Home / Michigan / Three Rivers
517 S Erie St., Three Rivers, MI 49093 · St. Joseph County · (269) 273-8661
100 certified beds, about 81 residents a day · For profit - Corporation · Medicare and Medicaid since 1979
CMS Care Compare ratings, data as of September 1, 2026 · CCN 235395 · See it on Medicare.gov · Compare with other homes
At its most recent standard inspection, on December 3, 2025, inspectors cited 14 health deficiencies (the Michigan average is 9.9, the national average 9.2).
Of 77 health citations since August 2023, 4 were rated as actual harm or immediate jeopardy to residents.
CMS lists 2 fines totaling $40,700 in the last three years; the largest was $26,685, and the latest is dated October 8, 2025.
Nurses and nurse aides worked 3.02 hours per resident per day, against 3.99 across Michigan and 3.86 nationally. Registered nurses accounted for 0.62 of those hours.
47.7% of nursing staff left within the year CMS measured (Michigan average 44.1%).
CMS links it to Optalis Health & Rehabilitation, an affiliated group of 36 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 77 health citations on file.
Inspectors wroteThis citation pertains to intake #3051796Based on observation, interview and record review, the facility failed to a safe and orderly discharge was in place for 1 of 1 resident (Resident #100) reviewed for discharge, resulting in Resident #100 being abruptly discharged from the facility without adequate outpatient services, community resources, and/or training on medical needs causing increased anxiety, agitation and emotional distress.
Inspectors wroteThis citation pertains to intake #3051796Based on interview and record review, the facility failed to adhere to the applicable components of the discharge summary for 1 (Resident #100) of 1 resident from the facility resulting in incomplete documentation that ensured the resident, family and outside health care providers were aware of Resident #100's medical needs.
Inspectors wroteThis citation pertains to intake #3002412Based on observation, interview, and record review, the facility failed to provide the necessary care and services to prevent, treat, and promote healing of pressure ulcers in 1 of 2 residents (Resident #106) reviewed for pressure ulcers, resulting in the lack of repositioning and implementation of care planned interventions, delayed healing of pressure ulcers for the resident, and the potential for infection and the development of new ulcers.
Inspectors wroteThis citation pertains to intake #3051796Based on interview and record review, the facility failed to provide medically related social services to support the physical and psychosocial health of 1 (Resident #100) of 3 residents reviewed for social services resulting in a lack of advocacy for Resident #100's rights during the discharge planning process.
Inspectors wroteThis citation pertains to intake #2803349. Based on interview and record review the facility failed to ensure the Director of Nursing (DON) of record worked full time defined as 40 hours a week for 3 weeks (from 3/2/2026 to 3/22/2026) resulting in the potential for unmet care needs for all residents who resided in the building during those weeks.
Inspectors wroteThis citation pertains to intake #2736915. Based on interview and record review, the facility failed to honor resident preferences regarding heating/reheating his favorite foods brought in by family in 1 (Resident #1) of 3 residents reviewed for resident rights resulting in feelings of frustration, not being able to enjoy his favorite foods and potentially causing further weight loss.
Inspectors wroteBased on observation, interview, and record review, the facility failed to revise a fall care plan for 2 residents (Resident #2, Resident #3) of 3 residents reviewed for fall care plan revision resulting in the potential for inaccurate care interventions that could potentially cause further falls.
Inspectors wroteThis citation pertains to intake #2732469. Based on interview and record review, the facility failed to maintain complete and accurate medical records for bowel and bladder in 1 resident (Resident #1) of 3 residents reviewed for ADLs (Activities of Daily Living) resulting in incomplete information in the medical record and not knowing if a resident received appropriate care.
Inspectors wroteBased on observation, interview, and record review, the facility failed to prepare food in accordance with professional standards for food service safety, resulting in the increased potential of food borne illness among all residents that consume food from the kitchen.
Inspectors wroteBased on interview and record review, the facility failed to ensure the Medical Director was a meaningful participant during QAPI (Quality Assurance and Performance Improvement) meetings, resulting in the potential for lack of coordination of resident care policies and overall medical care that could affect all 82 residents residing in the facility.
Inspectors wroteBased on interview, and record review, the facility failed to obtain informed consent for psychotropic medications for 2 (Resident #69, #7) out of 5 residents reviewed for psychotropic medications. This deficient practice resulted in the lack of communication/education to the resident/resident representatives for initiation and/or dose changes of psychotropic medications.
Inspectors wroteBased on interview and record review, the facility failed to address and resolve grievances reported in Resident Council Meetings as stated during a confidential Resident Council meeting resulting in unresolved concerns, unmet resident needs and frustration.
Inspectors wroteBased on observation, interview, and record review, the facility failed to maintain a safe, clean, homelike environment in 3 of 4 residents (Resident #19, #39, & #69) reviewed for environmental concerns, and maintain cleanliness of storage closets containing resident supplies, resulting in the potential for resident dissatisfaction, injury, and respiratory complications due to dust buildup.
Inspectors wroteBased on observation, interview, and record review, the facility failed to promote dignity in 2 of 4 residents (Resident #48, #69) reviewed for dignity/respect, resulting in long wait times for assistance, feelings of frustration, and dissatisfaction with care.
Inspectors wroteBased on observation, interview and record review the facility failed to ensure residents medication was not left at bedside in 1 of 4 residents (Resident #69) reviewed for medication administration, when licensed nursing staff failed to ensure that Resident #69's medications were administered as ordered and per facility policy.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure appropriate bariatric bed and assistive devices were available for use to promote independence for 1 resident (Resident #7) of 1 resident reviewed for accommodation of needs, resulting in the development of a stage 3 pressure ulcer.
Inspectors wroteBased on observation, interview and record review, the facility failed to develop a person-centered care plan related to contact precautions for 1 resident (Resident #53) of 18 reviewed for person centered care plans resulting in the potential for unmet care needs of the resident.
Inspectors wroteBased on observation, interview and record review the facility failed to ensure residents received care by qualified persons in 1 of 5 residents (Resident #13) reviewed for psychotropic medications, when nursing staff completed Resident #13's Psychotropic Medication Review for GDR (Gradual Dose Reduction) assessment without involvement from the physician or nurse practitioner, resulting in an incomplete GDR assessment for Resident #13.
Inspectors wroteBased on observation, interview and record review, the facility failed to ensure indwelling catheter care was completed, monitored urinary output, ensured securement device positioning, and the urinary drainage bag was not resting on the floor for 1 (Resident #70) of 1 resident reviewed for indwelling catheter care, resulting in the potential of a urinary tract infection.
Inspectors wroteBased on observation, interview, and record review, the facility failed to administer oxygen therapy and provide respiratory care per physician order and professional standards of practice in 1 of 1 resident (Resident #19) reviewed for respiratory care, resulting in the potential for decreased oxygen levels and respiratory complications.
Inspectors wroteBased on interview and record review the facility failed to implement Enhanced Barrier Precautions (EBP) (an infection control measure designed to reduce the transmission of multidrug-resistant organisms (MDROs) in nursing homes) for 2 residents (Resident #94 & #19) of 6 residents reviewed for infection control and prevention, resulting in the potential for the spread of MDROs among a vulnerable population of residents.
Inspectors wroteBased on interview and record review, the facility failed to track and offer the pneumococcal vaccine for 1 (Resident #7) of 5 residents reviewed for immunizations, resulting in a delay of Resident #7, to be given the opportunity to receive or decline the pneumococcal vaccination.
Inspectors wroteThis citation pertains to intake #2641096. Based on observation, interview, and record review, the facility failed to ensure adequate supervision to prevent resident to resident abuse for 1 resident (Resident #1) of 3 residents reviewed for abuse, resulting in Resident #2 who had a history of delusions, hallucinations and aggression, pushed Resident #1. Resident #1 fell and sustained a closed left femoral neck (hip bone) fracture and subsequent surgical intervention.
Inspectors wroteBased on interview and record review, the facility failed to 1) provide the resident representative a written notice for a bed hold upon a transfer to the hospital and 2) follow up with the resident/responsible party and document the follow up in the resident's medical chart for 1 resident (Resident #1) of 1 resident reviewed for hospital transfers resulting in the potential for a resident and/or resident's representative being uninformed of the bed hold policy.
Inspectors wroteThis citation pertains to intake #2616813Based on observation, interview and record review, the facility failed to prevent an unnecessary discharge by providing individualized care for 1 of 1 resident (Resident #101) reviewed for discharge, resulting in Resident #101 being abruptly discharged from the setting in which he was familiar, to an unfamiliar locked memory care unit and subsequently experiencing increased anxiety, agitation and emotional distress requiring pharmacological treatment.
Inspectors wroteThis citation pertains to intake #2616813Based on observation, interview, and record review, the facility failed to protect a resident's right to be free from resident-to-resident verbal abuse for 2 (Resident #101 and Resident #100) of 3 residents reviewed for abuse, resulting in Resident #101 experiencing verbal threats, insults and mocking by Resident #100.
Inspectors wroteBased on interview and record review, the facility failed to report an allegation of abuse to the State Agency for 2 (Resident #100 and Resident #101) of 2 residents reviewed for abuse.
Inspectors wroteBased on interview and record review, the facility failed to investigate an allegation of abuse for 2 (Resident #100 and Resident #101) of 2 residents reviewed for abuse resulting in the potential for allegation to not be thoroughly investigated and further abuse to occur.
Inspectors wroteBased on interview and record review, the facility failed to ensure proper discharge notification was completed for 1 resident (Resident #101) of 2 residents reviewed for the discharge process, resulting in Resident #101's Durable Power of Attorney (DPOA) GG not receiving written notification of the reason for discharge and the right to appeal.
Inspectors wroteBased on interview and record review the facility failed to develop and implement person centered individualized care plan interventions for 2 (Resident #100 and Resident #101) of 5 residents reviewed for person centered individualized care plans resulting in the potential for residents to not attain or maintain their highest practicable physical, mental, and psychosocial well-being.
Inspectors wroteThis citation pertains to intake #2616813Based on interview and record review, the facility failed to provide medically related social services to support the mental and psychosocial health of 2 (Resident #101 and Resident # 100) of 3 residents reviewed for social services resulting in a lack of advocacy for Resident #101's rights, and a lack of individualized behavior management interventions and discharge planning for Resident #100 and Resident #101.
Inspectors wroteBased on interview and record review the facility failed to maintain clear and accurate medical records for 2 (Resident #100 and Resident #101) of 5 residents reviewed for clear and accurate medical records resulting in an incomplete reflection of resident's behaviors, ongoing care needs, and the need for Resident #101 to discharge from the facility.
Inspectors wroteThis citation pertains to intake 1213927. Based on interview and record review, the facility failed to protect the resident's right to be free from verbal abuse by staff for 1 resident (Resident #101) of 4 residents reviewed for abuse, resulting in Licensed Practical Nurse (LPN) K intimidating and threatening to take away the resident's phone and the potential for psychosocial harm.
Inspectors wroteThis citation pertains to intake 1213992,1213991, and 2570298. Based on observation, interview and record review the facility failed to ensure a resident received care in accordance with physician orders and professional standards of care in 1 resident (Resident #101) of 12 residents reviewed for quality of care, resulting in failure to adequately monitor Resident #101 with a history of recurrent Urinary Tract Infection (UTI), failure to accurately identify symptoms of UTI and provide necessary treatment, and failure to ensure hospital discharge physician orders for treatment of UTI were followed, resulting in Resident #101 requiring hospital intervention multiple times to receive treatment for UTI and the potential for negative resident outcomes.
Inspectors wroteThis citation pertains to intake 1213992. Based on interview and record review, the facility failed to provide medically related social services to attain and maintain the highest practicable physical, mental and psychosocial well-being for 1 resident (Resident #112) of 3 residents reviewed for social services, resulting in Resident #112 not receiving assistance with identifying community placement options and completion of the application process based upon the resident's expressed desire to discharge to the community, and not receiving timely quarterly care conference.
Inspectors wroteThis citation pertains to intake MI00150239. Based on interview and record review, the facility failed to prevent the use of physical restraint/confinement for 1 (Resident #100) of 3 residents reviewed for abuse, resulting in Resident #100 being confined by a locked wheelchair placed against the nurse's station and restrained into a seated position.
Inspectors wroteThis citation pertains to intake MI00150000. Based on interview and record review the facility failed to prevent the misappropriation of scheduled narcotic medication for 2 (R111 and R103) of 3 residents reviewed for misappropriation of property, resulting in the potential for ongoing misappropriation of narcotic medications.
Inspectors wroteBased on observation, interview and record review, the facility failed to adhere to nursing professional standards related to documentation of medication administration for 2 of 3 (Resident #206 and Resident #110) residents reviewed for medication administration documentation, resulting in a potential for missing controlled substances and inaccurate medication administration.
Inspectors wroteThis citation pertains to intake # MI00149896 Based on interview, and record review, the facility failed to comprehensively assess and prescribe appropriate treatment for 1 (Resident #103) of 3 residents reviewed for change of condition, resulting in Resident #103 being hospitalized with aspiration pneumonia.
Inspectors wroteBased on observation, interview, and record review, the facility failed to remove and safely dispose of discharged resident controlled substance medication in 1 of 3 residents (R111) reviewed for medication storage and disposal, resulting in diversion and/or misappropriation.
Inspectors wroteBased on interview and record review, the facility failed to ensure the identification and timely reporting of an injury of unknown origin in one Resident (#100) of three residents reviewed for reporting, resulting in the potential for unidentified abuse or neglect and further exposure to abusive situations.
Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to: (1) effectively clean and maintain food service equipment, and (2) date mark all potentially hazardous ready-to-eat food products effecting 82 residents, resulting in the increased likelihood for cross-contamination, bacterial harborage, and resident foodborne illness.
Inspectors wroteBased on observation, interview, and record review, the facility failed to develop and/or implement comprehensive care plans in 6 of 22 residents (Resident #46, #29, #19, #42, #41, & #51) reviewed for comprehensive care plans, resulting in the potential for unmet medical, physical, mental, and psychosocial needs.
Inspectors wroteResident #5 Review of an admission Record revealed Resident #5 was a female, with pertinent diagnoses which included chronic respiratory failure, muscle weakness, anemia, morbid obesity, peripheral vascular disease (PVD), high blood pressure, diabetes, seizure disorder, neuropathy (weakness, numbness, and pain from nerve damage), and major depression. Review of a Minimum Data Set (MDS) assessment for Resident #5, with a reference date of 8/21/24, revealed a Brief Interview for Mental Status (BIMS) score of 15, out of a total possible score of 15, which indicated she was cognitively intact. Review of a current Care Plan for Resident #5 revealed the focus .(Resident #5) has an ADL (Activities of Daily Living) Self care deficit as evidenced by weakness r/t (related to) morbid obesity, Chronic respiratory failure, PVD, Idiopathic neuropathy . [...]
Inspectors wroteIn an interview on 09/25/24 at 10:29 AM, Licensed Practical Nurse (LPN) I reported the agency had been brought in the last few weeks, the Director of Nursing and the Administrator left, and a bunch of nurses left after they did. During an observation on 09/27/24 09:41 AM, review of the resident listing revealed C Hallway had 18 residents with one CNA to provide care for them. The schedule indicated it was a split assignment but this writer did not observed the split CNA on the hallway throughout the observations the whole day. In an interivew on 09/27/24 at 09:45 AM, Anonymous LLL when queried reported the C Hallway always had one CNA. The CNAs never got breaks because there was not enough staff to cover. [...]
Inspectors wroteBased on interview and record review the facility failed to ensure annual competency evaluations were completed for 3 certified nursing assistants (CNAs) of 5 reviewed for annual competency evaluations resulting in the potential for unmet resident care needs.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure medications remained safely stored in 2 of 4 medication carts, resulting in the potential missing medications.
Inspectors wroteThis citation pertains to intake: MI00147064 Based on interview, observation, and record review, the facility failed to:1.) implement effective infection control to prevent the spread of COVID-19 and, 2.) maintain effective Enhanced Barrier Precautions (EBP) for 3 of 21 residents (Resident #23, #17, and #51) reviewed for infection control, resulting in the potential for the continued spread of COVID-19 with negative resident outcomes and the increased risk for the transmission/transfer of pathogenic organisms and cross contamination between residents.
Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to effectively clean and maintain the physical plant effecting 82 residents, resulting in the increased likelihood for cross-contamination, bacterial harborage, decreased air quality, and cross-connections between the potable (drinking) and non-potable (non-drinking) water supplies.
Inspectors wroteBased on observation, interview, and record review, the facility failed to promote dignity and respect in 2 of 7 residents (Resident #44 and Resident #58) reviewed for dignity, resulting in the potential for feelings of diminished self-worth, sadness, and anxiety.
Inspectors wroteBased on observation, interview, and record review, the facility failed to determine the safety of self-administration of medication in 1 of 6 residents (Resident #5) reviewed for medication administration, resulting in the potential for complications for Resident #5's medical condition.
Inspectors wroteBased on observation and interview the facility failed to honor resident choices in 2 (Resident #14 and Resident #42) of 7 residents reviewed for self-determination resulting in feelings of anger and frustration.
Inspectors wroteThis citation pertains to intake MI00146657 Based on interview and record review the facility failed to ensure mail was delivered to 1 (Resident #42) of 1 resident reviewed for mail delivery resulting in feeling of anger and frustration.
Inspectors wroteBased on observation, interview, and record review, the facility failed to update/revise a comprehensive care plan after a change in resident condition in 2 of 22 residents (Resident #44 & #14) reviewed for comprehensive care plans, resulting in an inaccurate reflection of the resident's status, and the potential for unmet medical, physical, mental, and psychosocial needs.
Inspectors wroteBased on observation, interview, and record review, the facility failed to implement care planned intervention and updated interventions after a fall to maintain safety in 1 of 4 residents (Resident #80) reviewed for falls, resulting in the potential for injury and continued falls.
Inspectors wroteBased on interview and record review, the facility failed to ensure that pneumococcal vaccines were offered to one resident (Resident #51) of five residents reviewed for pneumococcal vaccinations, resulting in the resident potentially acquiring and experiencing complications related to pneumonia.
Inspectors wroteBased on interview and record review, the facility failed to ensure COVID-19 immunizations were offered to three residents (Residents #51, #343, #23) of five residents reviewed for COVID-19 immunizations, resulting in the increased likelihood of severe infection and complications/death related to COVID-19.
Inspectors wroteBased on interview and record review the facility failed to ensure the completion of 12-hours of annual in-service trainings by 1 Certified Nursing Assistant (CNA) of 5 reviewed for the completion of 12-hours of annual in-service training, resulting in the potential of unmet resident care needs.
Inspectors wroteThis citation pertains to intake #MI00142953, and MI00144298. Based on observation and interview, the facility failed to maintain a safe, and sanitary environment resulting in the increased likelihood for resident to sustain injuries, bacterial harborage, increased dust particulate in the air, and the potential for decrease in the satisfaction of environment for residents of the facility.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure 1 (Resident #104) of 3 residents reviewed for management of personal funds, had ready and reasonable access to those funds upon request, resulting in Resident #104 experiencing anxiety and frustration related to a delay in access to her money that could result in a loss of property and life insurance coverage.
Inspectors wroteThis citation pertains to intake #MI00143174 Based on interview, and record review, the facility failed to prevent misappropriation of resident money for 1 of 3 residents (Resident #104) reviewed for misappropriation, resulting in the loss of Resident #104's lock box(that contained $152), and feelings of frustration, and helplessness.
Inspectors wroteThis citation pertains to intakes #MI00139525, MI00139682, MI00139556, and MI00139691. Based on observation, interview and record review, the facility failed to protect resident's right to be free from abuse for 5 (Resident #101, #102, #116, #117, and #118) of 9 residents reviewed for abuse, when Resident #102 physically abused Resident #101, Resident #116, Resident #117, and Resident #118, causing physical pain and emotional distress.
Inspectors wroteThis citation pertains to intakes #MI00139682, MI00139556, and MI00139691. Based on interview and record review, the facility failed to immediately report incident's of resident to resident abuse to the State Agency for 5 of 5 Residents (Resident #101, #102, #116, #117 and #118) reviewed for abuse, resulting in the potential for continued unidentified, unreported abuse to occur.
Inspectors wroteThis citation pertains to intakes #MI00139682, MI00139556, and MI00139691. Based on interview and record review, the facility failed to thoroughly investigate alleged violations and prevent further resident to resident abuse from occurring in 5 of 5 residents (Resident #101, #102, #116, #117, and #118) reviewed for abuse, resulting in the lack of thorough investigations and continued resident to resident abuse.
Inspectors wroteBased on observation, interview, and record review the facility failed to: 1. Clean food and non-food contact surfaces to sight and touch; 2. Datemark and discard potentially hazardous foods; and 3. Repair a water-damaged wall in the kitchen area. These conditions resulted in an increased risk of contaminated foods and an increased risk of food borne illness for all residents who consume food from the kitchen.
Inspectors wroteBased on observation, interview, and record review, the facility failed to securely store resident medications in 2 out of 4 medication carts reviewed for medication storage, resulting in the potential for the compromise of medications and/or the misappropriation of medication.
Inspectors wroteBased on observation, interview and record review the facility failed to: 1.) ensure proper infection control measures were implemented for hand hygiene during a dressing change for 1 of 1 resident (Resident #62) reviewed for dressing changes and 2.) ensure hand hygiene practices before and after entering/exiting resident rooms, resulting in the increased potential for the development and transmission of communicable diseases and infection in a vulnerable population.
Inspectors wroteBased on observation and interview the facility failed to provide activities of daily living (ADL) care to promote dignity in 1 of 18 residents (Resident #5) reviewed for dignity resulting in the potential for a reasonable person to experience feelings of embarrassment and/or shame.
Inspectors wroteBased on interview and record review the facility failed to allow and accommodate resident choice related to showers in 1 of 18 residents (Resident #70) reviewed for resident choice, resulting in feelings of frustration and embarrassment.
Inspectors wroteBased on interview, and record review, the facility failed to notify the resident and/or the resident's representative in writing of the reason for a transfer to the hospital in 1 of 3 residents (Resident #68) reviewed for transfer and discharge requirements, resulting in the potential for residents and/or their representatives to not be fully informed of the reason for a hospital transfer and their rights in regard to an appeal hearing.
Inspectors wroteBased on interview, and record review, the facility failed to provide written notification of the bed hold policy upon transfer to the hospital in 1 of 3 residents (Resident #68) reviewed for transfer and discharge requirements, resulting in the potential for residents and/or their representatives to be unaware of their rights in regard to facility bed holds.
Inspectors wroteBased on interview and record review, the facility failed to ensure Preadmission Screening (PAS) / Annual Resident (ARR) Mental Illness / Intellectual Disability / Related Conditions Identification forms DCH-3877 and/or DCH-3878) documents were completed annually for 1 (Resident #26) of 18 sampled residents, resulting in the potential for unmet mental health care needs.
Inspectors wroteBased on observation, interview, and record review, the facility failed to develop and implement comprehensive care plans in 2 of 18 residents (Resident #21 & #6) reviewed for comprehensive care plans, resulting in the potential for falls/injury for Resident #21 and a lack of resident-centered interventions for dementia care for Resident #6.
Inspectors wroteBased on observation, interview, and record review, the facility failed to revise a care plan to include relevant interventions for 1 of 18 residents (Resident #23) reviewed for care plans, resulting in the potential for weight loss, malnourishment, and resident dissatisfaction of the dining experience.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure assistance with eating was provided for 1 of 3 residents (Resident #23) reviewed for activities of daily living, resulting in Resident #23 missing breakfast, and the potential for weight loss, feelings of hunger and an overall decline in health.
Inspectors wroteBased on observations, interview, and record review the facility failed to ensure portable supplemental oxygen was administered to 1 of 1 resident (Resident #52) reviewed for oxygen use resulting in shortness of breath, feelings of anxiety, and fatigue.
Inspectors wroteThis citation pertains to Intake # MI00138015. Based on interview and record review, the facility failed to ensure a resident with documented food allergies was not served those foods in 1 (Resident #43) of 18 sampled residents, resulting in the resident consuming a portion of the allergenic food item, having a mild allergic reaction, and feelings of frustration and meal dissatisfaction.
32 fire safety citations on file: 3 on April 2, 2026, 2 on April 1, 2026, 7 on December 3, 2025, 11 on October 1, 2024, 9 on August 2, 2023.
| Date | Penalty | Amount or length |
|---|---|---|
| October 8, 2025 | Fine | $14,015 |
| October 8, 2025 | Fine | $26,685 |
| February 21, 2025 | Payment Denial | 26 days from March 20, 2025 |
A payment denial means Medicare and Medicaid stopped paying for new admissions for that period.
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 | Michigan | United States |
|---|---|---|---|
| All nursing staff (RN, LPN and aides) | 3.02 | 3.99 | 3.86 |
| Registered nurses | 0.62 | 0.78 | 0.69 |
| All nursing staff on weekends | 2.77 | 3.50 | 3.42 |
| Nurse aides | 1.87 | ||
| Licensed practical nurses | 0.54 | ||
| Nursing staff turnover (share who left in a year) | 47.7% | 44.1% | 45.8% |
| Registered nurse turnover | 52.6% | 39.2% | 42.9% |
| Administrators who left | 1 |
CMS expects 3.61 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 3.13 on weekdays and 2.77 on weekends, 12% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 5.1% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 3.40 in April to June 2025 to 3.02 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 | 3.02 | 0.62 | 3.13 | 2.77 | 5.1% | 0 of 90 | 81 |
| Oct to Dec 2025 | 3.09 | 0.67 | 3.19 | 2.84 | 5.8% | 0 of 92 | 82 |
| Jul to Sep 2025 | 3.09 | 0.63 | 3.18 | 2.85 | 9.9% | 0 of 92 | 84 |
| Apr to Jun 2025 | 3.40 | 0.72 | 3.50 | 3.14 | 10.7% | 0 of 91 | 84 |
| United States, Jan to Mar 2026 | 3.75 | 0.62 | 3.92 | 3.33 | 5.3% | 0.5% of days | |
| Michigan, Jan to Mar 2026 | 3.95 | 0.70 | 4.14 | 3.45 | 3.3% | 0.4% 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. If you work here, your report helps start one.
| Job | Median | Middle half | Employed |
|---|---|---|---|
| Michigan, all employers | |||
| CNAs (nursing assistants) | $19.03 | $18.35 to $21.59 | 43,290 |
| LPNs and LVNs | $31.47 | $29.83 to $35.52 | 10,880 |
| Registered nurses | $45.34 | $39.46 to $49.74 | 104,950 |
| 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 | Michigan | US |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1 | 5.2 | 10.8 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 0.8 | 0.8 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 1.8 | 1.5 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 4.6 | 3.0 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 0.0 | 1.1 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 11.9 | 12.0 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 7.0 | 5.1 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 9.7 | 14.8 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 31.1 | 24.0 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 20.8 | 11.7 | 12.0 |
For a stay to recover after a hospital visit, these are the results CMS publishes for Optalis Health and Rehabilitation of Three Rivers's Medicare short-stay residents. On returning residents home or to the community, CMS rates it no different from the national rate (57.5% of residents, after adjusting for how sick they were). How to read these, and what Medicare pays for.
57.5% this home
No different from the national rate
US median of homes 51.5% · Michigan: 89 better, 22 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. 122 eligible stays.
11.7% this home
No different from the national rate
US median of homes 10.7% · Michigan: 0 better, 9 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. 136 eligible stays.
5.8% this home
No different from the national rate
US median of homes 7.1% · Michigan: 1 better, 1 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. 65 eligible stays.
80.5% this home
Median of homes: Michigan57.6% · 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. 41 residents counted.
3.1% this home
Median of homes: Michigan0.0% · 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. 64 residents counted.
5.5% this home
Median of homes: Michigan1.3% · 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. 64 residents counted.
100.0% this home
Median of homes: Michigan99.5% · 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. 30 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: OPTALIS THREE RIVERS OPCO LLC. CMS links this home to Optalis Health & Rehabilitation, a group of 36 nursing homes averaging 2.4 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Om Holdco 5 LLC | 5% or greater direct ownership interest | Organization | 100% | 04/07/2023 |
| Charles Franklin LLC | 5% or greater indirect ownership interest | Organization | 04/07/2023 | |
| Charles Westland LLC | 5% or greater indirect ownership interest | Organization | 04/07/2023 | |
| Hemant Shah 2018 Irrevocable Trust | 5% or greater indirect ownership interest | Organization | 04/07/2025 | |
| Optalis LP Investors 5 LLC | 5% or greater indirect ownership interest | Organization | 04/07/2025 | |
| Snw LLC | 5% or greater indirect ownership interest | Organization | 04/07/2023 | |
| Optum Management Solutions. Inc | Indirect ownership interest | Organization | 04/07/2023 | |
| Siena Lending Group LLC | 5% or greater security interest | Organization | 04/07/2023 | |
| Patel, Rajan | Managing control - governing body | Individual | 04/07/2023 | |
| Sharon, Robert | Managing control - governing body | Individual | 05/13/2024 | |
| Optum Management Solutions. Inc | Operational/managerial control | Organization | 04/07/2023 | |
| Dorsey, Jasmine | Operational/managerial control | Individual | 01/01/2025 | |
| Keith, Angie | Operational/managerial control | Individual | 12/01/2025 | |
| Nona Morgan, Charity Renee | Operational/managerial control | Individual | 01/01/2025 | |
| Patel, Rajan | Operational/managerial control | Individual | 04/07/2023 | |
| Sharon, Robert | Operational/managerial control | Individual | 05/13/2024 | |
| Dunn, Charles | Individual is an owner, partner or trustee of any ADP of the SNF | Individual | 11/28/2025 | |
| Shah, Hemant | Individual is an owner, partner or trustee of any ADP of the SNF | Individual | 11/28/2025 | |
| Cliftonlarsonallen LLP | Adp of the SNF | Organization | 01/01/2025 | |
| Optum Management Solutions. Inc | Adp of the SNF | Organization | 11/28/2025 | |
| Schlaupitz Madhavan | Adp of the SNF | Organization | 01/01/2025 | |
| Conner, Marianne | Adp of the SNF | Individual | 05/13/2024 | |
| Dorsey, Jasmine | Adp of the SNF | Individual | 11/28/2025 | |
| Keith, Angie | Adp of the SNF | Individual | 12/19/2025 | |
| Sharon, Robert | Adp of the SNF | Individual | 05/13/2024 |
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.
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