Harmony Manor Skilled Nursing Facility
118 East Haskell St., Winnemucca, NV 89445 · Humboldt County · (775) 623-5222
42 certified beds, about 33 residents a day · Government - Hospital district · Medicare and Medicaid since 1974
CMS high performing icon Inside a hospital Certified for Medicaid Certified for Medicare
Overall
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
5 of 5
CMS Care Compare ratings, data as of September 1, 2026 · CCN 295024 · See it on Medicare.gov · Compare with other homes
The record in brief
At its most recent standard inspection, on April 23, 2026, inspectors cited 8 health deficiencies (the Nevada average is 9.7, the national average 9.2).
None of its 24 health citations since April 2024 was rated as actual harm or immediate jeopardy.
CMS lists no fines against this home in the last three years.
Nurses and nurse aides worked 6.14 hours per resident per day, against 4.34 across Nevada and 3.86 nationally. Registered nurses accounted for 1.65 of those hours.
32.7% of nursing staff left within the year CMS measured (Nevada average 45.1%).
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.
804/24
602/25
1004/26
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 24 health citations on file.
Severity
Isolated
Pattern
Widespread
Immediate jeopardy
0J
0K
0L
Actual harm
0G
0H
0I
Potential for more than minimal harm
21D
1E
0F
Potential for minimal harm
0A
1B
1C
April 23, 2026Standard inspection, Complaint inspection · 10 citations
- D Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Inspectors wroteBased on clinical record review, interview and document review, the facility failed to ensure an incident of resident-to-resident physical abuse was reported to the State Agency (SA) for 1 of 12 sampled residents (Resident #10). This deficient practice had the potential to result in lack of investigation of alleged incidents of abuse by the facility and/or the SA, placing residents at risk for further abuse.
- D Respond appropriately to all alleged violations.
Inspectors wroteBased on clinical record review, interview and document review, the facility failed to provide documented evidence a fall resulting in pain, swelling, and a skin tear, with an age-indeterminate fracture identified on post-fall imaging was thoroughly investigated to determine if the incident was a result of neglect for 1 of 12 sampled residents (Resident #10). This deficient practice had the potential to result in physical and/or psychosocial harm to residents due to incidents with the potential to indicate neglect not being thoroughly investigated and documented to ensure appropriate protections were in place to prevent future neglect.
- D Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Inspectors wroteBased on observation, interview, record review, and document review, the facility failed to ensure a care plan was developed with interventions to assist a resident to maintain continence after the previously continent resident began to experience occasional incontinence for 1 of 12 sampled residents (Resident #24). This deficient practice had the potential to result in staff not offering the resident services or assistance to maintain continence resulting in the resident experiencing worsening urinary incontinence.
- D Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Inspectors wroteBased on observation, interview, record review, and document review, the facility failed to ensure a previously continent resident received assistance or interventions to ensure the resident maintained or improved the resident's level of urinary continence when the resident began to experience occasional incontinence for 1 of 12 sampled residents (Resident #24). This deficient practice had the potential to result in a resident's incontinence worsening due to a lack of interventions or assistance to maintain or improve the resident's continence.
- D Observe each nurse aide's job performance and give regular training.
Inspectors wroteBased on interview, document review, and personnel record review, the facility failed to ensure a nurse aide performance review was completed at least once every 12 months and areas of weakness were identified and addressed for 1 of 2 sampled Certified Nursing Assistants (CNAs) employed at the facility greater than one year (Employee #8). This deficient practice had the potential to affect the care provided to all residents in the facility.
- D 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.
Inspectors wroteBased on interview and document review, the facility failed to ensure the Facility Assessment accurately reflected current staffing needs for the facility. This deficient practice had the potential to deprive residents of necessary care and services required to meet each individual's needs and preferences.
- D Provide and implement an infection prevention and control program.
Inspectors wroteBased on observation, staff interview, and document review, the facility failed to ensure the staff maintained sanitary floor drains. This deficient practice had the potential to result in development and transmission of infection.
- D Develop and implement policies and procedures for flu and pneumonia vaccinations.
Inspectors wroteBased on interview, record review, and document review, the facility failed to ensure a resident with a progressive, neurodegenerative disease was screened for a pneumococcal (PNA) vaccine for 1 of 5 residents reviewed for vaccine compliance (Resident #32). This deficient practice had the potential to result in a resident with a chronic illness not receiving a vaccine with the potential to prevent the resident from developing a severe illness leading to increased disability or death.
- D Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.
Inspectors wroteBased on interview, personnel record review, and document review, the facility failed to ensure elder abuse prevention training was completed timely for 2 of 18 sampled employees (Employee #16 and #17). This deficient practice had the potential to place all residents at risk for abuse and neglect.
- D Provide behavior health training consistent with the requirements and as determined by a facility assessment.
Inspectors wroteBased on interview, personnel record review, and document review, the facility failed to ensure annual behavioral health care training was completed for 1 of 18 sampled employees (Employee #7). This deficient practice had the potential to prevent residents with behavioral health care needs from attaining or maintaining their highest practicable physical, mental and psychosocial well-being.
February 6, 2025Standard inspection · 6 citations
- D Ensure each resident receives an accurate assessment.
Inspectors wroteBased on interview, clinical record review, and document review, the facility failed to ensure the accuracy of a Minimum Data Set 3.0 (MDS) assessment for 1 of 12 sampled residents (Resident #10). This deficient practice had the potential for the care plan to omit current needs, services, and monitoring for residents.
- D Ensure the activities program is directed by a qualified professional.
Inspectors wroteBased on interview, personnel record review, and document review, the facility failed to employ a trained Activity Coordinator. This deficient practice had the potential to affect resident safety and satisfaction for the entire facility census.
- D Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Inspectors wroteBased on observation, interview, and document review, the facility failed to ensure resident information was not visible on an unattended computer screen. This deficient practice had the potential for unauthorized access to residents' protected health information.
- D Provide and implement an infection prevention and control program.
Inspectors wroteBased on observation, interview, and document review, the facility failed to ensure a Licensed Practical Nurse (LPN) donned gloves, according to the facility's policy, prior to removal and placement of transdermal patches. This deficient practice had the potential to transfer bacteria, germs, and residual medication between residents.
- C Post nurse staffing information every day.
Inspectors wroteBased on observation and interview, the facility failed to ensure current nursing hours were posted for the facility. This deficient practice had the potential to result in a lack of awareness for residents and visitors regarding the number of nursing staff on duty.
- B Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
Inspectors wroteBased on interview and document review, the facility failed to ensure Minimum Data Set 3.0 (MDS) assessments were encoded and transmitted timely for November 2024. The deficient practice had the potential to impact resident care by delaying the development and implementation of resident care plans.
April 4, 2024Standard inspection · 8 citations
- E Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Inspectors wroteBased on interview and document review, the facility failed to ensure Monthly Medication Reviews (MMR) were completed monthly for 4 of 5 residents reviewed for unnecessary medications (Resident #11, #14, #30, and #12).
- D Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Inspectors wroteBased on observation, clinical record review, document review, and interview, the facility failed to ensure a care plan was developed and implemented related to a resident's hearing deficit and the use of a hearing device for 1 of 12 sampled residents.
- D Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Inspectors wroteBased on observation, interview, clinical record review, and document review the facility failed to ensure 1 of 12 residents (Resident #10) had an active order for the use and monitoring of a urinary catheter and failed to ensure the resident urinary drainage bag was maintained at a safe and appropriate level. The failure to maintain the urine collection bag at the appropriate level could have resulted in urine flowing back into the residents bladder, placing the resident at increased risk for infection.
- D Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Inspectors wroteBased on interview, clinical record review, and document review, the facility failed to ensure a resident on a psychotropic medication had a gradual dose reduction (GDR) for 2 of 12 sampled residents (Resident #28 and #12).
- D Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
Inspectors wroteBased on interview and document review, the facility failed to accurately report 24-hour licensed nursing coverage documented on the payroll-based staffing (PBJ) requirements submitted to the Center for Medicare and Medicaid Services (CMS).
- D Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Inspectors wroteBased on observation, interview, and document review, the facility failed to ensure the Quality Assurance and Process Improvement (QAPI) committee had the required members.
- D Develop and implement policies and procedures for flu and pneumonia vaccinations.
Inspectors wroteBased on clinical record review, interview, and document review the facility failed to ensure 1 of 5 residents sampled for vaccinations (Resident #31) was screened for eligibility to receive an influenza vaccine, education regarding the vaccine was provided to the resident and/or the Resident Representative, and the vaccine was offered and either administered or declined.
- D 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.
Inspectors wroteBased on clinical record review, interview, and document review the facility failed to ensure 1 of 5 residents sampled for vaccinations (Resident #30) was screened for eligibility to receive an updated/booster dose of COVID-19 (COVID) vaccine, education regarding the vaccine was provided to the resident and/or the Resident Representative, and the vaccine was offered and either administered or declined.
Fire safety inspections
17 fire safety citations on file: 6 on April 23, 2026, 5 on February 6, 2025, 6 on April 4, 2024.
Every fire safety citation17 citations
- E Ensure that testing and maintenance of electrical equipment is performed.
- D Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.
- D Follow proper procedures when the fire alarm was out of service for more than 4 hours.
- D Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.
- D Have properly installed electrical wiring and gas equipment.
- D Have generator or other power source capable of supplying service within 10 seconds.
- D Provide emergency officials' contact information.
- D Have properly located and lighted "Exit" signs.
- D Inspect, test, and maintain automatic sprinkler systems.
- D Properly select, install, inspect, or maintain portable fire extinguishes.
- D Have properly installed electrical wiring and gas equipment.
- D Establish policies and procedures for sheltering.
- D Establish policies and procedures for medical documentation.
- D Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.
- D Follow proper procedures when the fire alarm was out of service for more than 4 hours.
- D Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.
- D Have simulated fire drills held at unexpected times.
Fines and payment denials
CMS lists no fines or payment denials against this home in the last three years. The national average is 0.9 fines per home.
Staffing
Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.
| Measure | This home | Nevada | United States |
|---|---|---|---|
| All nursing staff (RN, LPN and aides) | 6.14 | 4.34 | 3.86 |
| Registered nurses | 1.65 | 1.12 | 0.69 |
| All nursing staff on weekends | 5.37 | 3.86 | 3.42 |
| Nurse aides | 4.00 | ||
| Licensed practical nurses | 0.49 | ||
| Nursing staff turnover (share who left in a year) | 32.7% | 45.1% | 45.8% |
| Registered nurse turnover | 46.2% | 43.4% | 42.9% |
| Administrators who left | not reported |
CMS expects 2.96 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
Staffing by quarter, from daily payroll records
Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 6.45 on weekdays and 5.37 on weekends, 17% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 8.6% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 5.77 in April to June 2025 to 6.14 in January to March 2026.
| Quarter | All nursing staff | Registered nurses | Weekdays | Weekends | Contract staff share | Days with no RN hours | Residents a day |
|---|---|---|---|---|---|---|---|
| Jan to Mar 2026 | 6.14 | 1.65 | 6.45 | 5.37 | 8.6% | 0 of 90 | 33 |
| Oct to Dec 2025 | 5.75 | 1.42 | 6.06 | 4.98 | 6.8% | 0 of 92 | 34 |
| Jul to Sep 2025 | 5.88 | 1.43 | 6.09 | 5.35 | 3.5% | 0 of 92 | 34 |
| Apr to Jun 2025 | 5.77 | 1.39 | 6.18 | 4.74 | 2.8% | 0 of 91 | 32 |
| United States, Jan to Mar 2026 | 3.75 | 0.62 | 3.92 | 3.33 | 5.3% | 0.5% of days | |
| Nevada, Jan to Mar 2026 | 3.88 | 0.85 | 4.05 | 3.46 | 2.7% | 0.1% of days |
Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.
Quality measures
The measures CMS uses for the quality star. Lower is better for every one of them.
| Measure | This home | Nevada | US |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1 | 21.1 | 12.6 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 6.5 | 1.6 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 0.8 | 1.9 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 3.9 | 2.0 | 3.2 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 10.0 | 13.5 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 2.4 | 5.4 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 11.8 | 17.1 | 15.4 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 0.7 | 1.9 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 0.9 | 1.4 | 1.8 |
Owners and operators
Legal business name: HUMBOLDT GENERAL HOSPITAL.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Humboldt General Hospital | 5% or greater direct ownership interest | Organization | 100% | 07/01/1985 |
| Dunckhorst, Robyn | W-2 managing employee | Individual | 01/08/2021 | |
| Plummer, Kimberley | W-2 managing employee | Individual | 10/01/2018 | |
| Powers, Timothy | W-2 managing employee | Individual | 08/17/2020 | |
| Dunckhorst, Robyn | Corporate officer | Individual | 01/08/2021 | |
| Powers, Timothy | Corporate officer | Individual | 08/17/2020 |
As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.
Questions to ask on a visit
Chosen from this home's own inspection record.
- When is the care plan meeting, and can family attend it?Inspectors cited 5 problems in this area, most recently on April 23, 2026: "Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured."
- What changed in infection control since the last inspection, and who on staff is the infection preventionist?Inspectors cited 5 problems in this area, most recently on April 23, 2026: "Provide and implement an infection prevention and control program."
- Who is the administrator and director of nursing, and how long have they been in the job?Inspectors cited 4 problems in this area, most recently on April 23, 2026: "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."
- How are allegations of abuse or neglect reported and investigated, and who tells the family?Inspectors cited 3 problems in this area, most recently on April 23, 2026: "Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities."
Common questions
- What is Harmony Manor Skilled Nursing Facility's Medicare star rating?
- CMS rates Harmony Manor Skilled Nursing Facility 5 out of 5 stars overall, with 4 for health inspections, 5 for staffing and 5 for quality measures (CMS data as of September 1, 2026).
- How many deficiencies did Harmony Manor Skilled Nursing Facility get at its last inspection?
- 8 health deficiencies at the standard inspection on April 23, 2026. The Nevada average is 9.7.
- Has Harmony Manor Skilled Nursing Facility been fined?
- CMS lists no fines in the last three years.
- Does Harmony Manor Skilled Nursing Facility accept Medicaid?
- It is certified to take Medicaid (CMS lists it as "Medicare and Medicaid"). Certification does not mean a Medicaid bed is open: ask the admissions office.
- Who owns Harmony Manor Skilled Nursing Facility?
- CMS lists 6 owners and managers. Legal business name: HUMBOLDT GENERAL HOSPITAL.
Sources
- Ratings, staffing and fines: CMS Provider Information, released September 30, 2026, data as of September 1, 2026.
- Citations: CMS Health Deficiencies and Fire Safety Deficiencies.
- Owners: CMS Ownership. Penalties: CMS Penalties.
- Staffing by quarter: CMS Payroll Based Journal Daily Nurse Staffing, April 2025 to March 2026, summed by NursingHomeClear.
- Inspector summaries: CMS Full Statement of Deficiencies (CMS-2567 text), data as of September 1, 2026. Each quote is the part of the statement before the detailed findings.
- Inspection reports with the inspectors' full notes are on this home's Medicare.gov page.
- Something wrong on this page? Ask for a correction. We fix errors in our copy of the data; findings themselves can only be changed by CMS and the state.
- NursingHomeClear is independent and not affiliated with CMS, Medicare or any state agency. This page reports federal records; it does not rate, recommend or endorse any home, and it is not medical or legal advice.