2850 Ruby Vista Drive, Elko, NV 89801 · Elko County · (775) 753-5500
146 certified beds, about 91 residents a day · For profit - Limited Liability company · Medicare and Medicaid since 2001
CMS Care Compare ratings, data as of September 1, 2026 · CCN 295078 · See it on Medicare.gov · Compare with other homes
At its most recent standard inspection, on August 7, 2025, inspectors cited 8 health deficiencies (the Nevada average is 9.7, the national average 9.2).
None of its 32 health citations since May 2023 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 3.37 hours per resident per day, against 4.34 across Nevada and 3.86 nationally. Registered nurses accounted for 0.71 of those hours.
45.5% of nursing staff left within the year CMS measured (Nevada average 45.1%).
CMS links it to The Charly Bello Family, the Maze Family, the Swain Family, & Walter Myers, an affiliated group of 20 nursing homes.
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.
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 32 health citations on file.
Inspectors wroteBased on interview and document review, the facility failed to ensure staff, residents, and residents' families were provided education at least annually regarding the facility's antibiotic stewardship program according to facility policy. This deficient practice had the potential to result in suboptimal treatment of infections and lack of knowledgeable staff to follow the facility's antibiotic use protocols.
Inspectors wroteBased on observation, interview, and document review, the facility failed to ensure staff performed hand hygiene upon entering the food preparation area of the kitchen and kitchenettes, and sanitary food handling occurred during lunchtime meal service. This deficient practice had the potential to result in placing residents at risk for food-borne illnesses.
Inspectors wroteBased on clinical record review, interview, observation, and document review, the facility failed to ensure a resident maintained a dignified existence when a resident's catheter drainage bag was visible with urine while the resident was in the hallway and in a communal area of the facility for 1 unsampled residents (Resident #4). This deficient practice had the potential to result in avoidable psychosocial harm to the resident.
Inspectors wroteBased on observation, interview, clinical record review, and document review the facility failed to ensure the Garden Court Unit (memory care unit) was free from accident hazards when a broken planter box with exposed nails/staples was in an area accessible to 28 of 28 residents residing on the unit and when staff provided hand sanitizing wipes to residents in the dining area without adequate supervision and a resident placed the sanitizing wipe in the resident's mouth (Resident #47). This deficient practice had the potential to result in injuries to residents and staff.
Inspectors wroteBased on observation, interview, record review, and document review, the facility failed to ensure a physician's order for dialysis was obtained for 1 of 3 residents (Resident #1) prior to the resident receiving dialysis treatments. This deficient practice had the potential to result in the resident not being assessed and monitored appropriately before and after dialysis. The importance of pre and post dialysis monitoring and assessments was to ensure the resident did not have an adverse outcome associated with dialysis including hypotension, muscle spasms, abnormal heart rhythms, and electrolyte imbalances.
Inspectors wroteBased on interview, clinical record review, and document review, the facility failed to ensure a clinical record was complete for 1 of 18 sampled residents (Resident #5). This deficient practice had the potential for care provided to residents, resident response to care provided, and refusals of care to not be documented and available for review as necessary.
Inspectors wroteBased on observation, clinical record review, interview, and document review, the facility failed to adhere to proper infection control protocols by 1) allowing a resident's catheter tubing to drag on the floor while the resident was seated in a wheelchair for 1 unsampled residents (Resident #4) and 2) failing to ensure reusable resident-care equipment was cleaned and disinfected after each use. This deficient practice had the potential to result in contamination of the catheter tubing, urinary tract infections, increased risk of other complications for the resident, and spread of infectious organisms throughout the facility.
Inspectors wroteBased on clinical record review, interview, and document review the facility failed to ensure 1 of 5 residents sampled for vaccines (Resident #69) was offered a 2024-2025 COVID-19 (Covid) vaccine after consenting to the vaccine. This deficient practice had the potential to result in severe illness and/or hospitalization from infection with Covid.
Inspectors wroteBased on observation, interview and document review the facility failed to ensure hand washing was performed between the passing of resident beverages, touching residents and in between assisting two residents with eating.
Inspectors wroteBased on observation, clinical record review, interview, and document review the facility failed to ensure 1) Enhanced Barrier Precautions (EBP) were implemented for 2 of 7 sampled residents (Resident #58 and #69), 2) the facility peformed active infection surveillance for July 2024, 3) a Licensed Practical Nurse (LPN) performed hand hygiene between residents while administering medications and 4) a resident on contact precautions did not share a room with another resident who did not have the same infection with the same microorganism, did not have meals in a shared dining room, and staff understood the Personal Protective Equipment (PPE) requirements when entering a room with contact precuation signage in place for 1 of 18 sampled residents (Resident #40).
Inspectors wroteBased on document review and interview, the facility failed to ensure tracking and trending of infections and antibiotic use was accurately monitored and completed for July 2024 for 2 of 2 residents on an antibiotic and diagnosed with an infection (Resident #13 and #8). The deficient practice had the potential to affect the facility's entire resident census of 79.
Inspectors wroteBased on observation, interview, clinical record review and document review the facility failed to ensure 1) the Director of Nursing (DON) had the knowledge necessary to correctly implement contact precautions for a resident with known infection with a Multi-Drug Resistant Organism (MDRO), and 2) the DON had the knowledge and skills necessary to access resident records and navigate the Electronic Medical Record (EMR) after the facility underwent a change of ownership with a new EMR program. This lack of knowledge had the potential to effect the entire census of 79.
Inspectors wroteBased on observation, interview, clinical record review, and document review, the facility failed to 1) ensure the Infection Preventionist (IP) had the education and competency to demonstrate the tracking and trending of infections was accurately completed and monitored with the potential to affect the facility's entire resident census of 79, 2) retain education and training when the Infection Preventionist did not demonstrate competency in the implementation of the Antibiotic Stewardship Program (ASP) and infection surveillance (lack of competency in medication differentiation, inaccurate infection control log, lack of infection surveillance), and 3) demonstrate understanding of contact precautions and following of the Center for Disease Control (CDC) guidance related to the implementation of contact precautions for 1 of 18 sampled residents (Resident #40).
Inspectors wroteBased on observation, interview, record review and document review the facility failed to ensure a resident's call light was not draped over an oxygen concentrator and out of reach of the resident for 1 of 18 sampled residents (Resident #53).
Inspectors wroteBased on interview, clinical record review, and document review, the facility failed to ensure a resident's fall with major injury, resulting in a fracture and incurred at the facility, was reported to the State Agency (Resident #132). The deficient practice could allow a fall with major injury to not be investigated for potential abuse or neglect and not be reported to the State Agency (SA).
Inspectors wroteBased on observation, interview, and document review, the facility failed to ensure 1) a comprehensive care plan was updated to reflect the assessed wound staging for a Stage III pressure ulcer (Resident #69) and 2) a comprehensive care plan for a resident with a history of falls was updated when new interventions were implemented (Resident #31) for 2 of 18 sampled residents.
Inspectors wroteBased on observation, clinical record review, interview, and document review, the facility failed to ensure the catheter drainage bag for a resident with a Foley catheter was placed below the level of the resident's bladder to prevent the potential for urine in the tubing and draining bag from flowing back into the bladder for 1 of 18 sampled residents (Resident #58).
Inspectors wroteBased on interview, clinical record review, and document review, the facility failed to ensure a resident with an ostomy received care consistent with professional standards of practice when a Certified Nursing Assistant (CNA) changed the resident's colostomy wafer for 1 of 18 sampled residents (Resident #21).
Inspectors wroteBased on observation, interview, clinical record review, and document review the facility failed to ensure oxygen was administered as ordered for 1 of 19 sampled residents (Resident #25).
Inspectors wroteBased on observation, clinical record review, interview, and document review the facility failed to ensure Dialysis Communication forms were completed and maintained for 1 of 18 sampled residents (Resident #24) and a resident with a hemodialysis catheter did not share a room with a resident who had a wound infected with a multi-drug resistant organism (MDRO) for 1 of 18 sampled residents (Resident #26).
Inspectors wroteBased on observation, interview, and document review the facility failed to ensure expired medications were not kept in a medication cart for 1 of 2 medication carts reviewed for medication storage.
Inspectors wroteBased on interview, document review, and clinical record review, the facility failed to ensure treatment administered, side effect monitoring, pain monitoring, COVID-19 symptom monitoring, and behavior monitoring was documented for 1 of 18 sampled residents (Resident #20).
Inspectors wroteBased on clinical record review, interview, and document review the facility failed to ensure a resident was screened for eligibility to receive the influenza and pneumococcal vaccinations for 1 of 5 residents sampled for vaccinations (Resident #26).
Inspectors wroteBased on observation and interview, the facility failed to ensure the most recent survey results were made available in the facility's secured memory care unit to be readily accessible to residents and visitors. This restricted access had the potential to affect 27 residents.
Inspectors wroteBased on observation and interview, the facility failed to ensure nursing hours were posted in the facility's secured memory care unit to be readily accessible to visitors and residents. This restricted access to nursing hours had the potential to affect 27 residents.
Inspectors wroteBased on interview, record review and document review, the facility failed to ensure allegations of abuse were reported to the State agency for 1 of 16 sampled residents (Resident #18).
Inspectors wroteBased on clinical record review , interview, and document review the facility failed to ensure care plans were completed and up to date for 2 of 15 sampled residents (Resident # 22 and #30). The failure had the potential to delay implementation of appropriate resident care interventions.
Inspectors wroteBased on observation, interview, and document review the facility failed to secure sharp items in the locked unit for 1 of 16 sampled residents (Resident #32).
Inspectors wroteBased on interview and document review, the facility failed to ensure drug regimen reviews were completed monthly for 1 of 5 residents reviewed for unnecessary medications. (Resident #36)
Inspectors wroteBased on observation, interview and document review, the facility failed to ensure food was labeled appropriately and discarded by expiration date for food brought to residents by visitors, with the potential to effect all residents located on the 400 hall.
Inspectors wroteBased on clinical record review, interview, and document review the facility failed to ensure 1 of 5 residents sampled for vaccinations (Resident #11) was screened for eligibility to receive an influenza vaccination, education regarding the vaccine was provided to the resident and/or the Resident Representative, and the vaccine was offered and either administered or declined.
Inspectors wroteBased on clinical record review, interview, and document review the facility failed to ensure 3 of 5 residents sampled for immunizations (Resident #49, #42, and #57) were screened for eligibility to receive a 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.
18 fire safety citations on file: 6 on August 7, 2025, 8 on July 18, 2024, 4 on May 18, 2023.
CMS lists no fines or payment denials against this home in the last three years. The national average is 0.9 fines per home.
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) | 3.37 | 4.34 | 3.86 |
| Registered nurses | 0.71 | 1.12 | 0.69 |
| All nursing staff on weekends | 3.15 | 3.86 | 3.42 |
| Nurse aides | 2.08 | ||
| Licensed practical nurses | 0.58 | ||
| Nursing staff turnover (share who left in a year) | 45.5% | 45.1% | 45.8% |
| Registered nurse turnover | 25.0% | 43.4% | 42.9% |
| Administrators who left | 0 |
CMS expects 3.72 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
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 3.46 on weekdays and 3.15 on weekends, 9% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 0.0% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 3.19 in April to June 2025 to 3.37 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 | 3.37 | 0.71 | 3.46 | 3.15 | 0.0% | 0 of 90 | 91 |
| Oct to Dec 2025 | 3.01 | 0.78 | 3.06 | 2.89 | 0.0% | 0 of 92 | 89 |
| Jul to Sep 2025 | 3.06 | 0.81 | 3.13 | 2.87 | 0.0% | 0 of 92 | 89 |
| Apr to Jun 2025 | 3.19 | 0.82 | 3.33 | 2.86 | 0.0% | 0 of 91 | 83 |
| 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.
Staff pay reports
No staff pay figure for this home has passed review yet. A figure appears only after at least 5 reports from at least 3 different people, sent over at least 60 days, have passed review.
| Job | Median | Middle half | Employed |
|---|---|---|---|
| Nevada, all employers | |||
| CNAs (nursing assistants) | $21.87 | $18.80 to $23.07 | 8,100 |
| LPNs and LVNs | $36.62 | $31.70 to $38.26 | 3,350 |
| Registered nurses | $49.84 | $41.76 to $57.82 | 27,070 |
| United States, nursing care facilities | |||
| CNAs (nursing assistants) | $20.67 | $17.91 to $22.55 | 534,270 |
| LPNs and LVNs | $33.86 | $30.05 to $37.40 | 188,210 |
| Registered nurses | $41.11 | $37.85 to $47.68 | 142,270 |
Hourly wages; the middle half runs from the 25th to the 75th percentile. Source: U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2025. BLS has no separate estimate for medication aides. These are survey estimates for whole occupations, not figures for any one home.
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 | 16.9 | 12.6 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 0.3 | 1.6 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 5.2 | 1.9 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 1.6 | 2.0 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 0.0 | 1.8 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 16.8 | 13.5 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 3.0 | 5.4 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 8.2 | 17.1 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 17.4 | 23.2 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 13.0 | 9.6 | 12.0 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.5 | 1.9 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 2.2 | 1.4 | 1.8 |
For a stay to recover after a hospital visit, these are the results CMS publishes for Highland Manor of Elko Rehabilitation LLC's Medicare short-stay residents. On returning residents home or to the community, CMS rates it no different from the national rate (57.0% of residents, after adjusting for how sick they were). How to read these, and what Medicare pays for.
57.0% this home
No different from the national rate
US median of homes 51.5% · Nevada: 9 better, 7 worse
Rate of successful return to home or community from a SNF (risk-standardized discharge to community rate). Higher is better. October 2022 to September 2024. 151 eligible stays.
8.5% this home
No different from the national rate
US median of homes 10.7% · Nevada: 0 better, 5 worse
Rate of potentially preventable hospital readmissions 30 days after discharge from a SNF (risk-standardized rate). Lower is better. October 2022 to September 2024. 156 eligible stays.
6.2% this home
No different from the national rate
US median of homes 7.1% · Nevada: 1 better, 0 worse
Percentage of infections residents got during their SNF stay that resulted in hospitalization (risk-standardized rate). Lower is better. October 2023 to September 2024. 100 eligible stays.
69.3% this home
Median of homes: Nevada60.3% · US 56.6%
Percentage of residents who are at or above an expected ability to care for themselves and move around at discharge. Higher is better. October 2024 to September 2025. 88 residents counted.
0.0% this home
Median of homes: Nevada0.4% · US 0.0%
Percentage of SNF residents who experience one or more falls with major injury during their SNF stay. Lower is better. October 2024 to September 2025. 113 residents counted.
3.0% this home
Median of homes: Nevada1.6% · US 1.7%
Percentage of residents with pressure ulcers or pressure injuries that are new or worsened (adjusted rate). Lower is better. October 2024 to September 2025. 113 residents counted.
98.2% this home
Median of homes: Nevada91.8% · US 98.7%
Percentage of residents where the SNF provided a current medication list to the resident, family, and/or caregiver at final discharge. Higher is better. October 2024 to September 2025. 54 residents counted.
Source: CMS Skilled Nursing Facility Quality Reporting Program - Provider Data, released 2026-09-30. Better, no different and worse are CMS's own comparisons with the national rate, after adjusting for how sick residents were. Medians of homes and the state counts are worked out by us from the same file.
Legal business name: HIGHLAND MANOR OF ELKO REHABILITATION LLC. CMS links this home to The Charly Bello Family, the Maze Family, the Swain Family, & Walter Myers, a group of 20 nursing homes averaging 1.7 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Charly Bello Family Limited Partnership | Direct ownership interest | Organization | 04/18/2024 | |
| Maze Family Limited Partnership | Direct ownership interest | Organization | 04/18/2024 | |
| Pickd LLC | Direct ownership interest | Organization | 04/18/2024 | |
| Mahrt, David | Indirect ownership interest | Individual | 04/18/2024 | |
| Myers, Katie | Indirect ownership interest | Individual | 04/18/2024 | |
| Myers, Walter | Indirect ownership interest | Individual | 04/18/2024 | |
| Swain, Holly | Indirect ownership interest | Individual | 04/18/2024 | |
| Swain, Jared | Indirect ownership interest | Individual | 04/18/2024 | |
| Banford, Andrew | Operational/managerial control | Individual | 04/18/2024 | |
| Myers, Walter | Operational/managerial control | Individual | 04/18/2024 | |
| Rogers, Andrew | Operational/managerial control | Individual | 04/18/2024 | |
| Cottonwood Healthcare LLC | Adp of the SNF | Organization | 04/18/2024 | |
| Highland Manor of Elko Holdings LLC | Adp of the SNF | Organization | 08/15/2025 | |
| Slattery & Holman P.C. | Adp of the SNF | Organization | 04/18/2024 | |
| Banford, Andrew | Adp of the SNF | Individual | 04/18/2024 | |
| Rogers, Andrew | Adp of the SNF | Individual | 04/18/2024 |
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.
Chosen from this home's own inspection record.