Willow Knoll Post-Acute and Senior Living
4400 Vannest Avenue, Middletown, OH 45042 · Butler County · (513) 422-5600
58 certified beds, about 55 residents a day · For profit - Limited Liability company · Medicare and Medicaid since 1985
Part of a continuing care retirement community Certified for Medicaid Certified for Medicare
Overall
3 of 5
Health inspections
4 of 5
Staffing
1 of 5
CMS note: This facility reported a high number of days without a registered nurse onsite.
Quality measures
4 of 5
CMS Care Compare ratings, data as of September 1, 2026 · CCN 365648 · See it on Medicare.gov · Compare with other homes
The record in brief
At its most recent standard inspection, on December 5, 2025, inspectors cited 2 health deficiencies (the Ohio average is 10.5, the national average 9.2).
None of its 9 health citations since July 2021 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 3.41 hours per resident per day, against 3.69 across Ohio and 3.86 nationally. Registered nurses accounted for 0.17 of those hours.
40.8% of nursing staff left within the year CMS measured (Ohio average 48.7%).
CMS links it to PACS Group, an affiliated group of 275 nursing homes.
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.
607/21
008/24
212/25
106/26
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 9 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
2E
2F
Potential for minimal harm
0A
0B
0C
June 16, 2026Complaint inspection · 1 citation
- E Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Inspectors wroteBased on resident interview, observation, staff interview, review of facility records, and review of the facility policy, the facility failed to ensure water temperature in resident rooms were maintained at acceptable temperatures to prevent the possibility of scalding injuries. This affected thirteen (Residents #27, #30, #31, #34, #39, #40, #43, #44, #45, #46, #52, #54, and #55) and had the potential to affect all of the residents residing in the facility. The facility census was 54 residents.
December 5, 2025Standard inspection, Complaint inspection · 2 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 observation, interview, and facility policy review, the facility failed to store food in accordance with professional standards for food service safety. This deficient practice had the potential to affect all residents who received food from the kitchen. The facility census was 53.
- D Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Inspectors wroteBased on observation, interview, and facility document and policy review, the facility failed to provide a homelike environment for 3 (Resident #38, #57, and #70) of 8 sampled residents reviewed for environment. The facility census was 53.
August 22, 2024Standard inspection · 0 citations
July 9, 2021Standard inspection · 6 citations
- F Honor the resident's right to receive visitors of his or her choosing, at the time of his or her choosing.
Inspectors wroteBased on observation, visitation signage, interview, and review of the Centers for Medicare and Medicaid Services (CMS) guidance, the facility failed to ensure residents were allowed visitation. This affected all of the residents who resided in the facility. The census was 45.
- E Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Inspectors wrote2. Record review for Resident #24 revealed an admission date of 06/12/07. The last quarterly MDS assessment was dated 05/03/21. Review of care conferences for Resident #24 revealed the last one was held on 11/11/20. Interview with a family member on 06/28/21 at 3:02 P.M. revealed there hasn't been a care conference in several months. The family member stated they do have care conference, but due to their work schedule, they cannot attend. There have been no other arrangements made to attend a care conference. During interview on 07/01/21 at 1:38 P.M., Social Worker Designee (SWD) #26 confirmed the last care conference was on 11/20/20. 3. Record review for Resident #43 revealed an admission date of 01/18/21. The last quarterly MDS assessment was dated 06/13/21. Review of care conferences for Resident #43 revealed a care conference had never been held. [...]
- D Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Inspectors wrote2. Record review revealed Resident #22 was admitted on [DATE]. Medical diagnoses included hemiplegia and hemiparesis following cerebral infarction affecting left non-dominant side, diabetes, rheumatoid arthritis, diabetes, atrial fibrillation, morbid obesity, chronic kidney disease, anxiety, depression, and unsteadiness on her feet. Review of quarterly MDS dated [DATE] revealed Resident #22 was cognitively intact. Review of physician orders for Resident #22 revealed she was prescribed Losartan 100 milligram (mg), Metoprolol 25 mg ER and Diltiazem Extended Release (ER) 180 mg and for high blood pressure, Lipitor 10 mg for high cholesterol, Fluoxetine 40 mg for depression, and Synthroid 125 micrograms (mcg) for low thyroid. Review of the revised care plans, dated 04/28/21, revealed no plan of care for high cholesterol, hypothyroidism, depression and hypertension. [...]
- D Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Inspectors wrote3. Medical record review for Resident #22 revealed she was admitted on [DATE]. Review of consultation report from the pharmacy issued on 03/02/21 and 05/05/21 revealed a request for Lantus insulin 10 units in the morning and 25 units in the evening to be combined and given in the evening. The recommendation was not reviewed, signed or dated by the physician. During interview on 07/01/21 at 3:30 P.M., the Administrator and Director of Nursing (DON) stated the Assistant Director of Nursing (ADON) had the pharmacy recommendation records offsite and they would try to get the information from the pharmacy. At the time of exit, no policy on pharmacy recommendations and none of the information from the offsite location or the pharmacy had been provided. Based on record review and interview, the facility failed to ensure the physician documented review of pharmacy recommendations. [...]
- D Ensure that residents are free from significant medication errors.
Inspectors wroteBased on observation, staff interview and policy review the facility failed to prime insulin needles before administration for one (#26) of one reviewed for insulin injections during the medication administration. The facility identified six residents who received insulin pens. The census was 45.
- D Provide and implement an infection prevention and control program.
Inspectors wroteBased on observation, record review, interview and policy review, the facility failed to ensure a staff member donned appropriate personal protective equipment when caring for a resident on quarantine. This affected one (Resident #9) of three residents identified by the facility as being under quarantine. The facility census was 45.
Fire safety inspections
46 fire safety citations on file: 8 on December 5, 2025, 17 on August 22, 2024, 21 on July 9, 2021.
Every fire safety citation46 citations
- F Have approved installation, maintenance and testing program for fire alarm systems.
- F Inspect, test, and maintain automatic sprinkler systems.
- F Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
- F To conduct inspection, testing and maintenance of fire doors by qualified individuals.
- F Have generator or other power source capable of supplying service within 10 seconds.
- E Install an approved automatic sprinkler system.
- E Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- E Have restrictions on the use of highly flammable decorations.
- F 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.
- F Provide properly protected cooking facilities.
- F Have approved installation, maintenance and testing program for fire alarm systems.
- F Follow proper procedures when the fire alarm was out of service for more than 4 hours.
- F Inspect, test, and maintain automatic sprinkler systems.
- F Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.
- F Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- F Have properly installed electrical wiring and gas equipment.
- F Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
- F To conduct inspection, testing and maintenance of fire doors by qualified individuals.
- F Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
- F Have generator or other power source capable of supplying service within 10 seconds.
- E Have corridors or aisles that are unobstructed and are at least 8 feet in width.
- E Install an approved automatic sprinkler system.
- E Install properly constructed windows in hallway walls or doors.
- E Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
- E Provide properly sized and located linen or trash receptacles.
- F Develop and maintain an Emergency Preparedness Program (EP).
- F Conduct risk assessment and an All-Hazards approach.
- F Develop a communication plan.
- F Establish emergency prep training and testing.
- F Conduct testing and exercise requirements.
- F Install emergency lighting that can last at least 1 1/2 hours.
- F Provide properly protected cooking facilities.
- F Have approved installation, maintenance and testing program for fire alarm systems.
- F Inspect, test, and maintain automatic sprinkler systems.
- F Properly select, install, inspect, or maintain portable fire extinguishes.
- F Have properly installed electrical wiring and gas equipment.
- F Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
- F Have simulated fire drills held at unexpected times.
- F To conduct inspection, testing and maintenance of fire doors by qualified individuals.
- F Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
- F Have generator or other power source capable of supplying service within 10 seconds.
- E Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.
- E Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- E Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
- E Have restrictions on the use of highly flammable decorations.
- E Ensure proper usage of power strips and extension cords.
Fines and payment denials
CMS lists no fines or payment denials against this home in the last three years. The national average is 0.9 fines per home.
Staffing
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 | Ohio | United States |
|---|---|---|---|
| All nursing staff (RN, LPN and aides) | 3.41 | 3.69 | 3.86 |
| Registered nurses | 0.17 | 0.64 | 0.69 |
| All nursing staff on weekends | 2.89 | 3.28 | 3.42 |
| Nurse aides | 1.97 | ||
| Licensed practical nurses | 1.27 | ||
| Nursing staff turnover (share who left in a year) | 40.8% | 48.7% | 45.8% |
| Registered nurse turnover | not reported | 43.9% | 42.9% |
| Administrators who left | 0 |
CMS expects 4.60 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
Staffing by quarter, from daily payroll records
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 3.61 on weekdays and 2.89 on weekends, 20% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 14.2% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 3.62 in April to June 2025 to 3.41 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 | 3.41 | 0.17 | 3.61 | 2.89 | 14.2% | 21 of 90 | 55 |
| Oct to Dec 2025 | 3.66 | 0.27 | 3.78 | 3.36 | 12.9% | 0 of 92 | 54 |
| Jul to Sep 2025 | 3.51 | 0.30 | 3.67 | 3.12 | 13.1% | 0 of 92 | 54 |
| Apr to Jun 2025 | 3.62 | 0.35 | 3.79 | 3.19 | 4.5% | 0 of 91 | 51 |
| United States, Jan to Mar 2026 | 3.75 | 0.62 | 3.92 | 3.33 | 5.3% | 0.5% of days | |
| Ohio, Jan to Mar 2026 | 3.64 | 0.60 | 3.80 | 3.24 | 4.6% | 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.
Quality measures
The measures CMS uses for the quality star. Lower is better for every one of them.
| Measure | This home | Ohio | US |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1 | 3.0 | 5.3 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 0.0 | 0.2 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 1.6 | 0.5 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 0.5 | 3.2 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 1.0 | 1.2 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 0.0 | 6.1 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 0.5 | 3.4 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 6.1 | 8.8 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 19.5 | 24.9 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 13.8 | 12.9 | 12.0 |
Owners and operators
Legal business name: MIDDLETOWN POST ACUTE LLC. CMS links this home to PACS Group, a group of 275 nursing homes averaging 2.9 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Castellanos, Andrew | Contracted managing employee | Individual | 04/01/2023 | |
| Chaney, Steve | W-2 managing employee | Individual | 10/04/2021 | |
| Apt, Frederick | Corporate officer | Individual | 01/01/2024 | |
| Hancock, Mark | Corporate officer | Individual | 01/01/2024 | |
| Jergensen, Joshua | Corporate officer | Individual | 01/01/2024 | |
| Mitchell, John | Corporate officer | Individual | 01/01/2024 | |
| Chaney, Steve | Operational/managerial control | Individual | 10/04/2021 |
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.
Questions to ask on a visit
Chosen from this home's own inspection record.
- How do residents and families raise a complaint or grievance, and how fast is it answered?Inspectors cited 2 problems in this area, most recently on December 5, 2025: "Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely."
- When is the care plan meeting, and can family attend it?Inspectors cited 2 problems in this area, most recently on July 9, 2021: "Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals."
- How are medications reviewed, and how often are antipsychotic or sedating drugs used?Inspectors cited 2 problems in this area, most recently on July 9, 2021: "Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures."
- How do you prevent falls and pressure injuries, and how are families told when one happens?Inspectors cited 1 problem in this area, most recently on June 16, 2026: "Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents."
- Who is on the floor on Saturday and Sunday, and how many residents does each aide care for?Weekend nurse staffing here was 2.89 hours per resident per day, below the Ohio average of 3.28.
Other nursing homes nearby
- The Laurels of Middletown Middletown, 2.7 mi · 4 of 5 stars · 42 citations
- Momentous Health at Franklin Franklin, 3.2 mi · 1 of 5 stars · 36 citations
- Carlisle Manor Health Care Inc Carlisle, 3.3 mi · 4 of 5 stars · 12 citations
- Otterbein Middletown Franklin, 3.5 mi · 4 of 5 stars · 19 citations
- Arlington Pointe Care Center Middletown, 4.1 mi · 4 of 5 stars · 9 citations
- Astoria Health & Rehab Center Germantown, 5.9 mi · 5 of 5 stars · 1 citation
- Majestic Care of Middletown LLC Middletown, 6.1 mi · 2 of 5 stars · 58 citations
- Ohio Living Mount Pleasant Monroe, 6.4 mi · 4 of 5 stars · 11 citations
Ohio contacts for a concern about a nursing home
These are the official offices in Ohio. NursingHomeClear cannot take or act on complaints.
- Inspections and complaints: Ohio Department of Health, Nursing Homes and Facilities, the state agency that inspects nursing homes for CMS and takes complaints about care.
- Resident advocate: Ohio Office of the State Long-Term Care Ombudsman, 1-800-282-1206. The long-term care ombudsman is a free, confidential advocate for residents and families, set up under the federal Older Americans Act.
- State inspection reports: Ohio Long-Term Care Quality Navigator (Ohio Department of Aging), where Ohio publishes its own records on licensed homes.
Common questions
- What is Willow Knoll Post-Acute and Senior Living's Medicare star rating?
- CMS rates Willow Knoll Post-Acute and Senior Living 3 out of 5 stars overall, with 4 for health inspections, 1 for staffing and 4 for quality measures (CMS data as of September 1, 2026).
- How many deficiencies did Willow Knoll Post-Acute and Senior Living get at its last inspection?
- 2 health deficiencies at the standard inspection on December 5, 2025. The Ohio average is 10.5.
- Has Willow Knoll Post-Acute and Senior Living been fined?
- CMS lists no fines in the last three years.
- Does Willow Knoll Post-Acute and Senior Living accept Medicaid?
- It is certified to take Medicaid (CMS lists it as "Medicare and Medicaid"). Certification does not mean a Medicaid bed is open: ask the admissions office.
- Who owns Willow Knoll Post-Acute and Senior Living?
- CMS lists 7 owners and managers, and links the home to PACS Group. Legal business name: MIDDLETOWN POST ACUTE LLC.
Sources
- Ratings, staffing and fines: CMS Provider Information, released September 30, 2026, data as of September 1, 2026.
- Citations: CMS Health Deficiencies and Fire Safety Deficiencies.
- Owners: CMS Ownership. Penalties: CMS Penalties.
- Staffing by quarter: CMS Payroll Based Journal Daily Nurse Staffing, April 2025 to March 2026, summed by NursingHomeClear.
- Inspector summaries: CMS Full Statement of Deficiencies (CMS-2567 text), data as of September 1, 2026. Each quote is the part of the statement before the detailed findings.
- Inspection reports with the inspectors' full notes are on this home's Medicare.gov page.
- Something wrong on this page? Ask for a correction. We fix errors in our copy of the data; findings themselves can only be changed by CMS and the state.
- NursingHomeClear is independent and not affiliated with CMS, Medicare or any state agency. This page reports federal records; it does not rate, recommend or endorse any home, and it is not medical or legal advice.