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 12 health citations on file.
Severity
Isolated
Pattern
Widespread
Immediate jeopardy
0J
0K
0L
Actual harm
0G
0H
0I
Potential for more than minimal harm
11D
1E
0F
Potential for minimal harm
0A
0B
0C
March 12, 2026Standard inspection · 5 citations
- D
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Inspectors wroteBased on facility document review, clinical record review, staff interview, and policy review the facility failed to provide residents and families with 48 hour notification of financial responsibility when Medicare Part A services were scheduled to be discontinued for 1of 3 residents reviewed (Resident #53). The facility reported a census of 43 residents. Past non-compliance achieved through the following:On 3/11/26 at 11:50 AM the Administrator stated the facility had identified a concern regarding Advanced Beneficiary Notice (ABN) in 1/26 and as part of their Quality Assurance had developed a Performance Improvement Plan (PIP). The Social Services Director stated she typically received a notice from therapy regarding planned discharge 72 hours to a week in advance. [...]
- 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 clinical record review, resident interview, staff interviews, and policy review the facility failed to develop programs maintaining residents strength, range of motion (ROM), communication needs based on the comprehensive assessment for 1 of 14 residents reviewed (Resident #3). The facility reported a census of 43.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Inspectors wroteBased on observation, clinical record review, staff interview, and policy review, the facility failed to apply foot pedals to a resident's wheelchair during transport for 1 of 3 residents (#22) reviewed. The facility reported a census of 43 residents.
- D
Provide safe, appropriate dialysis care/services for a resident who requires such services.
Inspectors wroteBased on observation, clinical record review, resident and staff interviews, and policy review, the facility failed to consistently perform required pre-hemodialysis and post-hemodialysis assessments for 1 of 1 resident (#2) reviewed. The facility reported a census of 43 residents.
- D
Provide and implement an infection prevention and control program.
Inspectors wroteBased on observation, clinical record review, staff interview, and policy review, the facility failed to implement infection control practices by lifting an indwelling catheter drainage bag above the resident's bladder during perineal care for 1 of 1 resident (#7) reviewed and by carrying Personal Protective Equipment (PPE) out of the resident's room after it was used. The facility reported a census of 43 residents.
March 20, 2025Standard inspection · 5 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 policy review the facility failed to ensure that staff used adequate infection control practices during meal service. The facility reported a census of 40 residents.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Inspectors wroteBased on observations, clinical record review, and staff interviews, the facility failed to protect a resident from a possible accident and injury by not following the prevention of fall interventions for 1 of 12 residents (#14) reviewed. The facility reported a census of 40 residents.
- D
Provide safe and appropriate respiratory care for a resident when needed.
Inspectors wroteBased on observations, staff interviews, facility protocol and clinical record review the facility failed to implement interventions for 1 of 13 residents reviewed. Staff failed to use the As Needed (PRN) suctioning treatment and failed to complete regular vitals when Resident #16 was experiencing increased secretions. The facility reported a census of 40 residents.
- D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Inspectors wroteBased on observations, staff interviews and clinical record review the facility failed to accurately document treatments provided for 1 of 13 residents reviewed. Nursing staff documented that a wound treatment for Resident #91 had been done over two hours before it was actually completed. The facility reported a census of 40 residents.
- D
Provide and implement an infection prevention and control program.
Inspectors wroteBased on observation, clinical record review, staff interviews, and policy reviews the facility failed to implement appropriate hand hygiene and infection control practices to mitigate the spread of pathogens during resident cares for 2/12 residents (Resident #33, Resident #91). The facility failed to utilize hand hygiene, appropriate glove use, and Enhanced Barrier Precautions (EBP). The facility reported a census of 40.
May 30, 2024Standard inspection · 2 citations
- D
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Inspectors wroteBased on observation, staff interview, clinical record review and facility policy review, the facility failed to provide wound care treatments as ordered for 1 of 3 residents reviewed. Resident #6 had pressure wounds on her coccyx and inner ankle, in an observation it was discovered that the treatments were not in place. The facility reported a census of 43 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 observations, clinical record review, resident interview, staff interviews, and facility policy review, the facility failed to provide adequate fluids and failed to monitor and report intake and output for 1 of 1 residents reviewed for urinary tract infections and urinary catheter use (Resident #41). Resident #41 had a history of acute kidney injury and chronic urinary tract infections. He was found to have inadequate fluid intake and urine output and staff failed to monitor and report. The facility reported a census of 43 residents.
Fire safety inspections
7 fire safety citations on file: 1 on March 12, 2026, 3 on March 20, 2025, 3 on May 30, 2024.
Every fire safety citation7 citations
- F
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
K 321 · March 12, 2026 · Corrected (the home has a date of correction)
- F
Have simulated fire drills held at unexpected times.
K 712 · March 20, 2025 · Corrected (the home has a date of correction)
- E
Have properly located and lighted "Exit" signs.
K 293 · March 20, 2025 · Corrected (the home has a date of correction)
- E
Have properly installed electrical wiring and gas equipment.
K 511 · March 20, 2025 · Corrected (the home has a date of correction)
- F
Have simulated fire drills held at unexpected times.
K 712 · May 30, 2024 · Corrected (the home has a date of correction)
- F
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
K 761 · May 30, 2024 · Corrected (the home has a date of correction)
- D
Have proper medical gas storage and administration areas.
K 923 · May 30, 2024 · Corrected (the home has a date of correction)