Channel Islands Post Acute
3880 Via Lucero, Santa Barbara, CA 93110 · For profit - Corporation · 156 certified beds · (805) 687-6651 Medicare & Medicaid certified
This home’s record is mixed — some reassuring signs, some worth asking about.
- a strong health-inspection score (4/5) — the hardest rating to game (though it’s ranked within its own state, not nationally)
- no federal fines or payment denials on record
- a high payroll-based staffing rating (4/5)
- a high number of inspection citations overall (22) — worth reading through, though larger and more-often-surveyed homes tend to accrue more lower-severity tags
- its facility-reported quality-measure rating is low (1/5)
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 | 1 of 5 |
Location & what’s nearby
Open in Google Maps ↗ · Directions ↗ · Larger map ↗
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 | 1 of 5 |
| Long-stay residentspeople who live here | 1 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 fell from 5 to 2 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 | 6.1% | 10.2% | 15.4% | better |
| Long-stay residents who lose too much weight | 1.5% | 4.0% | 5.4% | better |
| Long-stay residents with a catheter left in their bladder | 0.3% | 0.8% | 0.9% | better |
| Long-stay residents with a urinary tract infection | 1.0% | 1.2% | 2.0% | better |
| Long-stay residents with depressive symptoms | 2.8% | 7.3% | 6.5% | better |
| 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 | 3.0% | 1.6% | 3.3% | worse than state‡ — see note marked double-dagger below the table |
| Long-stay residents whose ability to walk worsened | 4.4% | 9.8% | 16.1% | better |
| Long-stay residents on antianxiety or hypnotic medication | 17.7% | 13.7% | 18.9% | typical |
| Long-stay residents given the seasonal flu vaccine | 100.0% | 98.2% | 95.3% | typical |
| Long-stay residents with pressure ulcers | 3.5% | 4.3% | 4.7% | better |
| Long-stay residents with worsening bladder/bowel control | 18.6% | 10.2% | 21.2% | worse than state‡ — see note marked double-dagger below the table |
| Short-stay residents who newly got an antipsychotic medication | 2.3% | 1.5% | 1.4% | worse |
| Short-stay residents given the seasonal flu vaccine | 100.0% | 93.2% | 79.4% | better |
| Short-stay residents rehospitalized after admission | 22.4% | 23.0% | 22.6% | typical |
| Short-stay residents with an outpatient ER visit | 23.4% | 11.2% | 12.0% | worse |
| Long-stay hospitalizations per 1,000 resident days | 1.95 | 2.25 | 1.67 | worse |
| Long-stay outpatient ER visits per 1,000 resident days | 2.10 | 1.57 | 1.80 | worse |
‡ 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.
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.
Short-stay rehab — if you are coming here from a hospital
Arriving from a hospital right now? Read the discharge guide → — your appeal rights, how to slow a rushed discharge, and what to ask about the numbers below.
44.1% of the Medicare patients who left this home got back to the community and stayed there for at least 31 days — which CMS reads as no different from the national rate. This is CMS’s risk-adjusted rate over 196 Medicare stays in Oct 2022–Sep 2024, and CMS’s own comparison — not ours.
Met the expected recovery: 75.2% of this home’s Medicare short-stay residents left it at or above the ability to care for themselves and move around that CMS predicted for them, across 101 stays in Oct 2024–Sep 2025. The median of the 11,061 homes CMS publishes this for is 56.6%. Read it beside the getting-home figure, not instead of it: unlike the two measures above, CMS makes no better-or-worse call on this one and publishes no confidence interval for it, so this is a comparison and not a verdict — but it is the short-stay measure that separates homes most, and the one to ask about.
Therapy staffing: this home’s payroll records show 0.36 therapist hours per resident per day in 2026Q1 — more than 61% of the 13,892 homes that report any therapy hours at all.
Weekend therapy: weekend therapy hours are 12% of this home’s weekday level — it runs some therapy at the weekend, at a lower level than on weekdays. The median home that reports therapy runs 13% — weekday-focused therapy is the industry norm, not a shortfall. But recovery does not pause on a Saturday: ask what the weekend actually looks like here.
This section is about rehab stays, not living here. Most of this page — the stars, the quality measures, the inspection record — describes the home the way a permanent resident experiences it. These figures describe the short Medicare stay after a hospital discharge: a hip, a stroke, a bad infection, six weeks and home. They are different residents, different staff, often a different wing. Therapy hours are per resident in the building, not per rehab patient — the count includes every long-stay resident, and they mostly get no therapy at all. So a home with a small rehab wing inside a large nursing population reads low here even if its rehab patients get plenty of therapy, and a mostly-rehab home reads high. Use it to compare homes doing similar work, ask what a rehab resident actually gets in a day, and remember that CMS does not publish therapy minutes per patient — nobody does.
See every short-stay measure CMS publishes for this home
| Measure | This home | U.S. median | Period covered | CMS’s call |
|---|---|---|---|---|
| Got home and stayed homeRate of successful return to home or community from a SNF | 44.1%CMS range 36.7–52.1 | 51.5% | Oct 2022–Sep 2024 | no different from U.S. |
| Went back to hospitalRate of potentially preventable hospital readmissions 30 days after discharge from a SNF | 12.1%CMS range 9.2–15.2 | 10.7% | Oct 2022–Sep 2024 | no different from U.S. |
| Met the expected recoveryPercentage of residents who are at or above an expected ability to care for themselves and move around at discharge | 75.2% | 56.6% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Self-care at dischargePercentage of residents who are at or above an expected ability to care for themselves at discharge | 49.5% | 52.8% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Moving around at dischargePercentage of residents who are at or above an expected ability to move around at discharge | 65.3% | 50.0% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Medication problems followed upPercentage of residents whose medications were reviewed and who received follow-up care when medication issues were identified | 96.3% | 98.7% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Medication list to the next providerPercentage of residents where the SNF provided a current medication list to the next health care setting | 100.0% | 100.0% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Medication list to the familyPercentage of residents where the SNF provided a current medication list to the resident, family, and/or caregiver at final discharge | 76.7% | 98.7% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Falls with major injuryPercentage of SNF residents who experience one or more falls with major injury during their SNF stay | 1.1% | 0.0% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| New or worsened pressure ulcersPercentage of residents with pressure ulcers/pressure injuries that are new or worsened | 2.7% | 1.9% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Infections that led to hospitalPercentage of infections residents got during their SNF stay that resulted in hospitalization | 8.0%CMS range 5.7–11.1 | 7.1% | Oct 2023–Sep 2024 | no different from U.S. |
| Medicare spending per stayMedicare Spending Per Beneficiary (MSPB) for residents in SNFs | 1.33 | 1.02 | Oct 2022–Sep 2024 | CMS makes no comparison for this measure |
From the CMS Skilled Nursing Facility Quality Reporting Program — Medicare short-stay outcomes, which is a different dataset from the long-stay quality measures above and describes a different set of residents. Where CMS risk-adjusts a measure we show its adjusted rate, and the CMS range beside it is the confidence interval CMS publishes: a home whose range is wide is a home with few stays, where one patient moves the number several points. Read the period column. These measures do not share a window — the claims-based ones (getting home, readmission, spending) lag by a year or more, because a stay has to finish and its claims settle before it can be counted. CMS’s call is CMS’s, not ours: it is the only place anyone tests whether this home differs from the national rate at all, and most homes on most measures do not. Two caveats on it. CMS tests only three of these measures — getting home, readmission, and infections that led to hospital; on the other nine it publishes a rate and no comparison, and rather than compute a verdict CMS declined to make, we say so in the column. And on readmission almost every home in the country lands on “no different”, so that row separates homes far less than getting-home does — which is why met the expected recovery, a measure CMS does not test but which spreads across the whole range, is called out above the table rather than left in this list. The U.S. median column is our own, taken across every home CMS publishes that measure for in this same file; it is not a CMS-published benchmark. Homes CMS gives no rate for are left out of it rather than counted as zero. Medicare spending per stay is a ratio, not a percentage — 1.00 means this home’s Medicare spending for a stay matched the national figure CMS compares it against, and it measures cost to Medicare, not quality of care.
Staffing
How full it usually is: this home is certified for 156 beds and averages 144.2 residents a day — about 92% occupied, or roughly 12 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 4.10 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 0.71 is at or above the 0.55-hour RN benchmark and nurse-aide staffing of 2.29 is below 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 3.23 hrs/resident/day on weekends vs 4.45 on weekdays — 28% thinner on weekends — a notable drop. RN hours go from 0.78 to 0.54 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)
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 more than at the previous inspection — worsening. 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.
22 citations, most serious first. The 10 most serious are shown; the remaining 12 are one tap away and print in full.
- Potential for harm · D2026-04-13 · 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 record review, interview, and facility Policy and Procedure (P/P) the facility failed to ensure care plan interventions were updated following score increase, multiple subsequent falls for one and three resident (Resident 1). This facility failure resulted with resident having repeated preventable falls. During a concurrent interview on 4/12/26 at 11:30 a.m., the Minimum Data Set (MDS) coordinator confirmed that Resident 1 experienced three previous falls (on 10/17/25, 11/27/25, and 12/11/25) prior to a fourth fall on 3/31/26. This most recent incident resulted in a left periprosthetic femoral fracture (a break in the thigh bone adjacent to a hip prosthesis).A review of Resident 1's comprehensive care plan for falls initially dated 8/20/25, revised 8/30/25, revealed there was no documentation to show an updated interventions following Resident 1's multiple subsequent falls on 10/17/25, 11/27/25, and 12/11/25. While the fall on 3/31/26 was addressed, the interventions remained identical to the original 8/20/25 plan, indicating a lack of revision in response to changing…
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 · D2025-08-22 · tag F0725 — failed to have enough nursing staff — isolatedProvide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
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 sufficient staffing to provide care for the residents.This failure has the potential to affect the resident quality of care.A review of All Facilities Letter (AFL) dated 3/17/21, the AFL summary indicated In accordance with HSC sections 1276.5 and 1276.65, and W & I section 14126.022, this notice provides updated guidelines for facility requirements during state audits for compliance with the 3.5 DHPPD staffing requirements, of which a minimum of 2.4 DHPPD shall be performed by certified nurse assistants (CNAs).During a concurrent interview and record review on 8/19/25 at 4:30 p.m with the Director of Nursing (DON) the Census and Direct Care Service Hours Per Patient Day (DHPPD - a staffing metric for skilled nursing facilities (SNFs), for the dates of 7/24/25 - 8/6/25 was reviewed. On 7/6/25 (Saturday) the actual DHPPD was 3.03 and for Certified Nursing Assistant (CNA) was 1.71.On 7/2/25 (Sunday) the actual DHPPD was 2.93 and for CNA was 1.82. On 8/1/25 (Friday) the actual DHPPD for CNA was 2.24.On…
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 · D2025-08-12 · tag F0580 — failed to tell family and doctor about changes — isolatedImmediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
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 staff failed to ensure a significant change in condition for one of three sampled resident (Resident 1) was communicated to ensure prompt consult with the resident's physician when the Certified Nursing Assistant (CNA 1) noticed Resident 1 was becoming more tired and needed to be assisted with meals. This failure resulted in delay in treamnet for the resident. Review of Resident I clinical records indicated, Resident 1 was admitted to the facility on [DATE], with diagnoses that included Alcohol cirrhosis (chronic liver failure) of liver with ascites (abnormal build up of fluid in the abdomen), hepatic encephalopathy (altered level of consciousness as a result of liver failure), pleural effusion (accumulation of excessive fluid in the space that surrounds each lung), heart failure, generalized swelling. Furhter review of clinical records showed, Resident 1 had a change of condition (COC) on 7/08/2025, for weakness and dysphagia (difficulty swallowing), and COC…
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 before2025-06-20 · tag F0557 — isolatedHonor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
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 have one of three sampled residents (Resident 1) the right to retain and use personal possessions when a denture delivered to the resident was never documented nor found. This facility failure has the potential to create negative consequences whereby the resident feels not treated with respect. Findings: During a review of Resident 1's admission Record (AR), dated 6/4/25, the AR indicated Resident 1 was admitted to the facility on [DATE] with including diagnosis of Anxiety disorders (a group of mental health conditions characterized by excessive and persistent worry, fear) and altered mental status (AMS - refers to a change in a person's level of consciousness, awareness, or cognitive function). Further review of Resident 1's Dental notes record indicated dated 11/21/22, that Resident 1 full upper and full dentures were delivered. However, review of Resident 1's Inventory of Personal Effects record dated 4/15/22 showed record of…
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 · E2025-05-09 · tag F0755 — failed to provide safe pharmacy services — patternProvide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
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 its facility policies when: 1) Four expired drugs were available to be administered to residents 2) One medication was not administered as ordered by the physician for 1 of 31 sampled residents (Resident 43) 3) A consistent medication re-ordering process was not implemented 4) Multiple resident medications were not available timely and consistently 5) Two bags of sodium chloride (a salty solution given for dehydration) were inside the intravenous emergency kit (IV e-kit: a container with all the components needed to inject fluids, nutrients, and medications directly in the veins) but were not listed on the contents label. These failures had the potential to result in negative resident outcomes, jeopardizing the quality of safety of resident care. Findings: 1. a. During a concurrent observation and interview on 5/07/25 at 11:30 a.m. with Licensed Nurse (RN3) inside the medication storage room, a Med Pass 2.0 (a ready to drink calorie and protein-dense nutritional shake) with a use by date of 02/10/25…
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 · D2025-05-09 · tag F0554 — isolatedAllow residents to self-administer drugs if determined clinically appropriate.
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 follow its policy and procedure with Self-Administration of Medications for 1 of 31 sampled residents (Resident 39) found with multiple self-medications by the bedside. This failure has the potential to result in medication error. Findings: During a concurrent observation and interview of Resident 39's room on 05/05/25 at 09:45 a.m., supplemental medications were found by beside namely: Primal Harvest Hair Growth - Hair Growth Complex Supplement Immuneti Advanced Immune Defense. Primal Multivitamins (primal harvest). During an interview with Resident 39 when asked about the medication, Resident 39 stated I have been taking them by myself since I moved here into here into the facility. During a review of Resident 39's medical record (MR) indicated, resident was admitted to the facility on [DATE] with diagnoses that includes Suicidal Ideations (thinking about or being overly focused on death and dying), Alcohol abuse (craving and drinking…
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 · D2025-05-09 · tag F0584 — failed to keep a safe, clean, comfortable home — isolatedHonor 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.
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 safe, clean and home-like environment to 2 of 31 sampled residents (Residents 73 and 127) when: 1. Resident 127's room was found with loose floor tiles partially lifted creating a raised gap. 2. Resident 73's room was found with cobwebs in the ceiling, scratches on the wall by the headboard, and missing wall tiles in bathroom. These failures have the potential to affect residents' well-being. Findings: 1. During an observation on 5/5/25 at 10:20 a.m. in resident 127's room, one of the tiles on the floor was found to be loose and was partially lifted, creating a raised gap. During a review of the maintenance logbook for Station H2 (the section of the facility where Resident 127's room is located) reviewed dated 3/1/25 to 5/7/25 showed no requests directly added to maintenance logbook entries regarding a floor tile repairs for Resident 127's room and bathroom. During a concurrent observation and interview on 05/07/25 at 8:53 a.m. with the Maintenance supervisor (MS) in Resident 127's room, the MS…
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 before2025-05-09 · tag F0641 — isolatedEnsure each resident receives an accurate assessment.
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 observations, interviews and record review, the facility failed to accurately assess the status of residents to reflect with the Minimum Data Set (MDS - an assessment tool used to assess residents in nursing homes) for 3 of 3 unsampled residents (Resident 95, Resident 119 and Resident 130) when: 1. Resident 95 had an inaccurate assessment for injection (administering a substance using a needle and a syringe) use. 2. Resident 119 had an inaccurate assessment for anticoagulants (a medication that prevents blood clots from forming) use. 3. Resident 130 had an inaccurate assessment for tobacco use. These failures have the have the potential to prevent relevant care areas about the resident's status not being met. Findings: 1. During a review of Resident 95's admission Record (AR), dated 5/5/25, the AR indicated Resident 95 had a diagnosis of Type 2 Diabetes (abnormal blood sugar). During a review of the Physician's Progress Notes (PPN), dated 3/30/25, the PPN indicated, Resident 95 was taking insulin (a…
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 before2025-05-09 · tag F0645 — isolatedPASARR screening for Mental disorders or Intellectual Disabilities
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 that a PASSR Level I (preliminary assessment for individuals seeking admission to a Medicaid-certified nursing facility to determine if they might have a serious mental illness (SMI), intellectual disability (ID), or a related condition (RC)) and Level II (a comprehensive assessment conducted on individuals identified in the Level 1 screening as potentially having a mental illness or intellectual disability ID) were conducted for 2 of 31 sampled residents (Resident 10 and Resident 92). These failures had the potential to compromise resident care planning of the actual problems not to be addressed. Findings: During a review of the Medical Records (MR) for Resident 10 on 5/6/2025 indicated, Resident 10 was admitted to the facility dated on 03/08/2024 with diagnoses that includes Unspecified Schizophrenia' (a condition where a resident's symptoms do not meet the full diagnostic criteria for Schizophrenia or another more specific psychotic…
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 · D2025-05-09 · 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 review of the facility's policy and procedure (P&P), the facility failed to store medications in the storage refrigerator under proper temperature controls. This failure has the potential to result in a loss of effectiveness in medications. Findings: During a concurrent observation and interview on 5/07/25 at 11:49 a.m. with Licensed Nurse (RN3), the thermometer inside the medication storage refrigerator, there were Tuberculin (PPD - a diagnostic reagent used in the tuberculin skin test (TST) to detect tuberculosis (TB) infection), Insulin (medications used to treat sugar in the blood), and Hepatitis vials (single-dose vials containing purified surface antigen) stored inside the refrigerator. And the refrigerator temperature read 32°F (degrees Fahrenheit - temperature scale). During a concurrent observation and interview on 5/07/25 at 11:49 a.m. with RN3, RN3 confirmed the storage refridgerator temperature reading of 32°F and acknowledged the medications kept in the refrigerator were outside the acceptable range for the storage of medications.…
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 12 citations
- Potential for harm · Dcited before2025-05-09 · tag F0812 — failed to store, cook, and serve food safely — isolatedProcure 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 the dietary staff labelled and dated food storage stored. These deficient practices placed the residents at risk for foodborne illnesses (refers to illness caused by the ingestion of contaminated food or beverages). Findings: During an observation on 5/5/2025 at 9:20 am at the facitlity the kitchen, the following were observed: Three (3) packets of traditional stuffing with a date received but no label for date opened and expiry date were found. One open bag of bread buns, undated and in the freezer section, one bag containing four hamburger patties were undated and no expiry date. During an interview on 5/5/2025 at 9:20 a.m with the Assistant Administrator (AADM), the AADM acknowledged these findings. During a review of Policies and Procedures (P&P) titled Labeling and Dating of Foods dated 2023, the Labeling and Dating of Foods indicated in part, the use by date will be the absolute date in which the food must be consumed or discarded by the facility .the individual opening or preparing a food shall…
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 · D2025-04-17 · tag F0624 — isolatedPrepare residents for a safe transfer or discharge from the nursing home.
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 interviews and records review, the facility failed to provide sufficient discharge planning for one of three sampled residents (Resident 1) when the facility did not ensure needed home health services were in place prior to Resident 1's discharge. This failure resulted in Resident 1 not being provided needed home services. Findings: During a review of Resident 1, admission Record (AR), dated 04/09/25, the AR indicated, Resident 1 is a [AGE] year old male, admitted on [DATE] with diagnoses that included, fracture of right acetabulum and right pubis (a break in the socket of the hip joint), fall-subsequent encounter, Type 2 Diabetes Mellitus (the body cannot use insulin correctly and sugar builds up in the blood), and long-term use of insulin. Resident 1 was discharged to home on [DATE] at 11:14 a.m. with home health agency (HHA) services. During an interview on 4/09/25 at 12:24 p.m. with the Social Services Director (SSD), the SSD stated that social services staff coordinates continuity of care when…
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 before2024-07-18 · tag F0557 — isolatedHonor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
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 ensure that one of the three sampled residents (Resident 1) was treated with respect and dignity when Resident 1's personal belongings were relocated to another room. This failure created a situation whereby resident1's right to retain and use personal possessions was prevented. Findings: During a review of Resident 1's (R1) Clinical Record (CR) on 7/11/24 at 11:30 AM. The CR revealed Resident 1 was admitted to the facility on [DATE] with diagnoses that included Chronic Obstructive Pulmonary Disease (COPD - lung disease that causes obstructed air flow from the lungs), Congestive Heart Failure (CHF - heart's capacity to pump blood can't keep up with the body's need), pneumonia (infection of the lungs). During a review of Resident 1's inventory of personal effects (IPE-belonging list), dated 6/10/24, the IPE indicated, R1's personal items included cell phone/cord/charger and reading glasses. During a review of Resident 1's Nursing Progress Notes (NPN)…
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 before2024-07-18 · 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 person focused care plan for one of the three sampled residents(Resident 1) when activities of daily living (ADL) self-care deficit nursing needs were not addressed. This failure placed Resident 1 at risk of not having care needs met secondary to no plan in place. Findings: During a review of Resident 1's (R1) Clinical Record (CR) on 7/11/24 at 11:30 AM. The CR revealed Resident 1 was admitted to the facility on [DATE] with diagnoses that included Chronic Obstructive Pulmonary Disease (COPD - lung disease that causes obstructed air flow from the lungs), Congestive Heart Failure (CHF - heart's capacity to pump blood can't keep up with the body's need), pneumonia (infection of the lungs). During a review of Resident 1's Comprehensive Care Plan (CP) dated 6/10/24, CP indicated, Resident1 had ADL self-care deficit related to .muscle weakness, unsteady gait .CHF ., with interventions, Resident 1 requires…
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 · D2024-07-18 · tag F0677 — failed to help fully-dependent residents with daily care — isolatedProvide care and assistance to perform activities of daily living for any resident who is unable.
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 ensure that one (Resident 1) of the three sampled residents received services (bathroom help) to maintain grooming and personal hygiene. Resident 1 was not assisted to the availability of a urinal ( bedside portable plastic receptable for male urine) for over an hour after requesting assistance with toileting and ended up wetting/urinating on self. This failure had the potential to weaken resident 1 ' s bladder muscles and could raise risk of moisture associated skin damage (MASD) if exposed to various body wastes and fluids over an extended period of time. Findings: During a review of the facility policy and procedure (P&P) titled ADL, Services to carry out reviewed 1/2024, the P&P indicated, .Residents who are unable to carry out activities of daily living will receive necessary services, on a daily and as needed basis, to maintain . grooming and personal hygiene . During a review of the complaint report [Number], received 7/3/24, the report…
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 before2024-05-02 · tag F0645 — isolatedPASARR screening for Mental disorders or Intellectual Disabilities
What the surveyor found here — an excerpt from the official record, may be distressing
Based on interview, record review, and facility policy review, the facility failed to ensure residents with a positive Level I Preadmission Screening and Resident Review (PASRR) received a Level II evaluation. Specifically, after the cases for 2 (Resident #80 and Resident #5) of 5 residents reviewed for PASRR requirements were closed, the facility failed to resubmit Level I PASRRs to reopen the cases as directed by the Department of Health Care Services to ensure Level II evaluations were completed. Findings Included: A facility policy titled, PASRR, reviewed in 01/2024, revealed, It is the policy of this facility to ensure that each resident is properly screened using the PASRR specified by the State. 1. An admission Record revealed the facility originally admitted Resident #80 on 01/24/2012 and readmitted the resident on 12/24/2022. According to the admission Record, the resident had a medical history that included diagnoses of bipolar disorder, major depressive disorder, anxiety disorder, post-traumatic stress disorder (PTSD), and paranoid schizophrenia. A quarterly Minimum Data…
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 · D2024-05-02 · 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
Based on observation, interview, record review, and facility document and policy review, the facility failed to ensure the residents' environment remained as free of accident hazards as possible when unsecured medications were observed in residents' rooms without staff present. This deficient practice affected 1 (Resident #33) of 3 sampled residents reviewed for accidents and 1 (Resident #65) of 2 sampled residents reviewed for choices. Findings included: A facility policy titled, Medication Administration-General, revised in 11/2023, revealed, 9. The person administering medication must remain with the resident until all medication has been swallowed. A facility policy titled, Accident Prevention and Intervention, revised in 11/2023, revealed, It is the policy of this facility that the resident environment remains as free of accident hazards as is possible and that each resident receives adequate supervision and assistance devices to prevent accidents. A facility policy titled, Storage of Medications, revised in 11/2023 , indicated, It is the policy of this facility that all…
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 before2023-09-07 · 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
Based on observation, interview, and record review, the facility failed to implement one of two sampled residents (Resident 1) care plans indicating, Resident 1's bed should have bedside rails. The facility's failure placed Resident 1 at risk of falling out of bed and needing assistance with mobility and repositioning. Findings: During a concurrent observation and interview on 8/28/23 at 4:00 p.m with certified nursing assistant (CNA 2), Resident 1's bed was observed without 1/4 side rails. CNA 2 stated, No, there has not been any side rails on this bed as long as I can remember . During a review of Resident 1's care plan titled, ADL Self-Care Performance deficit r/t disease process, Dementia, Cognitive impairment, , revised 4/5/22, the care plan indicated, under Interventions,SIDE RAILS: ¼ side rails up as enabler for bed mobility and repositioning. The care plan titled, At risk for falls r/t Dementia, HTN, with BP medication management, MVA, Confusion, Hx. of closed injury, Psychotropic medication use, revised 2/7/23, indicated under Interventions, 1/4 bedside rails X 2. During an…
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 before2021-05-27 · tag F0641 — isolatedEnsure each resident receives an accurate assessment.
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 ensure one of 22 sampled residents (Resident 5) received an accurate admission Minimum Data Set (MDS, a standardized tool for care management) that is reflective of Resident 5's status. This facility failure had the potential to affect Resident 5's care needs and outcome. Findings: The facility policy titled Comprehensive Assessment dated 11/2019 indicated, in part, . It is the policy of this facility to complete a comprehensive assessment of the resident's needs which are based on the State's specific Resident Assessment Instrument. A review of the clinical record for Resident 5 revealed the following: >Resident 5 was admitted to the facility on [DATE] with diagnoses that included major depressive disorder, and unspecified dementia without behavioral disturbance. >A physician order dated 2/11/21 for the medication Celexa (for depression manifested by verbalizing sad statements). >An admission MDS dated [DATE] indicating Resident 5 received no…
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 · D2021-05-27 · tag F0658 — failed to meet professional standards of care — isolatedEnsure services provided by the nursing facility meet professional standards of quality.
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 policy and procedure was followed when: 1. No bottom sheet covered specialized mattress while one of twenty-two sampled residents (Resident 54) was lying in bed. This failure had the potential to cause skin breakdown and discomfort. 2. Staff did not dispose of thin single layer plastic bag containing brief with feces before holding the handles of a wheelchair to transport of one of twenty-two sampled residents (Resident 54) from the resident room into the common hallway. This failure had the potential to cause cross contamination of facility surfaces. Findings: 1. During an observation of Resident 54 on 5/24/21 at 11:47 a.m., Resident 54 was lying directly on a specialized bed mattress with no sheet covering the mattress. During an interview with a facility licernsed nurse (LN 2) on 5/24/21 at 11:47 a.m. LN 2 confirmed there was not sheet between Resident 54 and the mattress, and stated We have a special sheet we use for the mattress. The facility policy and procedure titled Low Air Loss, Alternating…
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 · D2021-05-27 · 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 as planned when: 1. Cranberry-ginger citrus sauce was placed on top of turkey for one of 22 sampled residents (Resident 54) on a CCHO diet (controlled carbohydrate/diabetic diet), instead of gravy as planned. 2. The portion size for one pureed item did not match the menu for one of 22 sampled residents (Resident 94). This facility failure had the potential to not meet the resident's nutritional needs per the planned menu as approved by the facility's Registered Dietitian. Findings: 1. During an observation on 5/25/20 at 11:15 AM, of the lunch trayline meal service in the kitchen, a cook (Cook 1) placed cranberry-ginger citrus sauce on top of turkey for Resident 54. Resident 54's meal tray card indicated, Diet Order: Mech [mechanical] Soft, Controlled CHO (CCHO). The meal tray was then placed on the meal delivery cart by a dietary aid (DA 2) after checking the meal tray for accuracy. DA 2 was asked to re-check Resident 54's meal tray for accuracy, in which she replied that it was correct.…
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 before2021-05-27 · tag F0812 — failed to store, cook, and serve food safely — isolatedProcure 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 a potentially hazardous food that was leftover from a dinner meal was cooled down to ensure food safety. This facility failure had the potential to cause foodborne illness. Findings: During an observation on 05/24/21 at 9:11 AM, inside the walk-in refrigerator in the kitchen, there was a container of cooked corn labeled 5/21 with a use by date of 5/24. A dietary aid (DA 1) stated the corn was leftover from dinner tray line meal service that occurred on 5/21/21. DA 1 was asked if the corn was expected to be on the cool down log, and she stated, Yes. Concurrently, DA 1 and the Dietary Manager (DM) reviewed the facility's cool down log and verified that the corn was not on the cool down log. The DM stated the corn needed to be thrown out since it was not documented as being cooled down safely. A review of the facility's menu indicated Confetti Corn was on the planned menu for the resident's dinner meal on 5/21/21. The facility policy and procedure titled Cooling And Reheating Potentially Hazardous Foods…
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
No federal fines in the current CMS record.
Part of a chain
This home belongs to THE ENSIGN GROUP — 342 facilities. Here is how its ratings compare with the chain’s average across all its homes: See the whole chain — ratings, flags, fines and finances →
| Rating | This home | Chain avg | |
|---|---|---|---|
| Overall | 3 of 5 | 3.2 | -0.2 vs chain |
| Health inspection | 4 of 5 | 2.8 | +1.2 vs chain |
| Staffing | 4 of 5 | 2.7 | +1.3 vs chain |
| Quality measures | 1 of 5 | 4.4 | -3.4 vs chain |
The other 341 homes this chain runs (chain average 3.2★, per CMS)
Showing 40 of 341; lowest-rated first.
A home rated well below its chain’s average can signal local problems; a chain with a low average across the board is a bigger pattern worth researching. CMS chain data under-reports private-equity and REIT ownership, so treat this as a floor, not the full picture.
Who owns this facility
| Owner / manager | Type | Role | Since |
|---|---|---|---|
| OTHMAN, SAMER | Individual | MANAGING CONTROL - GOVERNING BODY; OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNF | since 08/02/2022 |
| YAMAK, NAJIB | Individual | MANAGING CONTROL - GOVERNING BODY; OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNF | since 11/01/2019 |
| WILLITS, ADAM | Individual | CORPORATE DIRECTOR | since 07/24/2019 |
| BURNAM, SOON | Individual | CORPORATE OFFICER | since 07/24/2019 |
| CULLIFER, JARED | Individual | CORPORATE OFFICER | since 01/01/2024 |
| KEETCH, CHAD | Individual | CORPORATE OFFICER | since 03/01/2011 |
| SATO, AMI | Individual | CORPORATE OFFICER | since 09/09/2024 |
| FUSION MEDICAL STAFFING LLC | Organization | OPERATIONAL/MANAGERIAL CONTROL | since 11/01/2019 |
| PORT, BARRY | Individual | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | since 09/02/2025 |
| ENSIGN SERVICES INC | Organization | ADP OF THE SNF | since 07/24/2025 |
| LCCH INVESTMENT COMPANY | Organization | ADP OF THE SNF | since 11/01/2019 |
CMS files one row per role, so the 15 rows in the source record cover these 11 parties — each is shown once here with every role it holds. Nothing is omitted. The source lists no ownership percentage for any of them — PECOS records a share only for equity interests, not for board or management roles.
3 organizational owners 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.
Follow the money — this home’s finances
Where a nursing home’s revenue comes from and where it goes — including money paid to companies under the same ownership. Most consumer sites never show this; we reproduce it straight from the Medicare cost report.
About 76% of this home’s resident-days are paid by Medicaid, which reimburses well below the cost of care in most states. Heavily Medicaid-dependent homes run on thinner budgets — a context worth holding next to the staffing and inspection record, not a fault in itself. This home reported $2.2M paid to related parties — landlords or management companies under common ownership — equal to about 12% of its total expenses. Money routed to affiliated companies can leave a home’s own books looking lean while owners still profit; it is the mechanism regulators watch most closely in private-equity and REIT deals.
Source: CMS Healthcare Provider Cost Reporting Information System (HCRIS), Medicare cost report Form CMS-2540 · fiscal year 2023. Facilities self-file these reports; figures are unaudited and a year or two behind. A home with no Medicare cost report on file shows no figures here.
Cost & finances
Straight from this home’s Medicare cost report (CMS, FY2023). These are its operating economics — what it costs to run per resident-day and what it collects on average across Medicare, Medicaid, and private pay — not a private-pay quote. Your out-of-pocket cost depends on payer and room type, so ask the facility directly; a higher operating cost can reflect richer staffing or a sicker population. The cost-of-care planner shows regional benchmarks by care type.
What families pay in CA
This is a Medicare- and Medicaid-certified nursing home, so it can accept Medicaid for long-term care — like nearly all U.S. nursing homes. The private-pay figures below are what families without Medicaid pay; once a resident qualifies for Medicaid, out-of-pocket cost for covered nursing-home care is typically close to $0 (almost all of their income goes to the home as their share of the cost; they keep a small personal needs allowance — for clothing, haircuts, a phone — and Medicaid pays the rest). The amount of that allowance is set by each state. Confirm Medicaid-bed availability with the home, and see the California Medicaid page.
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 555875. CMS refreshes its data monthly, and the star rating rests on the last standard inspection — dated 2025-05-09, 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.