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 15 health citations on file.
Severity
Isolated
Pattern
Widespread
Immediate jeopardy
0J
0K
0L
Actual harm
0G
0H
0I
Potential for more than minimal harm
9D
4E
2F
Potential for minimal harm
0A
0B
0C
February 12, 2026Standard inspection · 8 citations
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Inspectors wroteBased on observation, interview, and record review, the facility failed to: 1. Ensure proper cooling of cooked, potentially hazardous (time-temperature for safety) food, taco meat and beef tips; 2. Consistently test the dish machine to ensure proper sanitization; 3. Ensure pans were properly cleaned and allowed to air dry before stacking; 4. Effectively clean a mounted fan; and 5. Properly maintain resident refrigerator. These deficient practices had the potential to affect all residents who consumed food from the kitchen, resulting in the increased potential for food borne illness.
- E
Keep all essential equipment working safely.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure the drain lines from the dish machine were maintained in a safe and sanitary operating condition, resulting in the dish machine not being protected against contamination from sewage or other sources of contamination
- E
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Inspectors wroteBased on observation, interview, and record review the facility failed to effectively clean and maintain the physical plant effecting four resident rooms out of 21 resident rooms sampled for a clean environment.
- D
Ensure services provided by the nursing facility meet professional standards of quality.
Inspectors wroteBased on observation, interview, and record review, the facility failed to follow standards of practice for medication administration for one resident (R24) of two residents reviewed for medication administration.
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Inspectors wroteBased upon interview and record review, the facility failed to notify the physician regarding elevated blood sugars for one resident (R54) of one resident reviewed for diabetes management.
- D
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Inspectors wroteBased on interview and record review the facility failed to maintain accurate reconciliation records for controlled medications (narcotics) in two of three medications carts resulting in the potential for drug diversion to go undetected.
- D
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 observation, interview, and record review the facility failed to store unopened insulins at the proper temperature in two of three medication carts reviewed for safe storage of medications and biologicals resulting in the potential for decreased efficacy of the insulin.
- D
Provide and implement an infection prevention and control program.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure staff completed appropriate hand hygiene during resident care for one resident (R60) of five residents reviewed for infection control, resulting in the potential for an increased risk of infection among residents.
November 15, 2024Standard inspection, Complaint inspection · 3 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 observations, interviews, and record reviews, the facility failed to effectively clean and maintain food service equipment effecting 86 residents, resulting in the increased likelihood for cross-contamination and bacterial harborage.
- F
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Inspectors wroteBased on observations, interviews, and record reviews, the facility failed to effectively clean and maintain the physical plant environment effecting 86 residents, resulting in the increased likelihood for cross-contamination, bacterial harborage, and cross-connections between the potable (drinking) and non-potable (non-drinking) water supplies.
- D
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
Inspectors wroteBased on observation, interview and record review the facility failed to include one resident (R8) out of four residents reviewed for limited ROM in the restorative program.
June 18, 2024Complaint inspection · 1 citation
- 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 interview, and record review the facility failed to ensure R250 a resident with a known history of PICA (an eating disorder that involves eating or craving nonfood items) from access to an object that could be swallowed and choked on resulting in the swallowing of gauze requiring an emergency procedure.
December 13, 2023Standard inspection · 3 citations
- E
Provide safe and appropriate respiratory care for a resident when needed.
Inspectors wroteBased on observation, interview, and record review the facility failed to obtain physician's orders for oxygen maintenance (R269), properly date and change oxygen tubing in 4 of 4 residents (R5, R40, R218, and R269) reviewed for oxygen therapy, resulting in the increased potential for lung infections, and adverse side effect from oxygen administration.
- 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, and record review, the facility failed to obtain orders for a suprapubic catheter (catheter inserted through the abdomen and into the bladder) and failed to ensure the catheter had a securement device (prevents pulling of catheter tubing), for one (R269) of one resident reviewed for catheter care, resulting in the potential for urinary tract infections and skin trauma.
- D
Provide and implement an infection prevention and control program.
Inspectors wroteBased on observation, interview, and record review the facility failed to follow the standards of infection control for proper PPE (personal protective equipment) use, disposal of PPE, and hand hygiene, for three residents (R65 and R269) out of a 20 sampled residents reviewed for infection control, resulting in the potential for increased cross-contamination of diseases which place a vulnerable population at high risk for infections.
Fire safety inspections
26 fire safety citations on file: 5 on February 12, 2026, 8 on November 15, 2024, 13 on December 13, 2023.
Every fire safety citation26 citations
- F
Provide properly protected cooking facilities.
K 324 · February 12, 2026 · Corrected (the home has a date of correction)
- F
Have approved installation, maintenance and testing program for fire alarm systems.
K 345 · February 12, 2026 · Corrected (the home has a date of correction)
- D
Have exits that are accessible at all times.
K 271 · February 12, 2026 · Corrected (the home has a date of correction)
- D
Install emergency lighting that can last at least 1 1/2 hours.
K 291 · February 12, 2026 · Corrected (the home has a date of correction)
- D
Have properly installed electrical wiring and gas equipment.
K 511 · February 12, 2026 · Corrected (the home has a date of correction)
- F
Provide properly protected cooking facilities.
K 324 · November 15, 2024 · Corrected (the home has a date of correction)
- F
Have approved installation, maintenance and testing program for fire alarm systems.
K 345 · November 15, 2024 · Corrected (the home has a date of correction)
- F
Inspect, test, and maintain automatic sprinkler systems.
K 353 · November 15, 2024 · Corrected (the home has a date of correction)
- F
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
K 761 · November 15, 2024 · Corrected (the home has a date of correction)
- F
Have generator or other power source capable of supplying service within 10 seconds.
K 918 · November 15, 2024 · Corrected (the home has a date of correction)
- E
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
K 222 · November 15, 2024 · Corrected (the home has a date of correction)
- E
Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.
K 223 · November 15, 2024 · Corrected (the home has a date of correction)
- E
Have properly installed electrical wiring and gas equipment.
K 511 · November 15, 2024 · Corrected (the home has a date of correction)
- F
Implement emergency and standby power systems.
E 41 · December 13, 2023 · Corrected (the home has a date of correction)
- F
Provide properly protected cooking facilities.
K 324 · December 13, 2023 · Corrected (the home has a date of correction)
- F
Install a fire alarm system that can be heard throughout the facility.
K 341 · December 13, 2023 · Corrected (the home has a date of correction)
- F
Have approved installation, maintenance and testing program for fire alarm systems.
K 345 · December 13, 2023 · Corrected (the home has a date of correction)
- F
Follow proper procedures when the fire alarm was out of service for more than 4 hours.
K 346 · December 13, 2023 · Corrected (the home has a date of correction)
- F
Inspect, test, and maintain automatic sprinkler systems.
K 353 · December 13, 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 · December 13, 2023 · Corrected (the home has a date of correction)
- E
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
K 222 · December 13, 2023 · Corrected (the home has a date of correction)
- E
Install emergency lighting that can last at least 1 1/2 hours.
K 291 · December 13, 2023 · Corrected (the home has a date of correction)
- E
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
K 321 · December 13, 2023 · Corrected (the home has a date of correction)
- E
Construct fire resistant interior walls.
K 331 · December 13, 2023 · Corrected (the home has a date of correction)
- E
Install corridor and hallway doors that block smoke.
K 363 · December 13, 2023 · Corrected (the home has a date of correction)
- E
Install smoke barrier doors that can resist smoke for at least 20 minutes.
K 374 · December 13, 2023 · Corrected (the home has a date of correction)