No sales calls · nothing personal collected unless you ask us to · no facility pays to be here
Text size
Contrast

Boulevard Rehabilitation Center

2839 S Seacrest Blvd, Boynton Beach, FL 33435 · For profit - Corporation · 167 certified beds · (561) 732-2464 Medicare & Medicaid certified

Call the home — (561) 732-2464 Need help choosing, fast? Free, unbiased: Eldercare Locator 1-800-677-1116
Abuse-prevention, restraint, or reporting citation — no harm found (F0609) — cited Oct 2023Behavioral-health or dementia-care citation — no harm found (F0758)
Insights

This home’s record is mixed — some reassuring signs, some worth asking about.

In its favor
  • a middle-of-the-pack inspection score (3/5)
  • no federal fines or payment denials on record
  • a high payroll-based staffing rating (4/5)
  • lower-than-typical staff turnover (31% vs 45% nationally) — better care continuity
Worth asking about
  • it has a citation for its abuse-prevention policies, restraint use, or reporting and investigating of allegations (F0609) — cited below the harm level, meaning inspectors found the process wanting but did not find a resident harmed
  • a high number of inspection citations overall (21) — worth reading through, though larger and more-often-surveyed homes tend to accrue more lower-severity tags
  • its facility-reported quality-measure score sits well above its independent inspection score

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.

4/5
CMS overall
4 of 5
Health inspectionSurveyor-assigned, ranked within your stateInspector-verified 3 of 5
StaffingFrom payroll records (PBJ) 4 of 5
Quality measuresSelf-reported by the facility 5 of 5

Worth a closer look. This home's quality-measure rating runs 2 stars above its independent health-inspection score. The inspection is done by state surveyors; the quality-measure score leans on data the facility reports about itself — so a gap this large is worth reading the inspection record for.

Location & what’s nearby

Hospital
★★ 2/5 CMS · Emergency dept. usually open 24/7 · ER 24/7
Urgent care / clinic
2800 S Seacrest Blvd · (561) 221-0123 · Call to confirm hours
Pharmacy
3625 S Federal Hwy · (561) 600-3095 · Call to confirm hours
Grocery
3625 S Federal Hwy · (561) 600-3088 · Call to confirm hours
Park
2882 SE 2nd St · (561) 742-6200 · Typically dawn to dusk
Place of worship
138 SE 27th Ave · (561) 737-4232

Nearest of each type, straight-line distance. Hospitals come from the CMS Hospital General Information registry; everything else from Overture Maps (public data). Hospital and park hours are typical — call ahead to confirm.

Quality measures — how residents actually fare

Overall quality measures 5 of 5
Long-stay residentspeople who live here 5 of 5
Short-stay residentsrehab / post-hospital 5 of 5

Quality-measure stars summarize outcomes CMS tracks from the assessments each home submits — avoidable hospitalizations and ER visits, falls with injury, pressure ulcers, unplanned weight loss, and long-term antipsychotic use. Because the underlying data is self-reported, weigh a high score against the independent inspection record. Long-stay = permanent residents; short-stay = rehab and post-hospital stays.

Trend — is this home getting better or worse?

Over 2025-02 to 2026-06, this home’s CMS overall rating held steady at 4 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.

Overall rating4★
Inspection scorelower = better
See all quality measures vs. state & national benchmarks
MeasureThis homeState avgTypical statevs typical state
Long-stay residents whose need for help with daily activities increased10.2%8.7%15.4%better
Long-stay residents who lose too much weight2.5%5.5%5.4%better
Long-stay residents with a catheter left in their bladder0.2%0.3%0.9%better than state — see note marked double-dagger below the table
Long-stay residents with a urinary tract infection0.5%0.7%2.0%better than state — see note marked double-dagger below the table
Long-stay residents with depressive symptoms3.0%4.6%6.5%better
Long-stay residents who were physically restrained0.0%0.0%0.1%better than state — see note marked double-dagger below the table
Long-stay residents with falls causing major injury0.2%2.5%3.3%better
Long-stay residents whose ability to walk worsened8.5%9.5%16.1%better
Long-stay residents on antianxiety or hypnotic medication9.1%14.4%18.9%better
Long-stay residents given the seasonal flu vaccine100.0%99.2%95.3%typical
Long-stay residents with pressure ulcers3.3%4.5%4.7%better
Long-stay residents with worsening bladder/bowel control11.6%10.5%21.2%worse than state — see note marked double-dagger below the table
Long-stay residents who got an antipsychotic medication — see the note below the table6.2%8.6%17.1%better
Short-stay residents who newly got an antipsychotic medication0.2%1.5%1.4%better
Short-stay residents given the seasonal flu vaccine94.7%94.7%79.4%better
Short-stay residents rehospitalized after admission22.6%26.1%22.6%typical
Short-stay residents with an outpatient ER visit9.2%9.1%12.0%better
Long-stay hospitalizations per 1,000 resident days1.502.131.67better
Long-stay outpatient ER visits per 1,000 resident days0.411.151.80better

On this measure the state average is at least twice (or half) the typical state — a gap that size is usually how the state codes and reports the measure, not how its homes actually perform. Against a benchmark this state does not sit on, a “vs typical state” verdict would mostly be measuring the state, so we compare this home with its own state instead and show both averages.

§ Antipsychotics carry an FDA boxed warning — they raise the risk of death in older people with dementia-related psychosis, and are not approved for that use. So this measure is partly a read on whether a home sedates residents instead of staffing for them. But read a low rate carefully in both directions: CMS excludes residents coded with schizophrenia (and Tourette's or Huntington's) from this measure, and federal auditors have found implausible increases in schizophrenia coding since the measure was published — so a very low rate can reflect recoding rather than less prescribing. Ask the home what share of its residents carry a schizophrenia diagnosis, and how it handles behavioral symptoms without medication.

CMS quality measures, as Care Compare shows them. For most rows lower is better (fewer falls, ulcers, hospitalizations); vaccination rates are the exception. Not every row is risk-adjusted. CMS adjusts some measures for resident mix, but falls with major injury, antipsychotic use, physical restraints and the vaccination rates are unadjusted rates — so a home caring for heavier or more behaviorally complex residents can look worse on them without providing worse care. The “typical state” column is the median of the 50 state averages — not a national average of all homes. We use it because a plain average across homes is pulled badly off course by a few states’ reporting habits (long-stay depressive symptoms is the clearest case: Illinois codes it several times higher than most states, which alone lifted the all-homes figure to about twice what a typical state records). The median of state averages resists that — but it does weigh every state equally, so a large state counts no more than a small one, and it is a benchmark of our construction rather than a CMS-published figure. better/worse means the home differs from that benchmark by more than 10% of it; closer than that reads typical. CMS does not publish how many residents each measure covers, and the counts are often small — a single resident can move a rate by several points — so treat small gaps as noise. These come from data the facility reports, so weigh them against the independent inspection record above.

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.

52.0% 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 160 Medicare stays in Oct 2022–Sep 2024, and CMS’s own comparison — not ours.

52.0%U.S. median 51.5%
Got home and stayed home
13.1%U.S. median 10.7%
Went back to hospital
71.2%U.S. median 56.6%
Met the expected recovery
0.54U.S. median 0.31
Therapy hours / resident / day
0.26hours / resident / day
Physical therapy
0.20hours / resident / day
Occupational therapy
0.08hours / resident / day
Speech therapy

Met the expected recovery: 71.2% 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 111 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 0.54 therapist hours per resident per day in 2026Q1 — more than 85% of the 13,892 homes that report any therapy hours at all.

Weekend therapy: weekend therapy hours are 22% 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
MeasureThis homeU.S. medianPeriod coveredCMS’s call
Got home and stayed homeRate of successful return to home or community from a SNF52.0%CMS range 43.1–59.551.5%Oct 2022–Sep 2024no different from U.S.
Went back to hospitalRate of potentially preventable hospital readmissions 30 days after discharge from a SNF13.1%CMS range 10.4–17.110.7%Oct 2022–Sep 2024no 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 discharge71.2%56.6%Oct 2024–Sep 2025CMS 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 discharge63.1%52.8%Oct 2024–Sep 2025CMS makes no comparison for this measure
Moving around at dischargePercentage of residents who are at or above an expected ability to move around at discharge63.1%50.0%Oct 2024–Sep 2025CMS 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 identified96.8%98.7%Oct 2024–Sep 2025CMS 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 setting89.5%100.0%Oct 2024–Sep 2025CMS 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 discharge91.7%98.7%Oct 2024–Sep 2025CMS 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 stay0.0%0.0%Oct 2024–Sep 2025CMS makes no comparison for this measure
New or worsened pressure ulcersPercentage of residents with pressure ulcers/pressure injuries that are new or worsened1.8%1.9%Oct 2024–Sep 2025CMS makes no comparison for this measure
Infections that led to hospitalPercentage of infections residents got during their SNF stay that resulted in hospitalization7.0%CMS range 4.4–11.27.1%Oct 2023–Sep 2024no different from U.S.
Medicare spending per stayMedicare Spending Per Beneficiary (MSPB) for residents in SNFs1.031.02Oct 2022–Sep 2024CMS 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

0.65
RN hours/ resident / day
0.80
LPN hours/ resident / day
2.18
Aide hours/ resident / day
3.63
Total nurse hours/ resident / day
0.39
RN hoursweekends
31.3%
Total nursing turnover
44.4%
RN turnover

How full it usually is: this home is certified for 167 beds and averages 126.2 residents a day — about 76% occupied, or roughly 41 beds typically open. It usually has some room. 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 3.63 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 0.65 is at or above the 0.55-hour RN benchmark and nurse-aide staffing of 2.18 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 3.24 hrs/resident/day on weekends vs 3.79 on weekdays — 15% thinner on weekends. RN hours go from 0.76 to 0.39 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)

This home’s total nursing-staff turnover of 31% is below the national median of 45%.

Payroll-based (PBJ) staffing hours, as reported for Jan–Mar 2026 (CMS PBJ CY2026Q1) — the most recent quarter CMS has published, so they can lag a change of operator or staffing agency. Higher is generally better. Registered-nurse coverage and weekend staffing are the numbers families most often overlook — an RN on site matters most when something goes wrong, and coverage usually thins on weekends. High turnover means residents rarely see the same caregiver twice. One caveat: these are hours as reported, not adjusted for how sick or heavy-care this home’s residents are. CMS separately publishes a case-mix-adjusted view; we show the reported hours. A home caring for higher-acuity residents needs more hours to deliver the same care, so compare these figures against homes doing similar work, and read them next to the inspection record rather than alone.

Inspection trend

7
deficiencies at the latest standard inspection (2025-02-27)
2
at the previous standard inspection (2023-10-20)

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.

ABCDEFGHIJKL

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.

21 citations, most serious first. The 10 most serious are shown; the remaining 11 are one tap away and print in full.

  • Potential for harm · E2025-02-27 · tag F0880 — failed to prevent and control infections — pattern
    Provide and implement an infection prevention and control program.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review, the facility failed to follow Enhanced Barrier Precautions (EBP) for 4 of 8 residents reviewed for EBP, as evidenced by not utilizing personal protective equipment (PPE) while performing physical therapy evaluation for Resident #41 and while providing assistance with feeding for Resident #388, failed to develop a care plan for EBP for a resident on Dialysis (Resident #477), and failed to implement EBP for a resident with an indwelling urinary catheter (Resident #58); and the facility failed to provide laundry services in a sanitary manner. The findings included: 1. Record review revealed Resident #41 was admitted to the facility on [DATE]. A comprehensive assessment dated [DATE] documented the resident had mild cognitive impairment and required partial/moderate assistance with activities of daily living. A review of Resident #41's care plans revealed a care plan for an indwelling urinary catheter. An intervention included Enhanced Barrier Precautions (EBP). 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.

    Infection Control Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2025-02-27 · tag F0550 — failed to protect resident dignity and rights — isolated
    Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review, the facility failed to provide assistance with dining in a manner to maintain dignity for 2 of 32 residents in the final sample (Resident #387 and #388). The findings included: 1. Record review revealed Resident #388 was admitted to the facility on [DATE]. A comprehensive assessment dated [DATE] documented the resident had severe cognitive impairment and was dependent for activities of daily living. An observation of Resident #388 was conducted on 02/24/25 at 12:15 PM during lunchtime. Resident #388 was observed sitting up in a wheelchair next to his bed. A bedside table was noted between the resident and the resident's bed with a lunch tray on top. Staff Z, a Certified Nurse Assistant (CNA), was observed standing and leaning over the front of the resident, feeding the resident. 2. Record review revealed Resident #387 was admitted to the facility on [DATE]. A comprehensive assessment dated [DATE] documented the resident had moderate cognitive impairment and…

    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 · D2025-02-27 · tag F0656 — failed to write and follow a full care plan — isolated
    Develop 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 care plan dentures for 1 of 1 resident reviewed for dental (Resident #34); Failed to implement a care plan for dialysis for 1 of 3 residents reviewed for dialysis (Resident #387); and Failed to implement interventions for behaviors during dining for 1 of 30 residents who eat lunch in the [NAME] Dining Room (Resident #66). The findings included: 1. Record review revealed Resident #34 was admitted to the facility on [DATE]. A comprehensive assessment dated [DATE] documented the resident was cognitively intact and was dependent for activities of daily living. The assessment further documented no dental concerns for the resident. An observation and interview with Resident #34 was conducted on 02/25/25 at 10:00 AM. The resident was observed without teeth or dentures. Resident #34 stated she needed dentures. A review of Resident #34's care plan did not identify the resident's need for dentures. An interview was conducted with the Social…

    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 before2025-02-27 · 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 observation, interview, and record review, the facility failed to ensure a resident's wheel chair was maintained in a manner to prevent a skin tear to 1 of 5 residents reviewed for accidents (Resident #388). The findings included: Record review revealed Resident #388 was admitted to the facility on [DATE]. A comprehensive assessment dated [DATE] documented the resident had severe cognitive impairment and was dependent for activities of daily living. An observation of Resident #388 was conducted on 02/25/25 at 11:00 AM. Resident #388 was sitting in a wheel chair (WC) in a lounge area with his significant other (SO). The resident was observed with a skin tear on the left outer calf area, that was bleeding. The resident's SO stated she had just noticed the area. Further observation revealed a tear on the resident's left leg rest of the WC, that was directly adjacent to the resident's fresh skin tear. Further observation of the tear on the resident's WC leg rest revealed the area was rigid and jagged. 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.

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2025-02-27 · tag F0690 — failed to manage incontinence, catheters, and urinary infections — isolated
    Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
    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 identify a resident with a urinary catheter, and failed to obtain urology consult as ordered for 1 of 2 residents reviewed for urinary catheter (Resident #58). The findings included: Record review revealed Resident #58 was admitted to the facility on [DATE]. A comprehensive assessment dated [DATE] documented the resident had mild cognitive impairment and required substantial/maximum assistance with activities of daily living. The assessment further documented the resident had an indwelling urinary catheter. A review of Resident #58's care plans revealed a care plan for resistive to care at times (dated 12/23/24 as resolved). Resident has an indwelling catheter but refuses to use the collection bag. He is clamping the tube and goes to the toilet to empty his bladder. A review of Resident #58's orders revealed an order dated 12/04/24 for a Urology follow up. An order dated 12/20/24 documented to discontinue Foley Catheter (urinary…

    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 · D2025-02-27 · tag F0698 — failed to provide proper dialysis care — isolated
    Provide safe, appropriate dialysis care/services for a resident who requires such services.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, interviews and record reviews, the facility failed to follow physician orders to not take blood pressure (BP) on dialysis access extremity for 3 of 5 residents (Resident #128, Resident #442, and Resident #387); and failed to have an order for dialysis for Resident #387. The findings included: A record review of a facility document titled, Nursing Facility Dialysis Agreement, dated 10/30/2017, revealed under Control of Care, that the medical management of the Nursing Facility's residents will be under the direction of the resident's attending physician. Section D under Care of Access Site, revealed that Nursing Facility will cooperate in monitoring and caring for each resident's access site including: 1. Avoidance of blood pressure readings, venipuncture, and trauma in dialysis access extremity; and 2. Evaluation of patency of dialysis access including but not limited to shunts, and fistulas. 1. Record review revealed Resident #128 was admitted on [DATE] with diagnoses that included End…

    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 · D2025-02-27 · tag F0755 — failed to provide safe pharmacy services — isolated
    Provide 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

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, interviews and record reviews, the facility failed to follow the professional standards for controlled substances reconciliation for 2 of 5 sampled residents (Resident #443 and Resident #107). The findings included: A review of a facility policy titled, Drug Reconciliation Review-Admission/Readmission, with a revision date of 12/2022, revealed the intent of the policy is to reconcile the medications by comparing a medication history with physician medication orders, and resolving any discrepancies to prevent prescribing errors, or omissions, wrong dosage or frequency of medication, and duplicate orders of the same classification of medications. 1)A review of record revealed Resident #443 was admitted on [DATE] with diagnoses including Chronic Obstructive Pulmonary Disease, Acute Kidney Failure, Essential Primary Hypertension and Insomnia. A review of the Minimum Data Set (MDS) assessment Section C revealed a Brief Interview for Mental Status (BIMS) score of 15 indicating good mental…

    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.

    Pharmacy Service Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2024-02-15 · tag F0842 — failed to keep accurate, complete medical records — isolated
    Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review and interview, the facility failed to ensure documentation was available to show whether dialysis treatment was started timely; the facility failed to ensure bathing preference was documented; and the facility failed to ensure physician order for self-administration of peritoneal dialysis was timely recorded, for 1 of 3 sampled residents (Resident #1). The findings included: Record review revealed, Resident #1, was admitted to the facility on [DATE], with diagnosis which included: End Stage Renal Disease (ESRD). Review of the admission Minimum Data Set assessment (MDS), reference date 01/09/24, revealed, Resident #1 had brief interview for mental status (BIMS) score of 14, which indicated Resident #1 was cognitively intact. Review of the self-administration evaluation record, dated 01/03/24, recorded, Resident #1 requested to continue to complete her peritoneal dialysis (PD), while at the facility. Resident #1 was completing her PD at home and desired to continue to complete her PD at 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 Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2023-10-20 · tag F0676 — failed to keep up residents' daily-living abilities — isolated
    Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.
    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, it was determined that the facility failed to provide care and services for assistance with eating for 2 (Resident #381 and #383) of 10 sampled residents reviewed for nutrition. The findings included: 1) Observation of the lunch meal on 10/17/23 noted tray served to the room of Resident #384. Resident appeared to be alert with visual impairment. The nurse was noted to inform the resident where food items were located on the tray but left the room without returning during the meal observation. Further observation noted the resident was attempting to take hot chicken off of the bone with great difficulty and became agitated with the attempts. it was also noted that the resident ate with hands and could not locate food item on tray. The resident was noted to be covered with food matter while attempting to self feed. The resident stated to the surveyor that he is not receiving the assistance needed with the meals. During a second lunch meal observation conducted 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.

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2023-10-20 · tag F0812 — failed to store, cook, and serve food safely — isolated
    Procure 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 and interview, it was determined that the facility failed to store, prepare, distribute, and serve food, in accordance with professional standards for food service safety. The findings included: During routine observation tours conducted on the nursing wing (South, East and West) food pantries/central supply rooms on 10/19/23 at 11:30 AM, accompanied with the Infection Control Prevention Director (ICP) , East Charge Nurse, and Certified Dietary Manager (CDM), the following were noted: 1) South Wing: < The room floor was noted to be heavily soiled and small areas of dried food mater. < The exterior of the reach-in refrigerator was rust laden. < There was an open trash/garbage bin located directly near the refrigeration unit. < The exterior of the 4 wooden shelves which housed dietary supplies was noted to be soiled and had areas of chipping paint. < A large plastic bin box of disposable plastic spoons was noted to be located on one of the shelves. Further observation that the bin did not have a cover and the spoons were totally exposed. < The findings were…

    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
Show the remaining 11 citations
  • Potential for harm · D2023-10-20 · tag F0585 — failed to handle grievances — isolated
    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

    Based on interview, observation, and record review, the facility failed to appropriately respond to a grievance related to billing for 1 of 1 resident, Resident #328. The findings included: On 10/18/23 at 1:31 PM, an interview was conducted with the Regional Business Office Manager (RBOM). When she was asked about the Notice of Medicare Non-Coverage (NOMNC) that was allegedly presented to the family of Resident #328, the RBOM stated the NOMNC would have been discussed with the Social Services Director. The RBOM stated there was a note in the resident's health record regarding the NOMNC. The RBOM was unable to locate the NOMNC letter at that time and requested to have time to research the issue. On 10/19/23 at 11:19 AM, a second interview was conducted with the RBOM. The RBOM explained she was unable to find the NOMNC letter documented as being issued and the Insurance Carrier for Resident #328 denied having a copy of the NOMNC letter in their files. It was at this time the RBOM was informed that a letter dated 08/30/23, from the family member, was uploaded to the facility's…

    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 · D2023-10-20 · tag F0609 — failed to report abuse allegations — isolated
    Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
    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 report an allegation of neglect related to a fall with major injury (fractured hip) for 1 of 5 residents reviewed for accidents (Resident #179). The findings included: A review of the facility's policy Abuse and Neglect Prohibition, effective 10/24/22, documented the definition of neglect means failure to provide goods and services necessary to avoid physical harm, mental anguish, or mental illness. The center Quality Assessment and Assurance Committee will investigate occurrences, patterns and trends that may indicate the presence of abuse, neglect, or misappropriation of resident's property and to determine the direction of the investigation/intervention through analysis of systems, audits, and reports. The center supervisory staff will integrate into the supervisory process monitoring the behavior of staff members and residents, which are indicative of high stress levels that may lead to abuse/neglect or may escalate on a continuum of aggression.…

    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 · Dcited before2023-10-20 · 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 interview, the facility failed to provide supervision and monitoring to prevent a fall with fracture for 1 of 5 residents reviewed for accidents (Resident #179). The findings included: Resident #179 was admitted to the facility on [DATE]. A comprehensive assessment dated [DATE] documented the resident as moderately cognitive impaired, and required limited 1 to 2 person assist with activities of daily living. Resident #179 was care planned for at risk for falls related to confusion and psychoactive drugs. An intervention included to maintain a safe environment. Resident #179 was further care planned for impaired cognitive function/impaired thought process related to Dementia. An intervention included to cue, reorient, and supervise as needed. A review of Resident 179's progress notes revealed a nurse note dated 07/31/23 at 2:36 PM that documented the resident was agitated, verbally and physically aggressive towards staff. The resident was observed picking up books from the nursing…

    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 · Fcited before2022-06-23 · tag F0812 — failed to store, cook, and serve food safely — widespread
    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
    What the surveyor found here — the official record, unedited, may be distressing

    Based on observation and interview, the facility failed to prepare and serve food in a sanitary manner. Th findings included: On 6/20/22 at 9:30 AM , conducted an initial kitchen tour in the main kitchen, accompanied by the CDM and Assistant CDM. The following was observed: (1) A box of Pancake mix stored in an open container in the dry storage room. (2) A container of dried split pea stored in a open container in the dry storage room. (3) Toaster was dirty with built up bread crumbs. (4) Stove top all burners were greasy with built up burnt on, food spills. (5) Disposable containers and utensils stored in a open box with no cover. (6) The oven was greasy, dirty with built up food spills. (7) One 13 oz box of Cheerios open in the kitchen. (8) The table top can opener holder sticky and dirty. On 06/23/22 at 1:00 PM, conducted an interview with the CDM, and he was informed of the findings.

    Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2022-06-23 · tag F0584 — failed to keep a safe, clean, comfortable home — isolated
    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 facility policy, observation, interview, and record review, the facility failed to protect the residents' personal belongings (clothing) from being lost or damaged. This failure affected 4 0f 7 residents reviewed for personal belongings (Residents #65, #17, #12, and #100). The findings included: 1. On 06/22/2022 at approximately 1:00 PM the facility policy for maintaining resident laundry was requested from the facility administrator. She stated they were aware of problems with the residents' laundry being lost. Facility document provided by the Administrator titled Processing Resident Personal Clothing dated 09/05/2017 states, In long-term care, no area of laundry management is more critical to patient care and dignity issues than the area of resident clothing. Residents, resident's families, Admissions, Social Services, Administration, and, of course, Nursing, all are involved with Laundry in creating policies for getting resident clothing collected, washed, dried, and returned to residents on 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.

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2022-06-23 · tag F0679 — failed to provide activities — isolated
    Provide activities to meet all resident's needs.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview and record review, the facility failed to provide activities to meet the needs of a cognitively impaired resident for 1 of 4 residents reviewed for activities, Resident #61. The findings included: Resident #61 was admitted to the facility on [DATE] and most recently readmitted to the facility on [DATE]. According to the resident's most recent complete assessment, a Medicare 5-Day Minimum Data Set (MDS), Resident #61 was not assessed for cognition due to 'resident is rarely/never understood'. The MDS documented that Resident #61 was totally dependent upon staff for all activities of daily living. Resident #61's diagnoses at the time of the assessment included: Coronary Artery Disease; Neurogenic bladder; Diabetes Mellitus; Hyperlipidemia; Cerebral Infarction; Dysphagia Following unspecified Cerebrovascular Disease; Pressure Ulcer of left heel, unstageable; Pressure Ulcer of Sacral Region, Unstageable; Respiratory failure with Hypoxia or Hypercapnia; Pressure Ulcer of Sacral Region…

    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 · D2022-06-23 · tag F0684 — failed to provide proper treatment and quality of care — isolated
    Provide appropriate treatment and care according to orders, resident’s preferences and goals.
    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, record review and facility policy the facility failed to properly assist a resident with Preoperative care for 1 of 1 resident reviewed for surgery (Resident #17). The findings included: On 06/20/2022 at 2:38 PM Resident #17 stated that he was having eye surgery on Thursday (06/23/2022) at [NAME] Eye Institute. Record review of Resident #17 revealed he was admitted on [DATE] with diagnoses that include blindness, diabetes, heart failure and right foot amputation. A Minimum Data Set (MDS) assessment done 03/30/2022 documents Resident #17 as cognitively intact with a functional status of requiring extensive assistance to total care for all activities except eating, which requires set up and supervision. On 06/22/2022 at 11:20 AM, the Surveyor noted the anticoagulant (blood thinner) for Resident #17 was being held but no other preoperative instructions were documented on the chart. Staff F, RN was questioned about the preop instructions. She stated she was unable to locate 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.

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2022-06-23 · tag F0695 — failed to provide proper breathing / tracheostomy care — isolated
    Provide safe and appropriate respiratory care for a resident when needed.
    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 on observation, interview, and record review, the facility failed to perform tracheostomy (trach) care as ordered for 1 of 1 residents reviewed for trach care (Resident #107). The findings included: A review of the facility's policy titled Tracheostomy Care, dated 04/24/2018, revealed the purpose: 1. To maintain patency of the airway 2. To keep tracheostomy tube and the surrounding area clean 3. To prevent infection of the airways and the area around the tracheostomy tube and 4. To prevent excoriation of the area around the tracheostomy tube A Licensed Nurse or a Respiratory Care Practitioner performs this procedure. Resident #107 was admitted to the facility on [DATE] with diagnoses which included Acute Respiratory Failure and Tracheostomy (hole in the resident's neck to facilitate breathing). A recent comprehensive assessment dated [DATE] documented the resident had severe cognitive impairment, and required total two-person assist with activities of daily living. The comprehensive assessment further…

    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 · D2022-06-23 · tag F0756 — failed to review each resident's drug regimen — isolated
    Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
    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 document the providers' response and/or rationale to decline the pharmacist's recommendations from the Medication Regimen Review (MMR), for 5 of 5 residents reviewed (Residents #31, #56, #58, #78 and #103). The facility also failed to develop and implement policies and procedures for the required monthly Medication Regimen Review conducted by their pharmacy. The findings included: 1) On 06/23/2022 during review of the pharmacy recommendations from the monthly MRR (Medication Regimen Review) for Resident #103, the recommendation dated 02/15/2022 was to discontinue three medications for constipation to reduce long-term side effect and a request for an assessment of risk versus benefit, to validate continuing the medications. The document was signed by a provider and the DON (Director of Nursing) on the same day. Review of the medical record found all three medications with new orders continuing daily administration a few days later (02/18/2022). 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.

    Pharmacy Service Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2022-06-23 · tag F0758 — failed to limit and justify psychotropic drugs — isolated
    Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review, the facility failed to monitor behaviors for psychotropic medications for 1 of 5 residents reviewed for unnecessary medications (Resident #56). The findings included: A review of the facility's policy Psychotropic Medication Assessment and Monitoring, dated 10/30/2018, documented; Monitoring of residents receiving antipsychotic medication will be completed by a licensed nurse as per acceptable standards of practice using the behavior monitoring record. The policy further documented each resident's drug regimen must be free from unnecessary drugs. An unnecessary drug is any drug when used without adequate monitoring. Resident #56 was admitted to the facility on [DATE]. A comprehensive assessment dated [DATE] documented the resident was cognitively intact, had some verbal behaviors toward others, and was on antidepressants. Resident #56 was care planned on 11/18/21 for having the potential to demonstrate physical and/or verbally abusive behaviors related to anger, at times…

    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.

    Pharmacy Service Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2022-06-23 · tag F0803 — failed to meet residents' dietary needs — isolated
    Ensure 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 provide meals according to residents' preferences for 1 of 4 residents reviewed for preferences, Resident #213. The findings included: Resident #213 was admitted to the facility for current stay on 06/17/22. An admission Assessment, dated 06/17/22, documented that Resident #213 had no dental/oral concerns. The assessment documented that Resident #213 was cognitively intact with a BIMS score of 15, with vision and hearing documented as 'adequate' without the use of devices. Resident #213's Diet orders were documented as, Regular - NAS diet, Regular texture - 06/17/22. Resident #213's care plan, created on 06/18/22, documented, [RESIDENT PREFERRED NAME] is at risk for decreased nutritional status & dehydration r/t. The goal of the care plan was documented as, Resident will be free from significant weight changes through the review date - 06/18/22. Interventions to the care plan included: * Assist with meals as needed * Diet as ordered * Encourage PO fluids * Labs as ordered * Monitor diet tolerance * Monitor PO…

    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.

Worried about a resident here? There are three different people you can turn to, and they do different jobs:
  • 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.
Not sure where to start, or need other help? Dial 2-1-1 for local resources — and if a call is hard or impossible for you, many local 211s also take a text (send your ZIP code to 898-211) or a web chat at 211.org; both vary by area, and 211.org will show what yours offers. Deaf or hard of hearing: dial 711 for the telecommunications relay service, then any number above. In an emergency, call 911.
It is illegal for a facility to retaliate against a resident or family for reporting a concern: federal law gives a resident the right to voice grievances — to the home or to any outside agency — without discrimination or reprisal (42 CFR §483.10(j)(1)). You may report anonymously.

Fines & penalties

No federal fines in the current CMS record.

Part of a chain

This home belongs to SOVEREIGN HEALTHCARE HOLDINGS — 43 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 →

RatingThis homeChain avg
Overall 4 of 53.7+0.3 vs chain
Health inspection 3 of 53.2-0.2 vs chain
Staffing 4 of 53.1+0.9 vs chain
Quality measures 5 of 54.5+0.5 vs chain
The other 42 homes this chain runs (chain average 3.7★, per CMS)
1 of 5Abercorn Rehabilitation CenterSavannah, GA 1 of 5Sunnybrook Rehabilitation CenterRaleigh, NC 2 of 5Lake Worth Rehabilitation CenterLake Worth, FL 2 of 5Monroe Rehabilitation CenterMonroe, NC 2 of 5Pinellas Point Nursing And Rehab CenterSaint Petersburg, FL 2 of 5Riviera Palms Rehabilitation CenterPalmetto, FL 2 of 5Rocky Mount Rehabilitation CenterRocky Mount, NC 3 of 5Bayshore Pointe Nursing And Rehab CenterTampa, FL 3 of 5Lanier Rehabilitation CenterJacksonville, FL 3 of 5Lincolnton Rehabilitation CenterLincolnton, NC 3 of 5Medicana Nursing And Rehab CenterLake Worth, FL 3 of 5Port Orange Nursing And Rehab CenterPort Orange, FL 3 of 5Raleigh Rehabilitation CenterRaleigh, NC 3 of 5Tiffany Hall Nursing And Rehab CenterPort Saint Lucie, FL 3 of 5Treyburn Rehabilitation CenterDurham, NC 4 of 5Atlantic Shores Nursing And Rehab CenterMelbourne, FL 4 of 5Bonifay Nursing And Rehab CenterBonifay, FL 4 of 5Braden River Rehabilitation Center LLCBradenton, FL 4 of 5Hunters Creek Nursing And Rehab CenterOrlando, FL 4 of 5Metro West Nursing And Rehab CenterOrlando, FL 4 of 5Northdale Rehabilitation CenterTampa, FL 4 of 5Ocala Oaks Rehabilitation CenterOcala, FL 4 of 5Orange City Nursing And Rehab CenterDebary, FL 4 of 5Pettigrew Rehabilitation CenterDurham, NC 4 of 5Royal Oaks Nursing And Rehab CenterTitusville, FL 4 of 5Sarasota Point Rehabilitation CenterSarasota, FL 4 of 5Silas Creek Rehabilitation CenterWinston-Salem, NC 4 of 5Warner Robins Rehabilitation CenterWarner Robins, GA 4 of 5Zebulon Rehabilitation CenterZebulon, NC 5 of 5Arbor Trail Rehab And Skilled Nursing CenterInverness, FL 5 of 5Boynton Beach Rehabilitation CenterBoynton Beach, FL 5 of 5Crestview Rehabilitation Center, LLCCrestview, FL 5 of 5Cypress Pointe Rehabilitation CenterWilmington, NC 5 of 5Fort Walton Rehabilitation Center, LLCFort Walton Beach, FL 5 of 5Jacksonville Nursing And Rehab CenterJacksonville, FL 5 of 5Macclenny Nursing And Rehab CenterMacclenny, FL 5 of 5Marianna Health And RehabilitationMarianna, FL 5 of 5Moultrie Creek Nursing And Rehab CenterSaint Augustine, FL 5 of 5Palm City Nursing & Rehab CenterPalm City, FL 5 of 5Parkview Rehabilitation Center At Winter ParkWinter Park, FL

Showing 40 of 42; 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 / managerTypeRoleSince
SOVEREIGN HEALTHCARE HOLDINGS LLCOrganizationDIRECT OWNERSHIP INTERESTsince 05/19/2009
CRONQUIST 2015 FAMILY TROrganizationINDIRECT OWNERSHIP INTERESTsince 12/31/2015
JOHN J NOTERMANN BUSINESS TROrganizationINDIRECT OWNERSHIP INTERESTsince 10/12/2017
CRONQUIST, ROYCEIndividualINDIRECT OWNERSHIP INTEREST; OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 02/01/2018
MANGINE, JOHNIndividualINDIRECT OWNERSHIP INTEREST; OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 01/01/2025
BERKADIA COMMERCIAL MORTGAGE LLCOrganization5% OR GREATER SECURITY INTERESTsince 09/23/2014
FL BOULEVARD MANOR HOLDINGS, LLCOrganization5% OR GREATER SECURITY INTEREST; ADP OF THE SNFsince 05/19/2009
HEALTH SERVICES PROPERTIES LLCOrganization5% OR GREATER SECURITY INTEREST; ADP OF THE SNFsince 05/19/2009
BELL, CHARLESIndividualMANAGING CONTROL - GOVERNING BODY; ADP OF THE SNFsince 09/15/2016
CHERY, DAWNIndividualMANAGING CONTROL - GOVERNING BODY; ADP OF THE SNFsince 06/08/2017
KAAR, SUSANIndividualMANAGING CONTROL - GOVERNING BODY; ADP OF THE SNFsince 05/19/2009
SOUTHERN HEALTHCARE MANAGEMENT LLCOrganizationOPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 10/01/2003
MELTON, DONALDIndividualOPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 02/15/2009
NOTERMANN, WILLIAMIndividualOPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 01/01/2025
RODRIGUEZ, YANITZAIndividualOPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 06/01/2025
WASKIEWICZ, TIMIndividualOPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 07/21/2023
NOTERMANN, BRENDAIndividualINDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNFsince 10/10/2025
FORVIS MAZARS LLPOrganizationADP OF THE SNFsince 01/01/2025
SOVEREIGN HEALTHCARE DISBURSEMENTS LLCOrganizationADP OF THE SNFsince 05/19/2009
KELLY, MICHELLEIndividualADP OF THE SNFsince 02/01/2018

CMS files one row per role, so the 34 rows in the source record cover these 20 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.

9 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.

$15.1M
Net patient revenuemost recent cost report
-5.1%
Operating marginrevenue minus expenses
$732K
Related-party expense5% of expenses
Who pays — share of resident-days
Medicaid 66%Medicare 11%Other / private 22%

This home reported $732K paid to related parties (affiliated landlords or management companies) in its most recent cost report. 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

$347per resident / day
operating cost
$10,543per month
≈ monthly operating cost
$330per day
avg. revenue, all payers

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 FL

Paying with Medicaid

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 Florida Medicaid page.

Typical monthly cost in Florida
$10,342/mo
Nursing home (semi-private)
$12,167/mo
Nursing home (private)
$5,610/mo
Assisted living

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 105067. CMS refreshes its data monthly, and the star rating rests on the last standard inspection — dated 2025-02-27, 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.

What to do next