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 5 health citations on file.
Severity
Isolated
Pattern
Widespread
Immediate jeopardy
0J
0K
0L
Actual harm
0G
0H
0I
Potential for more than minimal harm
2D
2E
1F
Potential for minimal harm
0A
0B
0C
May 29, 2026Standard inspection · 0 citations
April 17, 2025Standard inspection, Complaint inspection · 4 citations
- F
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 facility policy review, the facility failed to ensure all drugs were labeled in accordance with professional standards in 5 out of 6 treatment carts and 2 out of 6 medication carts. Observation on 04/16/2025 revealed that five treatment carts and two medication carts had many multi-use patient specific lotions, powders, creams, eye drops, nasal sprays, and inhalers that were not dated after being opened.
- E
Provide and implement an infection prevention and control program.
Inspectors wroteBased on observation, interview, record review, review of the manufacturer's directions for use, and review of the facility's policies, the facility failed to establish and maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment and helped prevent the development and transmission of communicable diseases and infections for three (3) of three (3) sampled residents reviewed for infection control, Resident (R) 6, R8, and R19. Observation on 04/15/2025 and 04/16/2025 revealed Licensed Practical Nurse (LPN) 3 did not perform appropriate hand hygiene and don (put on) gloves when required during medication administration for R6, R8, and R19. Additional observation on 04/16/2025 revealed LPN3 did not disinfect shared equipment when required; did not disinfect R19's glucometer as directed before and after use; [...]
- D
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
Inspectors wroteBased on interview, record review, and review of the facility's policies, the facility failed to document a resident's concern for lost, missing, or stolen items for 1 of 21 sampled residents, Resident (R) 363. In interviews with the Complainant and the facility's staff, they stated R363's dentures were lost, missing, or stolen. However, the facility failed to document the missing, lost, or stolen item on the grievance log, provide a facility investigation, and offer a replacement for the missing, lost, or stolen dentures.
- D
Ensure services provided by the nursing facility meet professional standards of quality.
Inspectors wroteBased on observation, interview, record review, and review of the facility's policy, the facility failed to ensure that services provided met professional nursing standards for 2 of 3 sampled residents, Residents (R) 6 and R19. On 04/15/2025 at 8:05 AM, Licensed Practical Nurse (LPN) 3 was observed during medication administration to give the medication cup containing each resident's medication to R6 and R19, but she did not to stay and watch the residents take their medications.
November 14, 2019Standard inspection · 1 citation
- E
Provide safe and appropriate respiratory care for a resident when needed.
Inspectors wroteBased on observation, interview, record review, and review of the facility policy, it was determined the facility failed to provide residents with necessary respiratory care and services in accordance with professional standards of practice for five (5) of twenty-eight (28) sampled residents (Residents #54, #60, #88, #301, and #302). Observation on 11/12/19, 11/13/19, and 11/14/19, revealed Resident #54, #60, #301, and #302's oxygen tubing and nasal cannula was not dated to indicate when it was last changed. In addition, observation on 11/12/19, revealed Resident #88's C-PAP (continuous positive airway pressure) tubing and mask was lying on his/her rolling walker and was not dated to indicate when it was last changed, nor was it in a protected bag while not in use.
Fire safety inspections
3 fire safety citations on file: 1 on April 17, 2025, 1 on July 16, 2024, 1 on November 14, 2019.
Every fire safety citation3 citations
- F
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
K 521 · April 17, 2025 · Corrected (the home has a date of correction)
- F
Provide a written emergency evacuation plan.
K 711 · July 16, 2024 · Corrected (the home has a date of correction)
- D
Ensure proper usage of power strips and extension cords.
K 920 · November 14, 2019 · Corrected (the home has a date of correction)