse. This failure had the possibility to negatively impact all 46 residents currently residing at the facility.
- D
Respond appropriately to all alleged violations.
Inspectors wroteBased on interview, record review, and policy review, the facility failed to thoroughly investigate an allegation of physical abuse for 1 of 1 resident (R46) reviewed for abuse in the sample of 14 residents. This failure had the potential to negatively impact all 46 residents currently residing at the facility.
- D
Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
Inspectors wroteBased on interview and document review, the facility failed to ensure that 2 of 6 (Certified Nursing Assistants (CNA5 and CNA8) completed the minimum of 12 hours of inservice training per year. The lack of inservice trainings could have a negative impact for all 46 residents currently residing at the facility.
September 7, 2023Standard inspection · 0 citations
Fire safety inspections
20 fire safety citations on file: 5 on February 25, 2026, 5 on October 3, 2024, 10 on September 7, 2023.
Every fire safety citation20 citations
- E
Install an approved automatic sprinkler system.
K 351 · February 25, 2026 · Corrected (the home has a date of correction)
- E
Have power receptacles that are properly grounded.
K 912 · February 25, 2026 · Corrected (the home has a date of correction)
- D
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
K 372 · February 25, 2026 · Corrected (the home has a date of correction)
- D
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
K 521 · February 25, 2026 · Corrected (the home has a date of correction)
- D
Ensure proper usage of power strips and extension cords.
K 920 · February 25, 2026 · Corrected (the home has a date of correction)
- E
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
K 372 · October 3, 2024 · Corrected (the home has a date of correction)
- E
Have properly installed electrical wiring and gas equipment.
K 511 · October 3, 2024 · Corrected (the home has a date of correction)
- D
Provide properly protected cooking facilities.
K 324 · October 3, 2024 · Corrected (the home has a date of correction)
- D
Inspect, test, and maintain automatic sprinkler systems.
K 353 · October 3, 2024 · Corrected (the home has a date of correction)
- D
Install corridor and hallway doors that block smoke.
K 363 · October 3, 2024 · Corrected (the home has a date of correction)
- F
Develop Emergency Preparedness policies and procedures.
E 13 · September 7, 2023 · Corrected (the home has a date of correction)
- F
Properly select, install, inspect, or maintain portable fire extinguishes.
K 355 · September 7, 2023 · Corrected (the home has a date of correction)
- E
Have approved installation, maintenance and testing program for fire alarm systems.
K 345 · September 7, 2023 · Corrected (the home has a date of correction)
- E
Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke.
K 362 · September 7, 2023 · Corrected (the home has a date of correction)
- E
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
K 372 · September 7, 2023 · Corrected (the home has a date of correction)
- D
Meet requirements for sections of health care facilities separated by fire resistive construction.
K 131 · September 7, 2023 · Corrected (the home has a date of correction)
- D
Construct fire resistant interior walls.
K 331 · September 7, 2023 · Corrected (the home has a date of correction)
- D
Inspect, test, and maintain automatic sprinkler systems.
K 353 · September 7, 2023 · Corrected (the home has a date of correction)
- D
Install corridor and hallway doors that block smoke.
K 363 · September 7, 2023 · Corrected (the home has a date of correction)
- D
Have power receptacles that are properly grounded.
K 912 · September 7, 2023 · Corrected (the home has a date of correction)