Laurel Heights Community Care
2740 California St, San Francisco, CA 94115 · For profit - Corporation · 32 certified beds · (415) 567-3133 Medicare only — no Medicaid
The public record raises real questions here. Weigh the concerns below carefully.
- a strong health-inspection score (4/5) — the hardest rating to game (though it’s ranked within its own state, not nationally)
- a high payroll-based staffing rating (4/5)
- lower-than-typical staff turnover (14% vs 45% nationally) — better care continuity
- fewer deficiencies at its most recent standard inspection than at the one before — a sign of improvement
- it has 1 actual-harm citation
- a high number of inspection citations overall (24) — worth reading through, though larger and more-often-surveyed homes tend to accrue more lower-severity tags
- the CMS record shows $8,018 in federal fines (most recent 2024-04-19)
One thing this read cannot see: what residents and families actually experience day to day. Public data misses the feel of a place — visit unannounced, ideally at a mealtime or on a weekend, talk to staff and families, and ask your tour questions.
A plain-English summary of the public record below — not a rating, ranking, or recommendation. We take no money from any facility.
| Health inspectionSurveyor-assigned, ranked within your stateInspector-verified | 4 of 5 |
| StaffingFrom payroll records (PBJ) | 4 of 5 |
| Quality measuresSelf-reported by the facility | 5 of 5 |
Location & what’s nearby
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Nearest of each type, straight-line distance. Hospitals come from the CMS Hospital General Information registry; everything else from Overture Maps (public data). Hospital and park hours are typical — call ahead to confirm.
Quality measures — how residents actually fare
| Overall quality measures | 5 of 5 |
| Long-stay residentspeople who live here | 5 of 5 |
Quality-measure stars summarize outcomes CMS tracks from the assessments each home submits — avoidable hospitalizations and ER visits, falls with injury, pressure ulcers, unplanned weight loss, and long-term antipsychotic use. Because the underlying data is self-reported, weigh a high score against the independent inspection record. Long-stay = permanent residents; short-stay = rehab and post-hospital stays.
Trend — is this home getting better or worse?
Over 2025-02 to 2026-06, this home’s CMS overall rating improved from 3 to 5 stars. From monthly CMS archive snapshots.
Horizontal axis runs 2025-02 to 2026-06. That is where CMS’s monthly archive ends, so the right-hand edge of each line is that month — not today.
See all quality measures vs. state & national benchmarks
| Measure | This home | State avg | Typical state | vs typical state |
|---|---|---|---|---|
| Long-stay residents whose need for help with daily activities increased | 4.8% | 10.2% | 15.4% | better |
| Long-stay residents who lose too much weight | 3.9% | 4.0% | 5.4% | better |
| Long-stay residents with a catheter left in their bladder | 0.0% | 0.8% | 0.9% | better |
| Long-stay residents with a urinary tract infection | 0.0% | 1.2% | 2.0% | better |
| Long-stay residents with depressive symptoms | 0.0% | 7.3% | 6.5% | check this* — see note marked star below the table |
| Long-stay residents who were physically restrained | 0.0% | 0.4% | 0.1% | better than state‡ — see note marked double-dagger below the table |
| Long-stay residents with falls causing major injury | 0.0% | 1.6% | 3.3% | check this* — see note marked star below the table |
| Long-stay residents whose ability to walk worsened | 17.1% | 9.8% | 16.1% | typical |
| Long-stay residents on antianxiety or hypnotic medication | 0.0% | 13.7% | 18.9% | check this* — see note marked star below the table |
| Long-stay residents given the seasonal flu vaccine | 97.0% | 98.2% | 95.3% | typical |
| Long-stay residents with pressure ulcers | 1.4% | 4.3% | 4.7% | better |
| Long-stay residents with worsening bladder/bowel control | 4.4% | 10.2% | 21.2% | better than state‡ — see note marked double-dagger below the table |
| Long-stay residents who got an antipsychotic medication§ — see the note below the table | 8.3% | 12.0% | 17.1% | better |
* This home reported 0% on a measure where lower is better. That can mean genuinely excellent care — but because the number is self-reported, a zero can also mean the problem was not recorded. Weigh it against the inspection record above.
‡ On this measure the state average is at least twice (or half) the typical state — a gap that size is usually how the state codes and reports the measure, not how its homes actually perform. Against a benchmark this state does not sit on, a “vs typical state” verdict would mostly be measuring the state, so we compare this home with its own state instead and show both averages.
§ Antipsychotics carry an FDA boxed warning — they raise the risk of death in older people with dementia-related psychosis, and are not approved for that use. So this measure is partly a read on whether a home sedates residents instead of staffing for them. But read a low rate carefully in both directions: CMS excludes residents coded with schizophrenia (and Tourette's or Huntington's) from this measure, and federal auditors have found implausible increases in schizophrenia coding since the measure was published — so a very low rate can reflect recoding rather than less prescribing. Ask the home what share of its residents carry a schizophrenia diagnosis, and how it handles behavioral symptoms without medication.
CMS quality measures, as Care Compare shows them. For most rows lower is better (fewer falls, ulcers, hospitalizations); vaccination rates are the exception. Not every row is risk-adjusted. CMS adjusts some measures for resident mix, but falls with major injury, antipsychotic use, physical restraints and the vaccination rates are unadjusted rates — so a home caring for heavier or more behaviorally complex residents can look worse on them without providing worse care. The “typical state” column is the median of the 50 state averages — not a national average of all homes. We use it because a plain average across homes is pulled badly off course by a few states’ reporting habits (long-stay depressive symptoms is the clearest case: Illinois codes it several times higher than most states, which alone lifted the all-homes figure to about twice what a typical state records). The median of state averages resists that — but it does weigh every state equally, so a large state counts no more than a small one, and it is a benchmark of our construction rather than a CMS-published figure. better/worse means the home differs from that benchmark by more than 10% of it; closer than that reads typical. CMS does not publish how many residents each measure covers, and the counts are often small — a single resident can move a rate by several points — so treat small gaps as noise. These come from data the facility reports, so weigh them against the independent inspection record above.
Staffing
How full it usually is: this home is certified for 32 beds and averages 30.0 residents a day — about 94% occupied, or roughly 2 beds typically open. It runs fairly full. This is a CMS average, not live availability — no public source publishes real-time vacancies, and a home can be full the day you call. Confirm with the home, and if you need a Medicaid bed specifically, ask about that separately: a home with open beds may still not have an open Medicaid bed.
Against a benchmark — not a legal minimum. In May 2024 CMS finalized the first federal staffing floor for nursing homes: 3.48 total nurse hours per resident per day, including 0.55 RN hours and 2.45 nurse-aide hours. Its hour requirements never took effect and are no longer on the books. Homes had until 2026 (2027 if rural) to comply, and that deadline never arrived: a federal court vacated the hour requirements in April 2025 (CMS has appealed), Congress then barred enforcement until 2034, and CMS formally repealed them by rule effective February 2026. This home is not required to meet these numbers, and is not violating anything by missing them. We still show the comparison because the figures are CMS’s own published estimate of adequate staffing, which makes them a useful yardstick — but they are our benchmark, not federal law: this home’s total nurse staffing of 4.09 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 0.43 is below the 0.55-hour RN benchmark and nurse-aide staffing of 2.85 is at or above the 2.45-hour aide benchmark. What federal law does require today is unchanged: “sufficient” nursing staff for residents’ needs and an RN on duty at least 8 consecutive hours a day, 7 days a week (42 CFR 483.35). Those are judged by inspectors on site, not by these averages, so read this comparison alongside the inspection record rather than as a pass/fail.
Weekend coverage: total nurse staffing is 3.99 hrs/resident/day on weekends vs 4.14 on weekdays — 4% thinner on weekends. RN hours go from 0.44 to 0.39 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)
This home’s total nursing-staff turnover of 14% is below the national median of 45%.
Payroll-based (PBJ) staffing hours, as reported for Jan–Mar 2026 (CMS PBJ CY2026Q1) — the most recent quarter CMS has published, so they can lag a change of operator or staffing agency. Higher is generally better. Registered-nurse coverage and weekend staffing are the numbers families most often overlook — an RN on site matters most when something goes wrong, and coverage usually thins on weekends. High turnover means residents rarely see the same caregiver twice. One caveat: these are hours as reported, not adjusted for how sick or heavy-care this home’s residents are. CMS separately publishes a case-mix-adjusted view; we show the reported hours. A home caring for higher-acuity residents needs more hours to deliver the same care, so compare these figures against homes doing similar work, and read them next to the inspection record rather than alone.
Inspection trend
Deficiencies are fewer than at the previous inspection — improving. Fewer citations over time suggests a home is fixing problems; a rising count is a warning sign — though two surveys are a short record, and survey teams differ. These counts are from the standard annual health survey only; the full citation list below may also include findings from complaint investigations, so the two won’t always add up.
Inspection deficiencies
State health-inspection citations, most serious first. Each carries an F-code (the federal rule it cites, e.g. F-684 = quality of care) and a letter A–L marking how serious and how widespread the problem was — we translate that grid into the plain tiers shown here. Wording is the official federal description.
Each letter is a CMS scope-severity level; highlighted ones are where this home has citations. A–C = no harm found; D–F = potential for harm; G–I = actual harm; J–L = immediate jeopardy. Within each band the later letter is the more widespread finding (an isolated G is one resident; a widespread I is a pattern), so rightward and downward is worse.
24 citations, most serious first. The 11 most serious are shown; the remaining 13 are one tap away and print in full.
- Actual harm · G2024-05-08 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolatedEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review, the facility failed to prevent an avoidable fall for one of four sampled residents (Resident 1) when Resident 1 fell from the mechanical lift device (also known as Hoyer lift, a device that helps caregivers lift and transfer residents from one place to another) while being transferred by Certified Nursing Assistant (CNA) 1 from his bed to recliner. This failure resulted in Resident 1 sustaining a head trauma (injury that occurs when there is a direct or indirect blow to the head), which led to hospitalization and subsequent death. Findings: Review of the facility's investigative report, dated [DATE], indicated On Friday, [DATE], at approximately 9:59 AM. (Name of Resident 1) under the care of a temporary agency (also known as registry - temporary staffing agency) Certified Nursing Assistant (CNA) during a morning shift, suffered a fall while being transferred using a Hoyer lift . We originally reported that the fall was caused by the incorrect use of the sling…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · Ecited before2025-07-31 · tag F0812 — failed to store, cook, and serve food safely — patternProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observation, interview, and record review, the facility failed to ensure safe and sanitary condition was met for food storage in the kitchen when there was a slight dent on a can of Hunt's Tomato Sauce in the storage room. This failure was likely to result in putting residents at risk for foodborne illness (diseases caused by consuming contaminated food or drink).During a concurrent observation and interview on 7/27/25 at 11:52 AM with Dietary Service Supervisor (DSS) in the storage room in the kitchen, there was a dent on the can of Hunt's Tomato Sauce on a shelf. The can indicated, . BEST BY OCT (October) 17 2026 . NET WT (Weight) 15 OZ (an abbreviation for ounce, a unit of weight or fluid volume) (425g (gram, a unit of mass in the metric system, equal to one thousandth of a kilogram)) . DSS stated, the can should not have the dent and he needed to throw it away. DSS further stated, I need to return it to the Sysco Company. During an Interview on 7/27/25 at 12:04 PM with DSS, DSS stated, Botulis (sic: Botulism is a rare but serious illness caused by a toxin that attacks…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2025-07-31 · tag F0657 — failed to keep the care plan current — isolatedDevelop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on interview and record review, the facility failed to develop and implement a comprehensive person-centered care plan within 7 days after completion of the comprehensive assessment in collaboration with the Interdisciplinary (professional disciplines, as appropriate, will work together to provide the greatest benefit to the resident) Team (IDT) and hospice provider for 1 of 3 residents (Resident 29) receiving hospice services.The deficient practice resulted in the potential for unmet physical, emotional and psychosocial needs, and lack of coordination between the facility and hospice.During a review of facility's clinical document titled admission Record dated 7/27/2025, the admission record indicated, Resident 29 was admitted in the facility 4/3/2024 with primary admitting diagnosis is Vascular Dementia (where the brain doesn't get enough blood flow, which damages brain cells and causes problems with thinking, memory).A review on Resident 29's care plan, on 7/29/2025, indicated, there was no documented participation or collaboration with the hospice IDT ((interdisciplinary…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2025-07-31 · tag F0849 — isolatedArrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on staff interview and record review, the facility failed to provide a written agreement with the hospice that defined the services to be provided, respective responsibilities, and established a process for communication and collaboration for one of three sampled residents (Resident 29).This deficient practice resulted in the potential for compromised quality of care due to lack of defined roles, responsibilities and communication between the facility and hospice provider for all residents receiving hospice services.During a review of facility's clinical document titled admission Record, dated 7/24/2025, admission record, indicated, resident 29 was admitted on [DATE], and is a Medicare and Medi-Cal beneficiary.During an interview on 7/29/2025 at 10:35AM with Registered Nurse/Infection Preventionist (RN/IP) 1, RN/IP 1, stated, I cant find a hospice written agreement that's why I've been calling Program of All-Inclusive Care for the Elderly (PACE) agency requesting the hospice agreement needed today for the…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · F2024-04-19 · tag F0801 — widespreadEmploy sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observation, staff interviews, and review of facility documents, the facility failed to: 1. Comply with Federal regulations related to the oversight of food service operations when the facility did not have a full-time dietitian and the requirements were not met as specified in established standards (California Code, Health and Safety Code - HSC § 1265.4) for food service managers which required, employment of a full-time, qualified dietetic supervisor when the dietitian was not full time. The lack of a qualified, competent, full-time supervisor resulted in staff not having adequate supervision, training, and knowledge to carry out Food and Nutrition Services in a safe and sanitary manner. 2. Ensure the Registered Dietitian (RD) provided sufficient consultation to the Food and Nutrition Services department. The lack of a qualified, full-time, competent supervisor to oversee Food and Nutrition Services, and lack of sufficient consultation from the RD, placed 27 residents who received food from the kitchen at risk for food borne illness (illness caused by food contaminated…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · F2024-04-19 · tag F0802 — failed to prepare enough nourishing food — widespreadProvide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observation, interview, and facility document review, the facility failed to ensure kitchen staff competency for: 1. Calibrating food thermometers; 2. Cooldown procedures for Time/Temperature Control for Safety (TCS) food (food which requires time and temperature monitoring to prevent the growth of harmful bacteria); 3. Procedures for monitoring dishmachine temperature and sanitizer strength; 4. Temperature monitoring for trayline food; 5. Temperature monitoring for food storage coolers; 6. Manual dishwashing using the two-compartment sink; and 7. Testing sanitizer strength used for food contact surfaces. The failure to ensure staff competency regarding required and/or performed tasks had the potential to result in contamination of food and/or utensils and equipment leading to illness caused by pathogens (harmful organisms) for 27 residents who received food from the kitchen. Findings: Review of the facility's undated job summary titled Dietary Supervisor showed the Dietary Supervisor was responsible for overseeing the dietary department. The supervisor was to manage…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · Fcited before2024-04-19 · tag F0803 — failed to meet residents' dietary needs — widespreadEnsure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observation, interview, and facility document review, the facility failed to follow the planned menu. This failure had the potential to result in inadequate and/or inappropriate nutrients served to residents leading to nutrient related medical complications for 27 residents who received food from the kitchen. Findings: Review of the facility's policy and procedure titled Food Preparation Portion Control dated 2018, showed to be sure portions served equal portion sizes listed on the menu, portion control equipment must be used. During an observation and interview on 4/15/24 at 11:15 a.m., the Kitchen Supervisor (KS) provided a document titled Week at a Glance, when she was asked for a copy of the spreadsheet used for trayline food service to indicate foods and serving sizes to serve for different prescribed diets. Week at a Glance showed the menu for the Regular diet for the week. It did not include therapeutic diets and it did not include serving sizes. When KS was asked how serving sizes and foods to serve for therapeutic diets were determined during trayline, she did not…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · F2024-04-19 · tag F0804 — failed to serve food at safe, palatable temperature — widespreadEnsure food and drink is palatable, attractive, and at a safe and appetizing temperature.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observation, interview, and facility document review, the facility failed to serve food that was flavorful and at a palatable temperature. This failure had the potential for decreased food intake leading to nutrient related complications for 27 residents who received food from the kitchen. Findings: Review of the facility policy and procedure titled Meal Service dated 2018, showed the Food and Nutrition Services staff member will take the food temperature prior to service of the meal with a thermometer. It may be necessary to take the temperature in more than one location on the food item to confirm the proper temperature has been reached. The food temperatures will be recorded. The food will be served on trayline at the recommended temperatures: meat, rice, and vegetable 160-170 degrees F. The minimum hot holding temperature on steam table is 140 degrees F. Temperatures of the food when the resident receives it is based on palatability. The goal is to serve cold food cold and hot food hot. The suggested minimum temperature for a hot entrée, starch, and vegetable is 120…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · Fcited before2024-04-19 · tag F0812 — failed to store, cook, and serve food safely — widespreadProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY The facility failed to serve food in a safe and sanitary manner when: 1. Time/Temperature Control for Safety (TCS; food which requires time and temperature monitoring to prevent the growth of harmful bacteria) foods were not monitored for cool down; 2. Raw meat was stored directly next to produce; 3. Different types of thawing meat were commingled; 4. Stored and ready to use utensils and equipment were not clean and/or in poor condition; a. Two of two food processors; b. Seven of seven cutting boards; c. A variety of cooking tools and equipment stored in drawers and on shelving; 5. Wood shelving, cabinets, and drawers had peeling paint and/or built-up residue and grime; 6. TCS food was not discarded by storage recommendations; 7. A storage container holding coffee was not cleaned before refilling; and 8. A freezer gasket was not maintained clean. This failure put residents at risk for consuming contaminated food and/or using contaminated utensils resulting in illness caused by pathogens (harmful organisms) for…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · E2024-04-19 · tag F0698 — failed to provide proper dialysis care — patternProvide safe, appropriate dialysis care/services for a resident who requires such services.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review, the facility failed to ensure one of two sampled residents (Resident 2) that require dialysis (mechanical removal of wastes and excess fluids from the body) receive services as consistent with professional standards of practice when there was no ongoing communication between the nursing home and the dialysis facility. This failure had the potential to result in misinformation that may negatively affect patient care. Findings: Review of Resident 2's admission Record, indicated Resident 2 was admitted on [DATE] with diagnoses that include end stage renal disease (a condition in which the kidneys stop working and are not able to remove waste and extra water from the blood or keep body chemicals in balance). During an interview on 4/15/24 at 1:12 PM, Resident 2 stated she goes to dialysis treatment every Tuesday, Thursday, and Saturday. Review of Resident 2's Current Physicians Orders, dated 4/24 indicated Dialysis .Schedule: Tuesday, Thursday, Saturday .Review Dialysis…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · E2024-04-19 · tag F0805 — failed to prepare food in a form residents can eat — patternEnsure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observation, interview, and facility document review, the facility failed to ensure the appropriate texture of pureed food was served to residents. This failure had the potential for residents to aspirate (breath in fluid into the lungs which can cause choking, aspiration pneumonia, and/or death) while consuming food for 10 residents with a prescribed a pureed diet. Findings: Review of the Daily Spreadsheet Monday dated March 18, 2024, (and was the spreadsheet for lunch served on 4/15/24) showed the foods and respective serving size to serve for therapeutic diets. On the spreadsheet, the therapeutic diet was indicated as Pureed (PU4). Also, the foods pureed diets received for lunch included but were not limited to pureed Spanish Rice and pureed Zucchini and Yellow Squash. Review of the Ala Carte Menus by [menu company name] Diet Manual dated 2021, showed Pureed (PU4) was a modified diet designed for people who have severe chewing and/or swallowing problems. Puree all foods to a smooth, lump-free, extremely thick consistency, and use an appropriate recipe. Foods on this…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
Show the remaining 13 citations
- Potential for harm · E2024-04-19 · tag F0880 — failed to prevent and control infections — patternProvide and implement an infection prevention and control program.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review, the facility failed to implement infection prevention and control measures when: 1. The urine drainage bag of Resident 131 was touching the floor. 2. Staff did not perform hand hygiene (a way of cleaning one's hands that substantially reduces harmful microorganisms on the hands) in between clean and dirty tasks. 3. Staff did not sanitize Resident 9's call light after picking it up from the floor and prior to placing it on Resident 9's bed. 4. Staff did not perform hand hygiene after handling dirty linens. These failures placed Resident 131 at risk for transmission of infectious organisms from the floor to the urinary tract and had the potential for spread of germs in the facility. Findings: 1. Review of Resident 131's admission Record indicated Resident 131 was admitted on [DATE]. Review of Resident 131's Discharge Summary (DS), from the general acute care hospital, dated 4/3/24, indicated Resident 131 had diagnoses that include nephrolithiasis (kidney stones)…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · Ecited before2024-04-19 · tag F0912 — patternProvide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation and record review, the facility failed to provide 80 square feet of living space for each resident, in two of 14 resident rooms (resident rooms [ROOM NUMBERS]). This failure had the potential to prevent staff from providing the necessary care and services to the residents, and it could potentially prevent the residents from having enough space for their personal belongings. Findings: During an observation on 4/15/24 at 10:37 AM, there were three were three occupied beds in resident room [ROOM NUMBER] and three occupied beds in resident room [ROOM NUMBER]. Review of the facility-provided floor plan indicated rooms [ROOM NUMBERS] had total of 214 square feet for each room providing only 71.3 square feet per resident. Review of the facility's resident census, dated 4/15/24 indicated resident rooms [ROOM NUMBERS] had three residents residing in each room. During an interview on 4/15/14 at10:38 AM, Certified Nursing Assistant (CNA) 1 stated she has been taking care of the residents in rooms [ROOM…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2024-04-19 · tag F0558 — failed to accommodate residents' needs and preferences — isolatedReasonably accommodate the needs and preferences of each resident.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observation, interview, and record review the facility failed to provide reasonable accommodation of resident needs when: On 4/15/24 at 10:15 AM Resident 9's call light was found on the floor and was not plugged in the wall socket. This failure created an un-individualized care and an environment that promotes neglect. Neglect occurs when the facility is aware of, or should have been aware of, goods or services that a resident(s) require but the facility fails to provide them to the resident(s) resulting in, or may result in, physical harm, pain, mental anguish, or emotional distress. FINDINGS: During a review of Resident 9's admission record, it indicated, he was admitted with diagnoses of major depressive disorder (a mental health disorder characterized by persistently depressed mood or loss of interest in activities, causing significant impairment in daily life), vascular dementia (a decline in thinking skills caused by conditions that block or reduce blood flow to various regions of the brain, depriving them of oxygen and nutrients), and type 2 diabetes (a condition…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2024-04-19 · tag F0637 — isolatedAssess the resident when there is a significant change in condition
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review and interview, the facility failed to complete a comprehensive assessment and failed to monitor weight weekly for one of two sampled residents (Resident 26) after Resident 26 had an unplanned, significant weight gain of 9.4% in February 2024. This failure had the potential for Resident 26 to not receive necessary treatment and care to related to the unplanned, significant weight variance, leading to medical related complications. Findings: Review of undated facility policy titled Weight Assessment and Intervention, indicated, Policy Statement - The nursing staff and the Dietitian will cooperate to prevent, monitor, and intervene for undesirable weight loss for our residents. Policy Interpretation and Implementation . 3. Any weight change of greater than or less than 5 (five) pounds within 30 days will be retaken the next day for confirmation. If the weight is verified, nursing will notify the physician and responsible party. 4. If the resident has a confirmed weight change of greater than…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2024-04-19 · tag F0656 — failed to write and follow a full care plan — isolatedDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview and record review, the facility failed to develop and implement a comprehensive care plan (CP) for one of 12 sampled residents (Resident 26) when Resident 26's care plan did not include the physician's order to use heel protectors (devices designed for the heel of the foot that help remove the pressure from the heels and prevent and treat pressure ulcers [breakdown of skin integrity due to pressure]). This failure resulted in the care plan not accurately reflecting individualized, person-centered intervention necessary to meet the care needs of Resident 26. Findings: Review of Resident 26's admission Record, indicated Resident 26 was admitted on [DATE] with diagnoses that include acute non-traumatic intracranial hemorrhage (spontaneous bleeding inside the skull or brain) with possible cystic lesion (lump or small pocket of tissue in the brain) and hemiparesis (weakness or inability to move on one side of the body). Review of Resident 26's Minimum Data Set (MDS - a standardized…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2024-04-19 · tag F0686 — failed to prevent and treat pressure sores (bedsores) — isolatedProvide appropriate pressure ulcer care and prevent new ulcers from developing.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review, the facility failed to provide care to prevent pressure ulcer for one of 12 sampled residents (Resident 26) when the physician's order to apply bilateral heel protectors was not carried out. This failure placed Resident 26 at risk to develop pressure injuries. Findings: Review of Resident 26's admission Record, indicated Resident 26 was admitted on [DATE] with diagnoses that include acute non-traumatic intracranial hemorrhage (spontaneous bleeding inside the skull or brain) with possible cystic lesion (lump or small pocket of tissue in the brain) and hemiparesis (weakness or inability to move on one side of the body). Review of Resident 26's Minimum Data Set (MDS - a standardized assessment tool that measures health status in nursing home residents), dated 3/11/24, indicated Resident 26's both lower extremities had limitation in movement. Review of Resident 26's Braden Scale - For Predicting Pressure Sore (Pressure Injury) Risk, dated 3/10/24, indicated…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2024-04-19 · tag F0758 — failed to limit and justify psychotropic drugs — isolatedImplement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review, the facility failed to ensure one of 12 sampled residents (Resident 131) was free from unnecessary psychotropic medications (drugs that affect brain activities associated with mental processes and behavior) when there was no side effect (also known as adverse reactions, are unwanted undesirable effects that are possibly related to a drug) monitoring for the use of Trazodone (a medication used to treat depression [a constant feeling of sadness and loss of interest, which stops a person from doing normal activities] or help with sleep problems). This failure had the potential to place Resident 131 at risk for unrecognized side effects associated with the use of Trazodone that could cause harm to resident. Findings: Review of Resident 131's admission Record indicated Resident 131 was admitted on [DATE] with diagnoses that include insomnia (a common sleep disorder that can make it hard to fall asleep or stay asleep). Review of Resident 131's Current Physicians Orders, dated…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2024-04-19 · tag F0761 — failed to label and store drugs safely — isolatedEnsure 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.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observation, interview and record review, the facility failed to ensure the Aspart insulin bottle was dated when first opened when: On 4/15/24, an Aspart insulin bottle was found not dated when first opened for use. This practice of either advertently or inadvertently not dating the insulin bottle or vial when first opened will put the resident's health at risk by receiving an expired medication or an insulin that is not potent. It can potentially cause more elevation of the resident's blood sugar resulting to organ damage and/or death. FINDINGS: Resident 19 was admitted with the following diagnoses: Alcohol dependence with induced persisting dementia, epilepsy (also known as a seizure disorder - a brain condition that causes recurring seizures.), Type 2 diabetes mellitus (a chronic disease characterized by high levels of sugar in the blood - called hyperglycemia), and chronic kidney disease (CKD - also known as chronic kidney failure, meaning a gradual loss of kidney function over time), among others. Resident 19 had no score on his brief interview for mental status (BIMS)…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2024-04-19 · tag F0908 — failed to keep essential equipment working — isolatedKeep all essential equipment working safely.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observation and interview, the facility failed to maintain one of three food refrigerators free of significant ice build-up. This failure had the potential to affect the quality and safety of food stored inside the refrigerator. Findings: According to the 2022 Federal Food Code, equipment shall be designed and constructed to retain their characteristic qualities under normal use. Equipment shall be maintained in a state of repair. Door seals shall be kept intact and tight. An observation on 4/15/24 at 11:07 a.m., showed a milk dispensing refrigerator located in the kitchen being used as refrigerator to store a variety of foods. There was a significant amount of ice build-up, in some areas over one inch thick, covering the majority of the interior sides and ceiling. In addition, it was noted the rubber gasket (the gasket creates a tight seal when the cooler door is closed in order to keep cool air inside the refrigerator) on the perimeter of the interior side of the door was dented, and was not a continuous, intact gasket. In an interview and observation on 4/16/24 at 1:55…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · Ecited before2021-12-09 · tag F0912 — patternProvide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview and record review, the facility failed to provide six of 31 residents with 80 square feet of usable space in two resident rooms, rooms [ROOM NUMBERS]. This failure had a potential to result in residents tripping and falling while trying to move throughout the rooms, and prevent staff from providing the necessary care and services to the residents. It could also potentially prevent the residents from having enough space for their belongings. During the meeting on 12/08/21, at 11: 30 a. m.,with Resident 2, Resident 2 stated, she attended the Resident Council meetings every month. She stated, No resident raised issues regarding lack of enough space in their rooms, during the last three Resident Council meetings. During random observations throughout the days of the survey on 12/7/21, 12/8/21, and 12/9/21, there were no issues identified in the provision of care in resident rooms [ROOM NUMBERS]. During a review of facility document titled Request for Variance, (written communications…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2021-12-09 · tag F0550 — failed to protect resident dignity and rights — isolatedHonor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview, observation, and record review, the facility failed to honor the rights and dignity of one of 14 sampled residents (Resident 16), when the resident, who required assistance to eat, was fed her lunch by a standing CNA 1 (Certified Nurse Assistant). The facility's failure to treat the resident with dignity decreased the resident's quality of life. Findings: Resident 16 was admitted to the facility on [DATE] with diagnoses including Alzheimer Disease, AD (causes memory loss, mental decline, and confusion), Chronic obstructive pulmonary disease, COPD (resulting in chronic cough, bronchitis, asthma, shortness of breath), kidney disease, and high blood pressure. Resident 16's Minimum Data Set (MDS), an assessment tool, dated 11/11/21, indicated resident required total dependence on one/two staff physical assist for bed mobility, transfer to bed/chair, for daily feeding, had impaired hearing/vision, limited verbal skills. During an observation on 12/8/21, at 1:03 PM - 1:08 PM, Resident 16 was…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · Dcited before2021-12-09 · tag F0803 — failed to meet residents' dietary needs — isolatedEnsure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observation, interview, and record review, the facility failed to follow the menu plan for the designated week, 12/5/21. This failure had the potential to cause loss of appetite and boredom with food repetition. Findings: During a tour of the kitchen on 12/7/21, at 9:45 AM, it was noted the dietary cook was following the Week at a Glance menus on the clipboard dated week of 11/14/21. The menu being followed for 12/7/21, Tuesday, was dated 11/16/21. It consisted of Texas Sliced French Toast, Breakfast Meat of Choice, Seasonal Fruit, Hot or Cold Cereal. For Lunch, Oven Fried Chicken, Yukon Gold Mashed Potatoes with Parsley, Mixed Vegetables, Bread or Roll & Butter or Margarine. For Dinner, Sausage with Peppers, Oven Browned Potatoes, Seasoned Beets, Bread or Roll & Butter or Margarine. The menu for 12/7/21, Tuesday, was Coconut Pancakes, Breakfast Meat of Choice, Seasonal Fruit, Hot or Cold Cereal. For Lunch, Braised Beef Tips, Parslied Rice, Seasoned Carrots, Bread or Roll & Butter or Margarine. For Dinner, Ravioli with [NAME] Sauce, Mixed Salad Greens with Dressing, Garlic…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- No harm found · Bcited before2025-07-31 · tag F0912 — patternProvide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review, the facility failed to ensure in two (resident rooms [ROOM NUMBERS]) of 14 residents' rooms met the required minimum of 80 square feet (sq ft) per resident.This failure has the potential for residents to not to have enough appropriate space for the provision of care or daily living.During an observation on 7/27/2025 at 10:00 AM, in the course of the initial tour of the facility conducted on the first-floor room [ROOM NUMBER] were occupied by three beds divided by curtains two residents, room [ROOM NUMBER] were occupied by three beds with three residents, with curtains to divide each bed.During an interview on 7/28/25 at 10:20 AM, Resident 24 in Room14, Resident was asked how the space was in their room. Resident 24 stated, I am okay staying with this room, I don't have any issue sharing it to my two neighbors.During an interview on 7/30/2025 at 2:44PM with Certified Nursing Assistant (CNA)1, CNA 1 stated, it's okay, when we use the Hoyer lift and there is still…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
“Cited before” means this same F-tag appears on at least one other survey date in the record we hold — counting complaint investigations as well as standard surveys, with no time limit. It is our own read of the data, not CMS’s: CMS uses repeat deficiency as a formal term tied to consecutive standard surveys, and that is a narrower test than this one. A tag marked here may or may not meet it.
- Long-Term Care Ombudsman — a free, confidential advocate for the resident. They act only with the resident’s consent and work to resolve the problem. Find yours at theconsumervoice.org/get_help.
- Adult Protective Services — the state agency that investigates suspected abuse, neglect, or exploitation of a vulnerable adult. Not sure of your state’s APS number? The federal Eldercare Locator will route you: 1-800-677-1116 or eldercare.acl.gov.
- State survey agency — the regulator that licenses and inspects the home. Every state has an official nursing-home complaint line and most take complaints online; the Ombudsman or Eldercare Locator can connect you.
Fines & penalties
$8,018 in federal fines across 1 penalty.
- $8,018 — penalty dated 2024-04-19
Dates are the dates CMS records the penalty, not the date of the conduct behind it. CMS publishes penalties on a rolling window, so this is what is currently on the public file — not the home’s lifetime history, and an older fine may attach to a problem that has since been corrected. The amounts are as imposed: the CMS file does not record whether a penalty was appealed, reduced, or paid, so we don’t say. Ask the home what each one was for and what changed since.
Who owns this facility
| Owner / manager | Type | Role | Share | Since |
|---|---|---|---|---|
| JC CARE INC | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | since 11/01/2014 |
| CHALICH, JOHN | Individual | 5% OR GREATER INDIRECT OWNERSHIP INTEREST; CORPORATE DIRECTOR; CORPORATE OFFICER; OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNF | 50% | since 11/01/2014 |
| CHALICH, TANYA | Individual | 5% OR GREATER INDIRECT OWNERSHIP INTEREST; CORPORATE OFFICER; ADP OF THE SNF | 50% | since 11/01/2014 |
| DIMACALI, EUFEMIA | Individual | OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNF | — | since 10/11/2023 |
| LANGNER, MIKAEL | Individual | OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNF | — | since 03/01/2026 |
CMS files one row per role, so the 13 rows in the source record cover these 5 parties — each is shown once here with every role it holds. Nothing is omitted.
1 organizational owner listed — a facility can be part of a larger chain. CMS ownership data is known to under-report private-equity and REIT ties; treat as a starting point.
What families pay in CA
CMS lists this home as Medicare-certified only — it is not Medicaid-certified, so it generally cannot accept Medicaid as payment for a long-term stay. That makes it one of roughly 545 homes nationally where a Medicaid-funded placement is not an option. If you expect to rely on Medicaid, ask the home directly before you tour, and see the California Medicaid page for homes that do.
Median private-pay cost, CareScout (Genworth) 2025 Cost of Care Survey — a regional midpoint, not any single community’s rate. Private rooms and higher care levels cost more; ask for a current quote. Project your own in the cost-of-care planner.
Every figure above is reproduced from the CMS Provider Data Catalog (a public record), from the CMS extract processed 2026-08-01 — CMS provider number 555869. CMS refreshes its data monthly, and the star rating rests on the last standard inspection — dated 2025-07-31, which can lag current conditions. Staffing hours are CMS PBJ CY2026Q1 (Jan–Mar 2026). Check this record against the government’s own page for it: this home on Medicare Care Compare ↗ — the authoritative source, and the place to confirm anything here before you act on it. How we present it →
Not a government site. Eldercare Lens is not affiliated with, endorsed by, or authorized by the Centers for Medicare & Medicaid Services (CMS), Medicare, or any government agency. The star ratings, citations, and inspection wording on this page are reproduced from the public CMS record; the plain-English summaries, tiers, and comparisons around them are ours. We do not speak for CMS, and CMS has not reviewed this page. For the official record, go to Medicare Care Compare. How we’re funded →
Are you this operator? If the record here is out of date, or misses what you have since fixed, tell us and we will look: hello@eldercarelens.com. We reproduce the public CMS record and cannot change what it says — corrections to the underlying data go through CMS and your state survey agency — but we will correct anything we have got wrong about it, and we will say so on the page.