Storybrook Care & Rehabilitation

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

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.

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.

Met the expected recovery: 65.5% 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 29 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 0.56 therapist hours per resident per day in 2026Q1 — more than 86% of the 13,892 homes that report any therapy hours at all.

Weekend therapy: weekend therapy hours are 10% 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.

Staffing

How full it usually is: this home is certified for 60 beds and averages 56.5 residents a day — about 94% occupied, or roughly 4 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 3.68 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 0.66 is at or above the 0.55-hour RN benchmark and nurse-aide staffing of 2.35 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 3.27 hrs/resident/day on weekends vs 3.84 on weekdays — 15% thinner on weekends. RN hours go from 0.74 to 0.45 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)

This home’s total nursing-staff turnover of 50% is about the same as 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.

This trend is not current. The most recent of these two inspections was over 2 years ago; the arrow describes what inspectors found then, not what the home is like now.

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.

34 citations, most serious first. The 15 most serious are shown; the remaining 19 are one tap away and print in full.

• Actual harm · Gcited before2025-10-15 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolated
  Ensure 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 record review and interviews, the facility failed to ensure residents received treatment and care in accordance with professional standards of practice and the comprehensive person-centered care plan for two (#7 and #5) of seven residents reviewed for quality of care out of 10 sample residents.Specifically, the facility failed to:-Ensure Resident #7 and Resident #5 were assessed by a registered nurse (RN) following falls; and,-Ensure Resident #7, who was on anticoagulant medication (a class of medications that prevent or slow down blood clotting and can increase the risk of bleeding), received consistent and increased monitoring following a fall on 7/25/25 where the resident hit her head. The resident was transported to the emergency room three days post-fall, where she was diagnosed with a significant subdural hemorrhage (bleeding in the brain). Resident #7, who was known to be at risk for falls, was admitted on [DATE] with diagnoses of displaced intertrochanteric fracture of the right femur, atrial…

  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.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Actual harm · G2024-09-19 · tag F0686 — failed to prevent and treat pressure sores (bedsores) — isolated
  Provide 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 interviews, observations, and record review, the facility failed to ensure one (#5) of two residents reviewed for pressure injuries out of 19 sample residents received the necessary treatment and services to prevent the development of pressure injuries. Resident #5, who had a diagnosis of multiple sclerosis (an immune disease that disrupts nerve communication between the brain and the body) and generalized muscle weakness, was admitted to the facility on [DATE] for ongoing medical management and rehabilitation after a tibial and fibular fracture. Resident #5 was admitted to the facility with intact skin of the feet and heels. On 4/25/24 Resident #5 was assessed for risk of developing pressure injuries and was identified as moderate risk due to a history impaired mobility and bowel incontinence. The facility initiated a skin care plan for pressure injury risk, however, the care plan did not include specific interventions to prevent pressure injuries from developing on the resident's feet. On 6/3/24 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.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Actual harm · Gcited before2023-04-11 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolated
  Ensure 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 record review and interviews, the facility failed to ensure one (#30) of four residents reviewed for accidents out of 28 sample residents remained as free from accident hazards as possible. Resident #30, who was identified as a high fall risk, had numerous predisposing factors which included dementia, confusion, unsafe sleeping habits and poor safety awareness. The facility failed to develop, communicate and implement effective interventions to prevent the resident from falling on multiple occasions. Due to the facility's failures, the resident sustained a fracture to her right femur (hip) subsequent to a fall on 12/5/22, requiring hospital treatment. Findings include: I. Facility policies and procedures The Fall Prevention policy, revised 4/1/19, was provided on 4/11/23 by the nursing home administrator (NHA). The policy read in part: The facility utilizes a standardized risk assessment for determining a resident's fall risk. a. The risk assessment categorizes residents according to low, moderate, or…

  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.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Actual harm · G2023-04-11 · tag F0692 — failed to prevent malnutrition and dehydration — isolated
  Provide enough food/fluids to maintain a resident's health.
  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, record review and staff interviews, the facility failed to ensure one (#30) of six residents observed for nutrition out of 28 sample residents to maintain acceptable parameters of nutritional status. The facility failed to provide meal supplements per registered dietitian (RD) order and provide assistance during meal times. Resident #30, who was identified as having a significant weight loss, had numerous predisposing factors which included dementia, lack of appetite and confusion. She was admitted to the facility on [DATE] with a weight of 126 pounds. Due to the facility's failures, the resident sustained a weight loss of 10.4% in six months. Resident #30 sustained a weight loss of 10.4% (14 lbs) from admission on [DATE] through 4/1/23 which was considered significant. Observations revealed that the nutritional interventions were not consistently implemented. Findings include: I. Resident status Resident #30, age [AGE], was admitted on [DATE]. According to the April 2023 computerized…

  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.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Actual harm · G2023-04-11 · tag F0697 — failed to manage pain — isolated
  Provide safe, appropriate pain management 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 observations, record review and interviews the facility failed to provide effective pain management during wound care for one (#10) of three out of 28 sample residents. The facility failed to assess Resident #10 for pain after he developed two stage 3 pressure injuries. Nursing staff did not offer pain medication to the resident prior to the dressing changes. The resident experienced severe pain during dressing changes and refused the care due to the pain. In addition, nursing staff did not follow up with the physician regarding pain management and did not obtain an order for pain control prior to wound care and continued to provide dressing changes without offering pain medication. Resident #10 frequently refused care and his wounds deteriorated. Findings include: I. Facility policies and procedures The Pain Management policy, updated [DATE], was received from the director of nursing (DON) on [DATE] at 8:27 a.m. It read in pertinent part: The facility must ensure that pain management was provided to…

  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.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2025-12-22 · tag F0658 — failed to meet professional standards of care — isolated
  Ensure 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 observations, record review and interviews, the facility failed to ensure the services provided or arranged by the facility met professional standards of quality for one (#7) of two residents out of nine sample residents. Specifically, the facility failed to ensure professional standards were followed when completing a peripherally inserted central catheter (PICC) line dressing for Resident #7.Findings include:I. Professional referenceThe University of California Los Angeles (UCLA) Health's Care and Maintenance of Peripherally Inserted Central Catheters (PICC) (2026), retrieved on 1/5/26 from https://www.uclahealth.org/medical-services/radiology/clinical-services/clincal-programs/peripherally-inserted-central-catheters-picc/care-and-maintenance, read in pertinent part, PICC line dressing steps: -Perform hand hygiene with hospital approved waterless alcohol gel or foam cleaning solution or, if visibly soiled, wash hands with soap and water for 20 seconds;-Apply clean gloves;-Apply mask to patient or ask patient to turn head away from catheter site;-Apply personal protective…

  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.

  Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Dcited before2025-12-22 · tag F0880 — failed to prevent and control infections — isolated
  Provide and implement an infection prevention and control program.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observations and interviews, the facility failed to ensure infection prevention and control programs (IPCP) were maintained and followed to provide a safe, sanitary and comfortable environment and to help prevent the development and transmission of communicable diseases and infections on one of two units. Specifically, the facility failed to ensure enhanced barrier precautions (EBP) were followed during a peripherally inserted central catheter (PICC) line dressing change.Findings include:I. Professional referenceAccording to the Centers for Disease Control and Prevention's (CDC) Implementation of Personal Protective Equipment (PPE) Use in Nursing Homes to Prevent Spread of Multidrug-resistant Organisms (MDROs), retrieved on 12/30/25 from https://www.cdc.gov/long-term-care-facilities/hcp/prevent-mdro/PPE.html, It read in pertinent part,Enhanced barrier precautions (EBP) are an infection control intervention designed to reduce transmission of resistant organisms that employ targeted gown and glove use during high contact resident care activities. Nursing home residents with…

  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.

  Infection Control Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2025-10-15 · tag F0600 — failed to protect residents from abuse and neglect — isolated
  Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
  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 interviews, the facility failed to ensure one (#6) of four residents were kept free from physical abuse out of 10 sample residents.Specifically, the facility failed to ensure Resident #6 was kept free from physical abuse by Resident #3. Findings include:I. Facility policy and procedureThe Abuse, Neglect and Exploitation policy, implemented on 10/16/24, was provided by the nursing home administrator (NHA) on 10/13/25 at 9:54 a.m. The policy revealed the facility would provide protections for the health, welfare and rights of each resident by developing, implementing written policies with procedures that prohibited and prevented abuse, neglect, exploitation and misappropriation of resident property. The term abuse meant the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting physical harm, pain or mental anguish, which could include staff to resident abuse and certain resident-to-resident altercations.Abuse also included the deprivation by…

  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.

  Freedom from Abuse, Neglect, and Exploitation Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Ecited before2025-06-03 · tag F0584 — failed to keep a safe, clean, comfortable home — pattern
  Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
  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, observations and interviews , the facility failed to provide a safe, clean, comfortable and homelike environment for the residents on two out of three hallways and one out of two dining rooms. Specifically, the facility failed to: -Ensure there were enough clean linens; and, -Maintain clean floors in the residents' rooms, hallways and main dining room. Findings include: I. Failure to ensure there were enough clean linens A. Facility policy and procedure The Laundry policy, dated October 2025 was provided by the nursing home administrator (NHA) on 6/3/25 at 2:30 p.m. It read in pertinent part, The facility launders linens and clothing in accordance with current CDC (Center for Disease Control and Prevention) guidelines to prevent transmission of pathogens. Laundry will be removed from washers promptly and will not be left in the machines overnight. B. Resident interviews Resident #5 was interviewed on 6/2/25 at 11:49 a.m. She said she did not get a shower last week, because the facility…

  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.

  Resident Rights Deficiencies · Deficient, Provider has date of correction
• Potential for harm · E2024-09-19 · tag F0565 — failed to support the resident council — pattern
  Honor the resident's right to organize and participate in resident/family groups in the facility.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on record review and interviews, the facility failed to provide a response, action and rationale to residents involved in group grievances. Specifically, the facility failed to: -Allow the resident council to meet without a staff member present; -Provide a private space for resident council; and, -Provide a response, action and rationale for food concerns. Findings include: I. Facility policy and procedure The Resident Council Meetings policy, revised June 2024, was provided by the nursing home administrator (NHA) on 9/19/24 at 3:15 p.m. It read in pertinent part, The facility shall act upon concerns and recommendations of the council, make attempts to accommodate recommendations to the extent practicable, and communicate its decision to the council. II. Resident group interview A group interview was conducted on 9/18/24 at 10:07 a.m. with five residents (#11, #14, #17, #31 and #35), who were identified as alert and oriented through facility and assessment. Resident #31 and Resident #11 said the resident council meeting was held in the large dining room. Resident #11 said 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.

  Resident Rights Deficiencies · Deficient, Provider has date of correction
• Potential for harm · E2024-09-19 · tag F0572 — pattern
  Give residents a notice of rights, rules, services and charges.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on record review and interviews, the facility failed to provide ongoing communication to residents about their rights; and failed to inform the resident both orally and in writing in a language that the resident understands of his or her rights and all rules and regulations governing resident conduct and responsibilities during the stay in the facility. Specifically, the facility failed to provide ongoing communication and discussion to the resident's about their rights and responsibilities. Findings include: I. Facility policy and procedure The Resident Rights policy, revised August 2024, was provided by the nursing home administrator (NHA) on 9/19/24 at 3:15 p.m. It read in pertinent part, Information about resident rights and responsibilities will be given to the resident both orally and in writing. II. Resident group interview A group interview was conducted on 9/18/24 at 10:07 a.m. with five residents (#11, #14, #17, #31, and #35), who were identified as alert and oriented through facility and assessment. Resident #11, Resident #17, Resident #31 and Resident #35 said 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.

  Resident Rights Deficiencies · Deficient, Provider has date of correction
• Potential for harm · E2024-09-19 · tag F0585 — failed to handle grievances — pattern
  Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
  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, record review, and interviews the facility failed to provide a prompt effort to resolve grievances for one (#28) and the resident group out of 19 sample residents. Specifically, the facility failed to: -Follow through on grievances for lost/stolen items for and #28; and, -Ensure the residents had information on how to file a grievance. Findings include: I. Facility policy and procedure The Resident and Family Grievances policy and procedure, dated January 2023, was provided by the regional clinical resource (RCR) on 9/19/24 at 4:00 p.m. It read in pertinent part, It is the policy of this facility to support each resident's and family member's right to voice grievances with prompt effort to resolve. Information on how to file a grievance or complaint will be available to the resident. The Resident Personal Belongings policy and procedure, dated April 2022, was provided by the regional clinical resource (RCR) on 9/19/24 at 4:00 p.m. It read in pertinent part, It is the policy of 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.

  Resident Rights Deficiencies · Deficient, Provider has date of correction
• Potential for harm · E2024-09-19 · tag F0791 — failed to provide routine dental services — pattern
  Provide or obtain dental services for each 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 record review, and interviews the facility failed to assist residents in obtaining routine or emergency dental services, as needed for three (#10, #11 and #17) of five residents reviewed for dental services out of 19 sample residents reviewed. Specifically, the facility failed to replace Resident #10, Resident #11 and Resident #17's dentures in a timely manner. Findings include: I. Facility policy and procedure The Dental Services policy and procedure, dated August 2024, was provided by regional clinical resource (RCR) on 9/19/24 at 4:00 p.m. It read in pertinent part, For residents with lost or damaged dentures, the facility will refer the resident for dental services within three days. The resident and/or representative shall be kept informed of all arrangements. II. Resident #10 A. Resident status Resident #10, age greater than 65, was admitted on [DATE]. According to the September 2024 computerized physicians order (CPO), diagnoses included dementia and dysphagia (difficulty swallowing). The 7/5/24…

  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.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · E2024-09-19 · tag F0804 — failed to serve food at safe, palatable temperature — pattern
  Ensure 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 interviews, observations, and record review, the facility failed to consistently serve food that was palatable, attractive, and at the appropriate temperature. Specifically, the facility failed to ensure resident food was palatable in taste, texture and appearance. Findings include: I. Facility policy and procedure The Food Preparation Guidelines policy, revised 4/2024, was provided by the nursing home administrator (NHA) on 9/19/24 at 3:15 p.m. It read in pertinent part, Food should be palatable, attractive, and at a safe and appetizing temperatures. II. Resident group interview A group interview was conducted on 9/18/24 at 10:07 a.m. with five (#11, #17, #31, #35 and #14) residents, who were identified as alert and oriented through facility and assessment. Resident #11, #17, #31 and #35 said the food was not palatable. The residents said the food was overcooked and watery. II. Individual resident interviews Resident #5 interviewed on 9/16/24 at 9:40 a.m. Resident #5 said sometimes the food was overcooked causing her to order take-out. Resident #17 was interviewed 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.

  Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
• Potential for harm · E2024-09-19 · tag F0806 — failed to honor food preferences — pattern
  Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
  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, record review and interviews, the facility failed to provide food that accommodated resident preferences for three (#31, #6, #17) of five residents out of 19 sample residents. Specifically, the facility failed to offer food choices according to resident preferences for Resident #31, #Resident #6 and Resident #17. Findings include: I. Facility policy and procedure The Food Preparation Guidelines policy, revised April 2024, was provided by the nursing home administrator (NHA) on 9/19/24 at 3:15 p.m. It read in pertinent part, Staff shall accommodate resident allergies, intolerances, and preferences, providing appropriate alternatives when needed. Alternatives shall be appealing and of similar nutritive value to the food that is being substituted. Alternatives shall be consistent with the usual and or ordinary food items provided by the facility. Resident preferences and allergies shall be obtained during the resident assessment process and added to the resident dietary tray card. II.…

  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.

  Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction

“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.

Fines & penalties

$36,180 in federal fines across 2 penalties.

• $4,333 — penalty dated 2025-10-15
• $31,847 — penalty dated 2024-09-19

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.

Part of a chain

This home belongs to SWEETWATER CARE — 8 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 →

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

CMS files one row per role, so the 15 rows in the source record cover these 6 parties — each is shown once here with every role it holds. Nothing is omitted.

4 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 78% 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 $589K paid to related parties — landlords or management companies under common ownership — equal to about 11% 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. A reported operating loss is common in this industry and is not by itself a sign of trouble — but paired with large related-party payments it can mean profit is being taken elsewhere in the ownership structure.

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 CO