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Vivo Healthcare Fort Pierce

700 S 29th Street, Fort Pierce, FL 34947 · For profit - Corporation · 79 certified beds · (772) 465-7560 Medicare & Medicaid certified

Call the home — (772) 465-7560 Need help choosing, fast? Free, unbiased: Eldercare Locator 1-800-677-1116
Resident-funds citation (F0565)
Insights

The public record raises real questions here. Weigh the concerns below carefully.

In its favor
  • no federal fines or payment denials on record
  • a high payroll-based staffing rating (4/5)
  • lower-than-typical staff turnover (30% vs 45% nationally) — better care continuity
Worth asking about
  • it has a citation for mishandling residents’ money or property (F0565)
  • a high number of inspection citations overall (26) — worth reading through, though larger and more-often-surveyed homes tend to accrue more lower-severity tags
  • its payroll- and facility-reported staffing and quality-measure scores sit well above its independent inspection score
  • its independent health-inspection rating is low (2/5)

One thing this read cannot see: what residents and families actually experience day to day. Public data misses the feel of a place — visit unannounced, ideally at a mealtime or on a weekend, talk to staff and families, and ask your tour questions.

A plain-English summary of the public record below — not a rating, ranking, or recommendation. We take no money from any facility.

3/5
CMS overall
3 of 5
Health inspectionSurveyor-assigned, ranked within your stateInspector-verified 2 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 staffing and quality-measure ratings run 3 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, and staffing on its payroll (PBJ) submissions — so a gap this large is worth reading the inspection record for.

Location & what’s nearby

Hospital
1/5 CMS · Emergency dept. usually open 24/7 · ER 24/7
Urgent care / clinic
2504 Acorn St · (772) 466-1112 · Call to confirm hours
Pharmacy
2301 Okeechobee Rd · (772) 464-3784 · Call to confirm hours
Grocery
Park
2501 Delaware Ave · Typically dawn to dusk
Place of worship

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 4 of 5

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

Trend — is this home getting better or worse?

Over 2025-02 to 2026-06, this home’s CMS overall rating improved from 2 to 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 increased8.3%8.7%15.4%better
Long-stay residents who lose too much weight7.4%5.5%5.4%worse
Long-stay residents with a catheter left in their bladder0.9%0.3%0.9%typical
Long-stay residents with a urinary tract infection0.0%0.7%2.0%better than state — see note marked double-dagger below the table
Long-stay residents with depressive symptoms2.1%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 injury2.0%2.5%3.3%better
Long-stay residents whose ability to walk worsened1.0%9.5%16.1%better
Long-stay residents on antianxiety or hypnotic medication10.6%14.4%18.9%better
Long-stay residents given the seasonal flu vaccine100.0%99.2%95.3%typical
Long-stay residents with pressure ulcers2.6%4.5%4.7%better
Long-stay residents with worsening bladder/bowel control12.0%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 table2.2%8.6%17.1%better
Short-stay residents who newly got an antipsychotic medication0.8%1.5%1.4%better
Short-stay residents given the seasonal flu vaccine98.3%94.7%79.4%better
Short-stay residents rehospitalized after admission31.3%26.1%22.6%worse
Short-stay residents with an outpatient ER visit3.6%9.1%12.0%better
Long-stay hospitalizations per 1,000 resident days1.782.131.67typical
Long-stay outpatient ER visits per 1,000 resident days0.361.151.80better

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.

55.6% 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 114 Medicare stays in Oct 2022–Sep 2024, and CMS’s own comparison — not ours.

55.6%U.S. median 51.5%
Got home and stayed home
12.1%U.S. median 10.7%
Went back to hospital
35.7%U.S. median 56.6%
Met the expected recovery
0.49U.S. median 0.31
Therapy hours / resident / day
0.21hours / resident / day
Physical therapy
0.22hours / resident / day
Occupational therapy
0.06hours / resident / day
Speech therapy

Met the expected recovery: 35.7% 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 84 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 0.49 therapist hours per resident per day in 2026Q1 — more than 80% of the 13,892 homes that report any therapy hours at all.

Weekend therapy: weekend therapy hours are 28% 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 SNF55.6%CMS range 46.7–63.951.5%Oct 2022–Sep 2024no different from U.S.
Went back to hospitalRate of potentially preventable hospital readmissions 30 days after discharge from a SNF12.1%CMS range 8.9–15.610.7%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 discharge35.7%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 discharge29.8%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 discharge45.2%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 identified97.0%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 setting100.0%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 discharge97.1%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 worsened1.5%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 hospitalization8.2%CMS range 5.1–14.37.1%Oct 2023–Sep 2024no different from U.S.
Medicare spending per stayMedicare Spending Per Beneficiary (MSPB) for residents in SNFs1.091.02Oct 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

0.68
RN hours/ resident / day
0.67
LPN hours/ resident / day
2.21
Aide hours/ resident / day
3.56
Total nurse hours/ resident / day
0.59
RN hoursweekends
30.3%
Total nursing turnover
50.0%
RN turnover

How full it usually is: this home is certified for 79 beds and averages 74.1 residents a day — about 94% occupied, or roughly 5 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 3.56 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 0.68 is at or above the 0.55-hour RN benchmark and nurse-aide staffing of 2.21 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 3.29 hrs/resident/day on weekends vs 3.67 on weekdays — 10% thinner on weekends. RN hours go from 0.72 to 0.59 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)

This home’s total nursing-staff turnover of 30% 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

8
deficiencies at the latest standard inspection (2025-02-13)
9
at the previous standard inspection (2023-11-02)

Deficiencies are fewer than at the previous inspection — improving. Fewer citations over time suggests a home is fixing problems; a rising count is a warning sign — though two surveys are a short record, and survey teams differ. These counts are from the standard annual health survey only; the full citation list below may also include findings from complaint investigations, so the two won’t always add up.

Inspection deficiencies

State health-inspection citations, most serious first. Each carries an F-code (the federal rule it cites, e.g. F-684 = quality of care) and a letter A–L marking how serious and how widespread the problem was — we translate that grid into the plain tiers shown here. Wording is the official federal description.

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.

26 citations, most serious first. The 10 most serious are shown; the remaining 16 are one tap away and print in full.

  • Potential for harm · D2026-07-02 · tag F0655 — isolated
    Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
    What the surveyor found here — the official record, unedited, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review and interview, the facility failed to complete baseline care plans in the required time frame for 1 of 9 sampled residents reviewed, Resident #93. The findings included:Record review revealed Resident #93 was admitted on [DATE] with a diagnosis to include Right Femur Fracture, Muscle Wasting and Atrophy, Essential Hypertension, and Benign Prostatic Hyperplasia without Lower urinary Tract Symptoms. Review of Resident #93 baseline care plan revealed that as of 07/01/26, the baseline care plan had not been completed and had been due by 06/28/26. During an interview on 07/01/26 at 12:05 PM with the Director of Nursing (DON) she was asked to locate Resident #93's baseline care plan. She acknowledged that it had not been done yet and that it was 3 days overdue.

    Resident Assessment and Care Planning Deficiencies · Deficient, Provider has plan of correction
  • Potential for harm · D2026-07-02 · tag F0732 — isolated
    Post nurse staffing information every day.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observations and interviews, the facility failed to ensure daily staffing was accurate and current for 2 of 6 days. The findings included:Upon entrance into the facility on Monday 06/29/26 at 6:12 AM, the staff posting was dated Friday 06/26/26 and the required number of licensed nurses was not updated prior to the night shift. An interview was conducted with the Staffing Coordinator on 07/02/26 at 8:42 AM and she was asked who posts the staffing sheet. She stated that she posts it every morning Monday through Friday. When the Staffing Coordinator was asked who posts it over the weekend, she stated that she leaves blank copies at the reception desk, but she was not sure if the receptionists know how to fill it out. The Staffing Coordinator was advised that the staff posting on Monday morning was dated Friday 06/26/26 and she agreed with the findings.The Staffing Coordinator was then asked why there was only one licensed nurse listed for the night shift on Friday 06/26/26 when the census was 75. She stated that on Friday 06/26/26 she had a nurse call out and did not update…

    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.

    Nursing and Physician Services Deficiencies · Deficient, Provider has plan of correction
  • Potential for harm · Dcited before2026-03-17 · 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 observation, interview, and record review, the facility failed to ensure a safe, clean, and homelike environment for 6 of 11 rooms observed as evidenced by discolored floors, molding and walls, stained/dirty privacy curtains, peeling wallpaper, damaged drywall, and a damaged/dirty electrical outlet cover in occupied and unoccupied rooms. The census at the time of survey was 72. The bed capacity was 79.The findings included: 1. Record review documented Resident #2 was admitted on [DATE] and discharged on 03/11/26. Review of the grievance report for Resident #2, submitted by the spouse on 02/05/26 about the floor in the resident's room, documented the floor was not clean. Observation of Resident #2's room was conducted on 03/17/26 at 10:40 AM revealed that the room had been deep cleaned as both beds had a dated paper (Bed A was dated 03/13/26 and Bed B 03/15/26) with the housekeeper's name that was placed on top of the mattresses. The observation revealed that Bed B's mattress still had a stained area 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.

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Ecited before2025-02-13 · 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 observation and interview, the facility failed to ensure timely housekeeping and maintenance in 2 of 4 (100 and 300) resident hallways, affecting Resident #224, #42, #23, and #66; and failed to maintain ceiling vents and common area walls on all four resident units and in the central common area. The findings included: 1. The following environmental and housekeeping concerns were observed during the survey: a) On 02/10/25 at 10:24 AM, Resident #224 stated the window air conditioner in her room was broken, and had been since her admission on [DATE]. The panel on the air conditioning unit showed a code of E3, indicating an error, and no air was blowing. b) On 02/10/25 at 11:09 AM, the privacy curtains for Resident #42 were noted to be stained on both sides. Photographic Evidence Obtained. There was also a urine odor noted upon entering the room. On 02/11/25 at 10:35 AM and on 02/12/25 at 9:29 AM, the urine odor remained. An observation of the resident's mattress at this time lacked any obvious signs of…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · E2025-02-13 · tag F0812 — failed to store, cook, and serve food safely — pattern
    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, the facility failed to ensure a clean and sanitary kitchen and failed to maintain food that was not past it's use-by or expired date. This could potentially affect 72 of 75 residents who consume an oral diet. The findings included: An observation of the kitchen was made on 02/10/25 beginning at 8:54 AM with the Kitchen Manager / Certified Dietary Manager (CDM). Upon entering the kitchen, the breakfast service was completed, the kitchen had been cleaned after the meal, and staff were in the process of doing the breakfast dishes. The following concerns were noted and confirmed by managerial staff, with Photographic Evidence Obtained: a) A table in the food preparation area had peeling paint on all the legs and shelf. b) A table in the food preparation area had legs and shelves with rust-like surfaces. c) Pitchers filled with juice to be used that day had leftover sticker debris that had not been cleaned off. d) A plastic serving cart with two shelves was marred, scratched, and with grey-black staining. e) The floor around the cooking appliances was…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2025-02-13 · tag F0558 — failed to accommodate residents' needs and preferences — isolated
    Reasonably accommodate the needs and preferences of 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 observation, interview, and record review, the facility failed to ensure the call bell was within reach for 1 of 1 sampled resident, Resident #42, who was capable to use the call bell and needed assistance. The findings included: Review of the record revealed Resident #42 was admitted to the facility on [DATE]. Review of the current Minimum Data Set (MDS) assessment dated [DATE] documented the resident needed maximum to total assistance from staff for activities of daily living (ADLs) to include mobility. An interview and observation was conducted on 02/10/25 at 11:02 AM. Although the record documented a low cognitive score, the resident could answer simple questions and make his needs known. He was able to reveal he had had a stroke that affected his left side. When asked how he gets help when needed, he stated he used the call bell. Resident #42 was in bed during the interview and reached for the call bell to his right side. The call bell was looped over the lowest part of the mobility bar with 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 · D2025-02-13 · tag F0677 — failed to help fully-dependent residents with daily care — isolated
    Provide care and assistance to perform activities of daily living for any resident who is unable.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on policy review, observation, interviews, and record review, the facility failed to ensure timely fingernail care for 2 of 5 sampled residents, Residents #6 and #61, reviewed for activities of daily living (ADLs) care. The findings included: Review of the policy, titled, Nail Care, dated 09/01/23, documented in part, . 3. routine cleaning and inspection of nails will be provided during ADL care on an ongoing basis. 4. Routine nail care, to include trimming and filing, will be provided on a regular schedule. Nail care will be provided between scheduled occasions as the need arises. 7. d. If trimming is allowed, clip nails using nail clippers straight across and even with tops of the fingers. 1. Review of the record revealed Resident #6 was admitted to the facility on [DATE]. Review of the Quarterly Minimum Data Set (MDS) assessment dated [DATE] documented the resident had a Brief Interview for Mental Status (BIMS) score of 9, on a 0 to 15 scale, indicating severe cognitive impairment. This MDS also…

    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 before2025-02-13 · 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 policy review, observation, interview, and record review, the facility failed to ensure wound dressing changes were completed per physician order for 1 of 2 sampled residents, Resident #61, reviewed for wound care. The findings included: Review of the policy, titled, Wound Treatment Management, revised 09/01/24, documented in part, 1. Wound treatments will be provided in accordance with physician orders 7. Treatments will be documented on the Treatment Administration Record. Review of the record revealed Resident #61 was admitted to the facility on [DATE]. Review of the Quarterly Minimum Data Set (MDS) assessment, dated 12/09/24, documented the resident had a Brief Interview for Mental Status (BIMS) score of 5, on a 0 to 15 scale, indicating severe cognitive impairment. Review of the current orders documented as of 02/04/25 that staff were to provide daily wound care to the right heel. An order dated 02/13/25 instructed nurses to provide daily care to the resident's right leg. An additional order dated…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2025-02-13 · 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 observation, interview and record review, the facility failed to effectively communicate the resident's complaint of pain, failed to evaluate the effectiveness of pain interventions, and failed to appropriately treat pain for 1 of 5 sampled residents, Resident #42, reviewed for pain management. The findings included: Review of the record revealed Resident #42 was admitted to the facility on [DATE]. Review of the Quarterly Minimum Data Set (MDS) assessment dated [DATE] documented the resident had a Brief Interview for Mental Status (BIMS) score of 3, on a 0 to 15 scale, indicating severe cognitive impairment. This MDS documented the resident needed maximum to dependent assistance for Activities of Daily Living (ADL). Review of the care plan, initiated on 11/28/22 and revised on 10/11/23, documented the resident had chronic pain related to a stroke, neuropathy (nerve pain), back pain, and left shoulder pain. This care plan instructed staff to evaluate the effectiveness of pain interventions as needed. It…

    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 · D2025-02-13 · tag F0757 — failed to avoid unnecessary drugs — isolated
    Ensure each resident’s drug regimen must be free from unnecessary drugs.
    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 policy review, interview, and record review, the facility failed to ensure adequate monitoring of side effects and behaviors for residents receiving psychotropic medications, for 1 of 5 sampled residents reviewed for unnecessary meds, Resident #16. The findings included: Review of the policy, titled, Use of Psychotropic Medication, dated 09/01/23, indicated Residents are not given psychotropic drugs unless the medication is necessary to treat a specific condition, as diagnosed and documented in the clinical record, and the medication is beneficial to the resident, as demonstrated by monitoring and documentation of the resident's response to the medication (s). A psychotropic drug is any drug that affects brain activities associated with mental processes and behavior. Psychotropic drugs include but are not limited to the following categories: Antipsychotics, antidepressants, anti-anxiety, and hypnotics. The resident's response to the medication (s), including progress towards goals and presence/absence…

    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
Show the remaining 16 citations
  • Potential for harm · D2025-02-13 · 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

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, record review, and policy review, the facility failed to use appropriate hand hygiene practices and personal protective equipment (PPE) when providing incontinence and wound care for 2 of 3 sampled residents observed for direct care, Residents #65 and #61. The findings included: Review of the policy, titled, Enhanced Barrier Precautions (EBP), implemented on 04/01/24 documented, in part, Definitions: 'Enhanced barrier precautions' refers to the use of gown and gloves for use during high-contact resident care activities for residents known to be colonized or infected with a multidrug-resistant organism (MDRO) as well as those at increased risk of MDRO acquisition (e.g., residents with wounds or indwelling medical devices.) . Policy Explanation and Compliance Guidelines: . 1.b) Clear signage will be posted on the door or wall outside of the resident room indicating the type of precaution, required (PPE), and the high contact resident care activities that require the use of gown 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.

    Infection Control Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2023-11-02 · tag F0561 — failed to honor residents' choices — isolated
    Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
    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 documented evidence of showers as per schedule and preference for 2 of 4 residents (Resident #2 and Resident #6). The findings included: 1.) Record review revealed Resident #6 was initially admitted to the facility on [DATE] with re-admission on [DATE] with diagnosis included Non-Alzheimer's Dementia. The annual minimum data set (MDS) assessment reference date 08/25/23 recorded a brief interview for mental status (BIMS) score of 12, which indicated Resident #6 was moderately cognitively intact. This MDS revealed that Resident #6 required extensive assistance with bed mobility, dressing and personal hygiene care. On 10/30/23, started at 10:13 AM Resident #6 was observed lying in bed, lethargic, he stated he was felt weak. On 10/31/23 at 8:36 AM Resident #6 was observed lying in bed, alert, oriented, and more awake, there were no signs of lethargic. During that time an interview was started, he stated, he felt much better today, he was…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2023-11-02 · tag F0565 — failed to support the resident council — isolated
    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 resident interviews, Resident Council meeting minutes, record reviews, and staff interviews, the facility failed to act upon Resident Council grievances in a timely manner regarding voiced resident concerns about direct care staff as consistently stated in each Resident Council Meeting Minutes reviewed from May 2023 to October 2023. The findings included: Policy title Resident and Family Grievances, implemented date 2/15/23; revised date 3/2/23; reviewed by clinical services. The policy indicated that it is the policy of this facility to support each residents and family member's right to voice grievances without discrimination, reprisal or fear of discrimination or reprisal. Prompt efforts to resolve include facility acknowledgment of a complaint/grievance and actively working toward resolution of that compliant/grievance. #7 of the policy indicated grievances may be voiced in the following forums: verbal complaint to a staff member or grievance officer. #10 procedure: a) the staff member receiving the grievance will record the nature and specifics of the grievance on 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 · D2023-11-02 · tag F0641 — isolated
    Ensure each resident receives an accurate assessment.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review, the facility failed to ensure Minimum Data Set (MDS) assessment accuracy related to Activities of Daily Living (ADLs), indwelling urinary catheter use, medications, and hospitalizations for 4 of 16 sampled residents (Resident #19, #28, 39, and #61). The findings included: 1) During an observation and interview on 10/31/23 at 9:42 AM, a urinary catheter bag was noted hanging from the bed of Resident #19. When asked how long she had the catheter, Resident #19 stated she had it for awhile. Review of the current orders revealed the use of an indwelling catheter since the admission of Resident #19 on 09/19/23. Review of the current MDS assessment dated [DATE] lacked the documented use of an indwelling catheter in section H0100. 2) On 10/31/23 in the afternoon, Resident #28 was observed up in his wheelchair, being pushed by one staff. During an interview on 11/01/23 at 11:29 AM, when told he was seen yesterday up out of bed, Resident #28 stated he wanted to get up 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.

    Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2023-11-02 · tag F0644 — isolated
    Coordinate assessments with the pre-admission screening and resident review program; and referring for services as 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 record review and interview, the facility failed to ensure completion of a Level 2 PASARR (Preadmission Screening and Resident Review) for 1 of 2 sampled residents. Resident #9 had a documented Level 1 PASARR dated 04/17/23, and a supplemental review on 11/02/23 that revealed the necessity for a Level 2, which was not completed. The findings included: Review of the record revealed Resident #9 was admitted to the facility on [DATE], and had five hospitalizations since admission. A Level 1 PASARR was completed on 04/17/23 by the previous Nursing Home Administrator (NHA), who was also a Medical Social Worker. This Level 1 screening indicated in Section II, there was an indication the individual has or may have had a disorder resulting in functional limitations in major life activities that would otherwise be appropriate for the individual's developmental stage. The instructions on this Level 1 PASARR documented the need for the Level 2 assessment. A supplemental letter to Resident #9 from the previous NHA,…

    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 · D2023-11-02 · tag F0645 — isolated
    PASARR screening for Mental disorders or Intellectual Disabilities
    What the surveyor found here — the official record, unedited, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review and interview, the facility failed to ensure Level 1 PASARR (Preadmission Screening and Record Review) screening was completed for 1 of 2 sampled residents prior to or upon admission (Resident #19). The findings included: Review of the record revealed Resident #19 was admitted to the facility on [DATE] for a Hospice respite, and subsequently admitted for long term care as of 09/24/23. Review of the record lacked any Level 1 PASARR screening. During a side-by-side record review and interview, the Social Services Director (SSD) was asked to locate and provide a Level 1 PASARR screening, and she was unable to find one. The SSD volunteered that the Hospice staff refused to complete the PASARR screening. When asked if she completed it upon admission to the facility, the SSD stated she had not.

    Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2023-11-02 · tag F0657 — failed to keep the care plan current — isolated
    Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review, the facility failed to update the comprehensive care plans and or ensure resident representative participation in the care needs for 3 of 16 sampled residents, after changes in condition were identified. Resident #23 had a decline in eating ability with facility failure to update the care plan. Resident #28 required two person assistance for transferred that was not reflected in the current care plan. Resident #39 had a decline in eating ability and the facility failed to update the care plan. The resident representative for Resident #39 had requested a consult for upper dentures and was not informed of the findings of the dentist. The findings included: 1) During an observation on 10/31/23 at 12:12 PM, Resident #23 was in the main dining room awaiting lunch. The resident was served her lunch meal, took a few bites independently, and then was fed the rest of the meal by Staff D, Certified Nursing Assistant (CNA). Review of the record revealed Resident #23 was…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2023-11-02 · 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, and record review, the facility failed to provide wound care, and accurately document the provision of dressing changes, as per physician order for 2 of 3 sampled residents with wounds (Residents #19 and #28). The findings included: 1) During an interview and observation on 10/30/23 at 3:00 PM, a gauze dressing with the date 10/27 was noted to the upper left arm of Resident #19. When asked how often the dressing was to be changed, Resident #19 was unsure. Review of the record revealed Resident #19 was admitted to the facility on [DATE]. Review of current orders revealed an order dated 10/09/23 for the dressing to the resident's left arm exposed hardware was to be cleaned with normal saline, with the application of calcium alginate, collagen and a clean dry dressing, every Monday, Wednesday, and Friday. This order was changed to daily as of 10/26/23. This dressing change was scheduled for the evening shift nurses to complete. Review of the October 2023 Medication Administration…

    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 · D2023-11-02 · 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 policy, observation, interview, and record review, the facility failed to ensure proper peri-care for 1 of 1 sampled resident who had a urinary tract infection (UTI), (Resident #4). The findings included: Review of Policy and Procedure: title perineal care. Date implemented: 01/2023. The Policy revealed it is the practice of this facility to provide perineal care to all incontinent residents during routine bath and as needed in order to promote cleanliness and comfort, prevent infection to the extent possible, and to prevent and assess for skin breakdown. Definition: perineal care refers to the care of the external genitalia and the anal area. #9 of the policy revealed to change gloves if soiled and continue with perineal care. Record Review revealed Resident #4 was initially admitted to the facility on [DATE] with re-admission on [DATE] with diagnosis included non-Alzheimer's dementia. The annual minimum data set (MDS) assessment, reference date 08/08/23 recorded a brief interview for mental status…

    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 · D2023-11-02 · 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, interview, and policy review, the facility failed to ensure accurate documentation related to Medication Administration Records (MARs), physician consults, and orders for 3 of 16 sampled residents. The record for Resident #39 lacked the provided dental consult, an order for Hospice services, and contained multiple blank areas in the MAR. The records for Residents #52 and #53 contained numerous blank areas in the MARs. The findings included: Review of the policy Documentation in Medical Record revised 08/25/22 documented, Policy Explanation and Compliance Guidelines: 1. Licensed staff and interdisciplinary team members shall document all assessments, observation, and services provided in the resident's medical record in accordance with state law and facility policy. 2. Documentation shall be completed at the time of service, but no later than the shift in which the assessment, observation, or care service occurred. 3. Principles of documentation include, but are not limited to: 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 Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Ecited before2022-07-08 · tag F0657 — failed to keep the care plan current — pattern
    Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review and interview the facility failed to document review and revision of the care plan with the required Interdisciplinary Team (IDT) for 3 of 18 residents in the final sample (Resident#18, #32, #39), and failed to document required IDT involvement in the care planning process for 9 of 18 residents in the final sample (Residents #32, #8, #39, #44, #61, #48, #17, #15, #7). The findings included: 1) Review of Resident #32's electronic medical records revealed resident was admitted to the facility on [DATE] with diagnoses to include Hypertension, Dementia with Behavioral Disturbances, Mood Disorder, Lack of Coordination, Muscle Weakness, Difficulty Walking, and History of Falling. A review of her IDT Care Conference meeting was dated 11/23/21, this is the most recent in her records and documents that a registered nurse (RN) and Social Service attended meeting and resident's guardian attended meeting by telephone. There was no direct care aide or dietary at the meeting. 2) Review of Resident #39'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 Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Ecited before2022-07-08 · tag F0684 — failed to provide proper treatment and quality of care — pattern
    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

    Based on Facility Policy, record review, interview, and observation the facility failed to document ongoing coordination of care with Hospice for 6 of 6 resident reviewed for Hospice (Resident #21, #67, #19, #68, #69 and #38). The findings include: The Facility Policy titled Hospice provided by the facility dated July 2017 states, In general it is the responsibility of the hospice to manage the resident's care as it relates to the terminal illness and related conditions, including the following: a) determining the appropriate hospice plan of care; b) changing the level of services provided when it is deemed appropriate; c) proving medical direction, nursing and clinical management of the terminal illness; In general, it is the responsibility of the facility to meet the resident's personal care and nursing needs in coordination with the hospice representative, and ensure that the level of care provided is appropriately based on the individual resident's needs. These responsibilities include the following: d) communicating with the hospice provider (and documenting such communication)…

    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 · D2022-07-08 · tag F0554 — isolated
    Allow residents to self-administer drugs if determined clinically appropriate.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on facility policy, observation, interview and record review, the facility failed to determine a resident was approved and safe to self-administer inhaler medications. This failure affected 1 of 1 residents reviewed for medication self-administration (#42). An inhaler is a medical device used for delivering medicines into the lungs through the work of a person's breathing. The findings include: Facility Policy titled Self-Administration of Medications dated February 2021 provided by the facility states, Residents have the right to self-administer medications if the interdisciplinary team has determined that it is clinically appropriate and safe for the resident to do so. If it is deemed safe and appropriate for a resident to self-administer medications, this is documented in the medical record and the care plan. Facility Policy titled Administering Medications dated April 2019 provided by the facility states, Residents may self-administer their own medications only if the Attending Physician, in conjunction with the Interdisciplinary Care Planning Team, has determined that…

    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 · D2022-07-08 · tag F0582 — isolated
    Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
    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 Notice of Medicare Non-Coverage (NOMNC) and Skilled Nursing Facility Advance Beneficiary Notice (SNFABN) in a timely manner in order for residents and or resident's representatives to file an appeal, and failed to provide and inform the residents of their financial responsibilities after being discharged from Medicare for 3 of 3 residents reviewed for Beneficiary Protection Notification (Residents #224, 225 and 226). The findings included: 1). Resident #224 was admitted to the facility on [DATE] and discharged on 04/10/22. A Modification of Admission/Medicare-5 Day Minimum Data Set (MDS) documented the resident as having a Brief Interview for Mental Status (BIMS) score of 14, indicating 'cognitively intact'. The SNF Beneficiary Protection Notification Review (form CMS-20052) filled out by the facility and provided to this surveyor documented Resident #224's Medicare Part A skilled services start date 01/24/22 and last covered day was 03/02/22.…

    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 · D2022-07-08 · 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 the facility was secure to prevent a resident with a risk of elopement from eloping the facility for 1 of 1 resident reviewed for accidents (Resident #54). The findings included: Resident #54 was initially admitted to the facility on [DATE]. According to an admission Minimum Data Set (MDS), dated [DATE], Resident #54 had a Brief Interview for Mental Status score of 12, indicating 'cognitively intact'. The MDS documented that Resident #54 'Usually Makes Self Understood' and had behaviors indicative of depression and behavioral symptoms not directed towards others (e.g., physical symptoms such as hitting or scratching self, pacing, rummaging, public sexual acts, disrobing in public, throwing or smearing food or bodily wastes, or verbal/vocal symptoms like screaming, disruptive sounds) 1 to 3 times during the 7-day look back period and wandering behaviors 1-3 days during the 7-day look back period. The MDS documented that Resident #54…

    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 · D2022-07-08 · 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

    Based on record and interview the facility failed to ensure accurate documentation of medication administration between the controlled substance record and the medication administration records (MARs) for 3 of 4 residents reviewed during the medication storage process (Residents #15, #59 and #68). The findings included: 1.On 07/06/22 at 9:33 AM the review of the medication storage process began, record review for Resident #15 revealed an order of oxycodone 5/325 mg one tablet by mouth every 8 hours as needed for pain for 7 days. The controlled substance record was compared against the July 2022 MARs. There were discrepancies found. The controlled substance record documented the medication was removed from the lock box 4 times on July 2nd: 7/2 at 12 AM, 8:30 AM, 5 PM, and 11 PM. The MARs did not have the 11 PM removal documented. The controlled substance record documented the medication was removed on July 3rd at 9:55 AM and 7:30 PM, the MARs did not show documentation for July 3rd 7:30 PM removal. The controlled substance record documented the medication was removed on July 4th at…

    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

“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 VIVO HEALTHCARE — 12 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 3 of 52.4+0.6 vs chain
Health inspection 2 of 51.9+0.1 vs chain
Staffing 4 of 52.7+1.3 vs chain
Quality measures 5 of 54.3+0.7 vs chain
The other 11 homes this chain runs (chain average 2.4★, per CMS)

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 / managerTypeRoleShareSince
FT PIERCE HOLDCO LLCOrganization5% OR GREATER DIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDEDsince 09/01/2023
JAKOBOVITS, NATHANIndividual5% OR GREATER DIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDEDsince 09/01/2023
KAGAN, JEFFREYIndividualDIRECT OWNERSHIP INTERESTsince 09/01/2023
JEK IRRV TR IIOrganization5% OR GREATER INDIRECT OWNERSHIP INTEREST9%since 09/01/2023
NMJ IRRV TR IIOrganization5% OR GREATER INDIRECT OWNERSHIP INTEREST6%since 09/01/2023
GLUCK, BENJAMINIndividual5% OR GREATER INDIRECT OWNERSHIP INTEREST; OPERATIONAL/MANAGERIAL CONTROL12%since 09/01/2023
JEK HOLDINGS LLCOrganizationINDIRECT OWNERSHIP INTERESTsince 09/01/2023
BECKER, YITZCHOKIndividualINDIRECT OWNERSHIP INTERESTsince 09/01/2023
CUKIER, JOSEFIndividualCORPORATE OFFICER; OPERATIONAL/MANAGERIAL CONTROLsince 09/01/2023
FRIEDLAND, SHALOMIndividualOPERATIONAL/MANAGERIAL CONTROLsince 09/01/2023
FORVIS MAZARS LLPOrganizationADP OF THE SNFsince 09/01/2023
PEASE BELL CPAS LLCOrganizationADP OF THE SNFsince 09/01/2023
SUMMATION FINANCIAL SERVICES LLCOrganizationADP OF THE SNFsince 09/01/2023
BOYKIN, IANIndividualADP OF THE SNFsince 09/01/2023
HARPER, CHARLESIndividualADP OF THE SNFsince 09/01/2023

CMS files one row per role, so the 17 rows in the source record cover these 15 parties — each is shown once here with every role it holds. Nothing is omitted.

7 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.

$5.9M
Net patient revenuemost recent cost report
-3.8%
Operating marginrevenue minus expenses
$117K
Related-party expense2% of expenses
Who pays — share of resident-days
Medicaid 52%Medicare 20%Other / private 29%

This home reported $117K paid to related parties (affiliated landlords or management companies) in its most recent cost report.

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

$363per resident / day
operating cost
$11,028per month
≈ monthly operating cost
$350per 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 105804. CMS refreshes its data monthly, and the star rating rests on the last standard inspection — dated 2025-02-13, 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.

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