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
5D
1E
1F
Potential for minimal harm
0A
1B
0C
February 13, 2025Complaint inspection · 1 citation
- D
Ensure each resident receives an accurate assessment.
Inspectors wroteBased on facility policy review, Resident Assessment Instrument (RAI) Manual 3.0 review, medical record review, and interview, the facility failed to accurately complete Minimum Data Set (MDS) assessments for 1 resident (Resident #1) of 3 residents reviewed for MDS assessments.
March 29, 2023Standard inspection · 4 citations
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Inspectors wroteBased on facility policy review, observations, and interview the facility failed to maintain a sanitary kitchen which had a potential to effect 114 of 116 residents of the facility.
- D
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Inspectors wroteBased on facility policy review, medical record review, observations, and interviews, the facility failed to ensure medical information was not visible for 2 residents (#56 and #84) of 38 residents reviewed for dignity.
- D
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
Inspectors wroteBased on facility policy review, record review, observation and interview, the facility failed to obtain the most recent Hospice plan of care for 1 resident (Resident #319) of 3 residents reviewed for Hospice services.
- B
Post nurse staffing information every day.
Inspectors wroteBased on observation and interview, the facility failed to post daily staffing for 1 of 3 days reviewed for residents in the facility.
February 20, 2020Standard inspection · 3 citations
- E
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.
Inspectors wroteBased on facility policy review, observation, and interview, the facility failed to dispose of expired medications and supplies in 2 medication storage rooms (South Wing and [NAME] Wing) of 3 medication storage rooms observed.
- D
Provide timely, quality laboratory services/tests to meet the needs of residents.
Inspectors wroteBased on facility policy review, medical record review, and interview, the facility failed to obtain laboratory tests as ordered by the physician for 1 resident (Resident #37) of 5 residents reviewed for laboratory tests.
- D
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Inspectors wroteBased on facility policy review, observation and interview, the facility failed to provide a safe environment for residents on 1 hall (North hall) of 3 halls observed in the facility.
February 21, 2019Standard inspection · 0 citations
Fire safety inspections
5 fire safety citations on file: 2 on March 29, 2023, 1 on February 20, 2020, 2 on February 21, 2019.
Every fire safety citation5 citations
- F
Inspect, test, and maintain automatic sprinkler systems.
K 353 · March 29, 2023 · Corrected (the home has a date of correction)
- D
Provide a written emergency evacuation plan.
K 711 · March 29, 2023 · Corrected (the home has a date of correction)
- F
Have generator or other power source capable of supplying service within 10 seconds.
K 918 · February 20, 2020 · Corrected (the home has a date of correction)
- F
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
K 372 · February 21, 2019 · Corrected (the home has a date of correction)
- D
Inspect, test, and maintain automatic sprinkler systems.
K 353 · February 21, 2019 · Corrected (the home has a date of correction)