Sunrise Health & Rehabilitation Center
4800 N Nob Hill Rd, Sunrise, FL 33351 · For profit - Limited Liability company · 237 certified beds · (954) 577-3600 Medicare & Medicaid certified
This home’s record is mixed — some reassuring signs, some worth asking about.
- 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 (30% vs 45% nationally) — better care continuity
- a high number of inspection citations overall (28) — 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
- about 21% of its spending goes to commonly-owned related companies
One thing this read cannot see: what residents and families actually experience day to day. Public data misses the feel of a place — visit unannounced, ideally at a mealtime or on a weekend, talk to staff and families, and ask your tour questions.
A plain-English summary of the public record below — not a rating, ranking, or recommendation. We take no money from any facility.
| Health inspectionSurveyor-assigned, ranked within your stateInspector-verified | 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
Open in Google Maps ↗ · Directions ↗ · Larger map ↗
Nearest of each type, straight-line distance. Hospitals come from the CMS Hospital General Information registry; everything else from Overture Maps (public data). Hospital and park hours are typical — call ahead to confirm.
Quality measures — how residents actually fare
| Overall quality measures | 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 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.
See all quality measures vs. state & national benchmarks
| Measure | This home | State avg | Typical state | vs typical state |
|---|---|---|---|---|
| Long-stay residents whose need for help with daily activities increased | 13.3% | 8.7% | 15.4% | better |
| Long-stay residents who lose too much weight | 4.1% | 5.5% | 5.4% | better |
| Long-stay residents with a catheter left in their bladder | 0.0% | 0.3% | 0.9% | better than state‡ — see note marked double-dagger below the table |
| Long-stay residents with a urinary tract infection | 0.0% | 0.7% | 2.0% | better than state‡ — see note marked double-dagger below the table |
| Long-stay residents with depressive symptoms | 1.6% | 4.6% | 6.5% | better |
| Long-stay residents who were physically restrained | 0.0% | 0.0% | 0.1% | better than state‡ — see note marked double-dagger below the table |
| Long-stay residents with falls causing major injury | 1.7% | 2.5% | 3.3% | better |
| Long-stay residents whose ability to walk worsened | 14.8% | 9.5% | 16.1% | typical |
| Long-stay residents on antianxiety or hypnotic medication | 14.2% | 14.4% | 18.9% | better |
| Long-stay residents given the seasonal flu vaccine | 100.0% | 99.2% | 95.3% | typical |
| Long-stay residents with pressure ulcers | 7.0% | 4.5% | 4.7% | worse |
| Long-stay residents with worsening bladder/bowel control | 16.1% | 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 table | 13.9% | 8.6% | 17.1% | better |
| Short-stay residents who newly got an antipsychotic medication | 1.4% | 1.5% | 1.4% | typical |
| Short-stay residents given the seasonal flu vaccine | 96.4% | 94.7% | 79.4% | better |
| Short-stay residents rehospitalized after admission | 21.0% | 26.1% | 22.6% | typical |
| Short-stay residents with an outpatient ER visit | 7.1% | 9.1% | 12.0% | better |
| Long-stay hospitalizations per 1,000 resident days | 2.22 | 2.13 | 1.67 | worse |
| Long-stay outpatient ER visits per 1,000 resident days | 0.51 | 1.15 | 1.80 | better |
‡ 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.
47.9% 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 345 Medicare stays in Oct 2022–Sep 2024, and CMS’s own comparison — not ours.
Met the expected recovery: 67.8% 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 401 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 0.63 therapist hours per resident per day in 2025Q4 — more than 90% of the 13,714 homes that report any therapy hours at all.
Weekend therapy: weekend therapy hours are 19% 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 14% — weekday-focused therapy is the industry norm, not a shortfall. But recovery does not pause on a Saturday: ask what the weekend actually looks like here.
This section is about rehab stays, not living here. Most of this page — the stars, the quality measures, the inspection record — describes the home the way a permanent resident experiences it. These figures describe the short Medicare stay after a hospital discharge: a hip, a stroke, a bad infection, six weeks and home. They are different residents, different staff, often a different wing. Therapy hours are per resident in the building, not per rehab patient — the count includes every long-stay resident, and they mostly get no therapy at all. So a home with a small rehab wing inside a large nursing population reads low here even if its rehab patients get plenty of therapy, and a mostly-rehab home reads high. Use it to compare homes doing similar work, ask what a rehab resident actually gets in a day, and remember that CMS does not publish therapy minutes per patient — nobody does.
See every short-stay measure CMS publishes for this home
| Measure | This home | U.S. median | Period covered | CMS’s call |
|---|---|---|---|---|
| Got home and stayed homeRate of successful return to home or community from a SNF | 47.9%CMS range 42.7–53.4 | 51.5% | Oct 2022–Sep 2024 | no different from U.S. |
| Went back to hospitalRate of potentially preventable hospital readmissions 30 days after discharge from a SNF | 10.9%CMS range 8.8–13.4 | 10.7% | Oct 2022–Sep 2024 | no different from U.S. |
| Met the expected recoveryPercentage of residents who are at or above an expected ability to care for themselves and move around at discharge | 67.8% | 56.6% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Self-care at dischargePercentage of residents who are at or above an expected ability to care for themselves at discharge | 61.4% | 52.8% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Moving around at dischargePercentage of residents who are at or above an expected ability to move around at discharge | 56.4% | 50.0% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Medication problems followed upPercentage of residents whose medications were reviewed and who received follow-up care when medication issues were identified | 99.3% | 98.7% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Medication list to the next providerPercentage of residents where the SNF provided a current medication list to the next health care setting | 98.5% | 100.0% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Medication list to the familyPercentage of residents where the SNF provided a current medication list to the resident, family, and/or caregiver at final discharge | 98.4% | 98.7% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Falls with major injuryPercentage of SNF residents who experience one or more falls with major injury during their SNF stay | 0.3% | 0.0% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| New or worsened pressure ulcersPercentage of residents with pressure ulcers/pressure injuries that are new or worsened | 1.8% | 1.9% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Infections that led to hospitalPercentage of infections residents got during their SNF stay that resulted in hospitalization | 9.2%CMS range 6.3–12.7 | 7.1% | Oct 2023–Sep 2024 | no different from U.S. |
| Medicare spending per stayMedicare Spending Per Beneficiary (MSPB) for residents in SNFs | 1.53 | 1.02 | Oct 2022–Sep 2024 | CMS makes no comparison for this measure |
From the CMS Skilled Nursing Facility Quality Reporting Program — Medicare short-stay outcomes, which is a different dataset from the long-stay quality measures above and describes a different set of residents. Where CMS risk-adjusts a measure we show its adjusted rate, and the CMS range beside it is the confidence interval CMS publishes: a home whose range is wide is a home with few stays, where one patient moves the number several points. Read the period column. These measures do not share a window — the claims-based ones (getting home, readmission, spending) lag by a year or more, because a stay has to finish and its claims settle before it can be counted. CMS’s call is CMS’s, not ours: it is the only place anyone tests whether this home differs from the national rate at all, and most homes on most measures do not. Two caveats on it. CMS tests only three of these measures — getting home, readmission, and infections that led to hospital; on the other nine it publishes a rate and no comparison, and rather than compute a verdict CMS declined to make, we say so in the column. And on readmission almost every home in the country lands on “no different”, so that row separates homes far less than getting-home does — which is why met the expected recovery, a measure CMS does not test but which spreads across the whole range, is called out above the table rather than left in this list. The U.S. median column is our own, taken across every home CMS publishes that measure for in this same file; it is not a CMS-published benchmark. Homes CMS gives no rate for are left out of it rather than counted as zero. Medicare spending per stay is a ratio, not a percentage — 1.00 means this home’s Medicare spending for a stay matched the national figure CMS compares it against, and it measures cost to Medicare, not quality of care.
Staffing
How full it usually is: this home is certified for 237 beds and averages 220.7 residents a day — about 93% occupied, or roughly 16 beds typically open. It runs fairly full. This is a CMS average, not live availability — no public source publishes real-time vacancies, and a home can be full the day you call. Confirm with the home, and if you need a Medicaid bed specifically, ask about that separately: a home with open beds may still not have an open Medicaid bed.
Against a benchmark — not a legal minimum. In May 2024 CMS finalized the first federal staffing floor for nursing homes: 3.48 total nurse hours per resident per day, including 0.55 RN hours and 2.45 nurse-aide hours. Its hour requirements never took effect and are no longer on the books. Homes had until 2026 (2027 if rural) to comply, and that deadline never arrived: a federal court vacated the hour requirements in April 2025 (CMS has appealed), Congress then barred enforcement until 2034, and CMS formally repealed them by rule effective February 2026. This home is not required to meet these numbers, and is not violating anything by missing them. We still show the comparison because the figures are CMS’s own published estimate of adequate staffing, which makes them a useful yardstick — but they are our benchmark, not federal law: this home’s total nurse staffing of 4.25 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 1.12 is at or above the 0.55-hour RN benchmark and nurse-aide staffing of 2.52 is at or above the 2.45-hour aide benchmark. What federal law does require today is unchanged: “sufficient” nursing staff for residents’ needs and an RN on duty at least 8 consecutive hours a day, 7 days a week (42 CFR 483.35). Those are judged by inspectors on site, not by these averages, so read this comparison alongside the inspection record rather than as a pass/fail.
Weekend coverage: total nurse staffing is 3.93 hrs/resident/day on weekends vs 4.33 on weekdays — 9% thinner on weekends. RN hours go from 1.18 to 0.91 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
Deficiencies are more than at the previous inspection — worsening. Fewer citations over time suggests a home is fixing problems; a rising count is a warning sign — though two surveys are a short record, and survey teams differ. These counts are from the standard annual health survey only; the full citation list below may also include findings from complaint investigations, so the two won’t always add up.
Inspection deficiencies
State health-inspection citations, most serious first. Each carries an F-code (the federal rule it cites, e.g. F-684 = quality of care) and a letter A–L marking how serious and how widespread the problem was — we translate that grid into the plain tiers shown here. Wording is the official federal description.
Each letter is a CMS scope-severity level; highlighted ones are where this home has citations. A–C = no harm found; D–F = potential for harm; G–I = actual harm; J–L = immediate jeopardy. Within each band the later letter is the more widespread finding (an isolated G is one resident; a widespread I is a pattern), so rightward and downward is worse.
28 citations, most serious first. The 10 most serious are shown; the remaining 18 are one tap away and print in full.
- Potential for harm · E2026-02-26 · tag F0812 — failed to store, cook, and serve food safely — patternProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observations and interviews, the facility failed to store, prepare, distribute, and serve food in accordance with professional standards for food service safety. This was observed during 2 of 2 visits conducted in the Main Kitchen. The findings included: On 02/23/26 at 8:47 AM, a tour of the facility's kitchen was conducted. Upon entering the kitchen, several male staff were observed with facial hair, none of which were wearing beard covers (Staff V, W, X, Y). Once the staff were alerted by the surveyor, Staff X donned a beard cover but did not cover his mustache. The surveyor had to explain to all the male staff that beard covers were to cover all facial hair, not just beards. The following was also observed: a. Two plates in the plate warmer were found to have food particles and the food contact surface of the plates showed signs of wear and excessive use. b. Two 50-ounce cans of Tomato Soup were noted with dents on the bottom of the cans in the dry stock room. c. The dishwashing machine was a high temperature model. During the observation, it was run 3 times, but it did…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2026-02-26 · tag F0641 — isolatedEnsure each resident receives an accurate assessment.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview and record review, the facility failed to correctly complete Minimum Data Set (MDS) assessments for 2 of 35 sampled residents, Resident #54 and Resident #98. The findings included:1. Record review revealed Resident #54 was admitted to the facility on [DATE] with diagnoses that included Cerebral Infarction, Type 2 Diabetes Mellitus, and Chronic Obstructive Pulmonary Disease. Review of the quarterly Minimum Data Set (MDS) assessment dated [DATE], under Section C revealed a Brief Interview of Mental Status (BIMS) score of 11 indicating the resident had moderate cognitive impairment. Section P-Restraints and Alarms of the same MDS revealed the MDS was coded as the resident using Bed Rails. An interview was conducted with Staff B, Licensed Practical Nurse (LPN), MDS Coordinator on 02/24/26 at 10:56 AM. She stated it was an error as they do not use restraints. 2. Record review revealed Resident #98 was admitted to the facility on [DATE] with diagnoses that included Hemiplegia 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.
- Potential for harm · D2026-02-26 · tag F0688 — failed to keep residents mobile / prevent decline — isolatedProvide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for 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, interviews, and record review, the facility failed to provide splints / protectors to assist in preventing contractures for 1 of 3 sampled residents reviewed for position and mobility, Resident #15. The findings included: Record review revealed Resident #15 was admitted to the facility on [DATE] with diagnoses of dementia, depression, and right-hand contracture. The [NAME] Data Set (MDS) dated [DATE] showed Resident #15's cognitive status to be severely impaired. A review of the physician's orders showed a Bilateral hand palm protector order every shift for skin integrity, dated 12/17/25. Review of the care plan dated 01/16/26 revealed contracture prevention and management, including split-type palm protectors for bilateral hands, refer to therapy as needed, and apply splints and remove them as scheduled. Review of the Occupational Therapy Evaluation and plan of treatment dated 12/12/25 revealed Resident #15 presents with Bilateral upper extremity hand contractures and recommended the use…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · Dcited before2026-02-26 · tag F0692 — failed to prevent malnutrition and dehydration — isolatedProvide enough food/fluids to maintain a resident's health.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, interviews, and record review, the facility failed to address weight loss in a timely manner and provide nutritional interventions for 3 of 5 sampled residents reviewed for nutrition, Resident #193, Resident #7, and Resident #59. The findings included: 1. Record review showed Resident #193 was admitted to the facility on [DATE] with diagnoses of Anemia and Depression. Review of the quarterly Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #193 has a Brief Interview of Mental Status (BIMS) score of 08, indicating moderate cognitive impairment. In an interview conducted on 02/24/26 at 9:10 AM with Resident #193, he stated that he was in so much pain and could not eat his breakfast. Closer observation showed that the breakfast meal was untouched. In an interview conducted on 02/24/26 at 11:39 AM, Resident #193 was in the room with his lunch, consisting of marinated pork cubes, fluffy rice, carrots, and vanilla ice cream. Resident #193 stated that he is not very hungry, but he…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2026-02-26 · tag F0694 — isolatedProvide for the safe, appropriate administration of IV fluids 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 review of policy and procedure, observation, record review and interview, the facility failed to provide care and services and change the dressings for residents' Midline Intravenous (IV) catheter dressing in a timely manner, for 1 of 1 sampled resident observed, on the Locked Memory Care, G-wing, with a Midline catheter in place, Resident #23.The findings included:Review of the facility policy title, Midline.Dressing Change, provided by the Director of Nursing (DON), revised on 01/2026 documented in the Policy Statement: It is the policy of this facility to change.Midline.dressing weekly, or if soiled, in a manner to decrease potential for infection and/or cross-contamination. Physician's orders will specify type of dressing and frequency of changes. Policy Explanation and Compliance Guidelines: g. Open sterile dressing kit.6. Inspect the catheter-skin junction and surrounding area, palpating through the intact dressing for redness, tenderness, swelling and drainage. Be attentive to any reports of…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2026-02-26 · tag F0695 — failed to provide proper breathing / tracheostomy care — isolatedProvide 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 observations, interviews, record reviews, and policy review, the facility failed to follow physicians' oxygen orders for 4 of 5 sampled residents reviewed for oxygen therapy and has the potential to affect 49 residents on oxygen therapy, Resident #38, Resident #229, Resident #108, Resident #228; failed to obtain physicians order for oxygen therapy administration for 1 of 5 sampled residents reviewed for oxygen therapy, Resident #49; and failed to follow the professional standards of practice during medication administration via an oral inhalation for 1 of 8 sampled residents for medication administration observation, Resident #54. The findings included:Review of the facility policy titled, Oxygen Therapy, provided by the Director of Nursing (DON) revised in 01/26, documented in the Policy Statement: To administer Oxygen when insufficient Oxygen is carried by the blood to the tissue.Procedure:.Place signs Oxygen in use and No Smoking signs outside room.Adjust rate of flow according to doctor'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.
- Potential for harm · D2026-02-26 · tag F0698 — failed to provide proper dialysis care — isolatedProvide 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, record review, and review of facility policy, the facility failed to ensure communication sheets were filled out accurately and completely for 2 of 3 sampled residents reviewed for dialysis, Resident #59 and Resident 105. The findings included: Review of the policy, titled, Weight Monitoring, dated 09/01/22, documented, weights should be recorded at the time obtained. Review of the facility's contract with an outside dialysis company, effective 02/14/25, page 6, documented, communication between the Facility and the Dialysis Center was via a communication form that must contain the most recent vital signs and current weights. The Dialysis Center was to enter the total amount of fluid removed. Review of the communication form revealed a notation stating the floor nurse was to report post weight promptly to dialysis. 1. Record review revealed Resident #59 was admitted to the facility on [DATE]. The following diagnoses were included: Diabetes, End Stage Renal Disease on Dialysis,…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2026-02-26 · tag F0842 — failed to keep accurate, complete medical records — isolatedSafeguard 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 observation, interview and record review, the facility failed to document the code status in the physician's orders for 1 of 35 sampled residents, Resident #6. The findings included:Review of the facility's policy titled, Communication of Code Status, date implemented 4/2022 and date revised 1/2025, revealed When an order is written pertaining to a resident's presence or absence of an Advance Directive, the directions will be clearly documented in designated sections of the medical records. Examples of directions to be documented include, but are not limited to:a. Full Codeb. Do Not Resuscitatec. Do Not Intubated. Do Not HospitalizeThe designated sections of the medical record are: Order Section of Point Click Care.On 02/24/26 at 10:22 AM a review was conducted of the Physician Orders for Resident # 6. The orders did not reveal a code status order.On 02/25/26 at 9:50 AM an interview was conducted with Staff A, a Licensed Practical Nurse (LPN) and Unit Manager. She stated to find the code status they…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2026-02-26 · tag F0919 — failed to provide a working call system — isolatedMake sure that a working call system is available in each resident's bathroom and bathing area.
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 maintain residents' call lights in a working manner for 2 of 35 residents in the final sample, Residents #112 and 225. The findings included:1. Record review revealed that Resident #112 was admitted to the facility on [DATE]. According to the resident's most recent complete assessment, a Quarterly Minimum Data Set (MDS) with a reference date of 02/02/26, Resident #112 had a Brief Interview for Mental Status (BIMS) score of 09, indicating the resident was moderately cognitively impaired. The assessment documented that the resident required partial/moderate assistance for transfers and was able to walk short distances independently and up to 150 feet with assistance and was frequently incontinent of bowel and blader. Resident #112's diagnoses at the time of the assessment included: Anemia, Hypertension, Heart failure, Renal insufficiency, DM, Hyperlipidemia, Hip fracture, Malnutrition, Chronic lung disease, refractory anemia, Pulmonary…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · Dcited before2024-08-08 · tag F0550 — failed to protect resident dignity and rights — isolatedHonor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY 4. Resident #162 was admitted on [DATE] with diagnoses of protein-calorie malnutrition, Type 2 diabetes, and muscle weakness. The admission Minimum Data Set (MDS) dated [DATE] revealed a Brief Interview of Mental Status (BIMS) score of 02, which indicated severe cognitive impairment. In an observation conducted on 08/05/24 at 6:25 PM, Resident #162 received her dinner tray, which was placed at the side table. At 6:55 PM (30 minutes later), Staff C, Certified Nursing Assistant, was noted standing over the Resident feeding her the dinner soup. A chair was noted near Staff C, which had enough space to pull the chair near Resident #162's bed. Staff C stopped when this Surveyor walked into the room and said, She is a feeder, in front of Resident #162. In an interview conducted on 08/07/24 at 3:40 PM, Staff H, a Certified Nursing Assistant, stated that she was educated on treating the residents with dignity while assisting with dining. She needs to make sure that she sits near the residents at eye level while feeding…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
Show the remaining 18 citations
- Potential for harm · Dcited before2024-08-08 · tag F0677 — failed to help fully-dependent residents with daily care — isolatedProvide care and assistance to perform activities of daily living for any resident who is unable.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, interviews, and record review, the facility failed to provide the necessary services to maintain good nutrition (assist with feeding) for a resident who is unable to carry out activities of daily living for 1 of 8 sampled residents reviewed for nutrition (Resident #121). The findings included: Resident #121 was admitted to the facility on [DATE] with diagnoses of Type 2 Diabetes, Heart Failure, and Muscle Wasting. The Significant Change Minimum Data Set (MDS) dated [DATE] revealed that Resident #121 has a Brief Interview of Mental Status (BIMS) score of 04, which is severe cognitive impairment. Section GG (eating) on the above MDS showed that Resident #121 needs set-up and clean-up assistance with her eating. The Care plan dated 07/19/24 showed Resident #121 has a self-care performance deficit related to impaired cognition. Resident #121 has impaired visual function related to blurred vision. In an observation conducted on 08/05/24 at 5:40 PM, Resident #121 was noted in her room 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.
- Potential for harm · D2024-08-08 · tag F0686 — failed to prevent and treat pressure sores (bedsores) — isolatedProvide appropriate pressure ulcer care and prevent new ulcers from developing.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on review of policy and procedure, interview and record review, the facility failed to assess skin in a timely manner, to identify a pressure ulcer for 1 of 7 sampled residents reviewed for facility acquired pressure ulcers, Resident #408. The findings included: Review of the facility policy and procedure on 08/08/24 at 3:10 PM titled Pressure Injury Prevention and Management provided by the Director of Nursing (DON) revised 10/2022 documented in the Policy Statement: This facility is committed to the prevention of avoidable pressure injuries .and to provide treatment and services to heal the pressure ulcer/injury, prevent infection and the development of additional pressure ulcers/injuries Policy Explanation and Compliance Guidelines: .2. The facility shall establish and utilize a systematic approach for pressure injury prevention and management, including prompt assessment and treatment; intervening to stabilize, reduce or remove underlying risk factors; monitoring the impact of the interventions; 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.
- Potential for harm · Dcited before2024-08-08 · tag F0692 — failed to prevent malnutrition and dehydration — isolatedProvide enough food/fluids to maintain a resident's health.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, interviews, and record review, the facility failed to monitor weights, provide appropriate nutritional interventions, and ensure that dietary interventions were followed as ordered for 2 of 8 sampled residents for nutrition (Resident #162 and Resident #98). The findings included: A review of the facility's policy titled Nutritional Management, revised on 09/2022, revealed the following: A systematic approach is used to optimize each Resident's nutritional status: a. Identifying and assessing each Resident's nutritional status and risk factors. b. Evaluating/analyzing the assessment information. c. Developing and consistently implementing pertinent approaches. d. Monitoring the effectiveness of interventions and revising them as necessary. A review of the facility's policy titled Weight Monitoring: revised on 09/01/2022 revealed the following: Based on the Resident's comprehensive assessment, the Center will ensure that all residents maintain acceptable parameters of nutritional statuses,…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2024-08-08 · tag F0697 — failed to manage pain — isolatedProvide safe, appropriate pain management for a resident who requires such services.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, interviews and record review, the facility failed to ensure that pain management is provided to residents who require such services, consistent with professional standards of practice for 1 of 1 resident reviewed for pain (Resident #358). The findings included: A review of the facility's policy titled Pain Management, revised on 09/01/2022, revealed the following: facility staff will observe for nonverbal indications that may indicate the presence of pain. These indicators include but are not limited to, the impact of pain on quality of life (sleeping, appetite, and mood), currently prescribed pain medications, dosage and frequency, and the resident's goals for pain management and satisfaction with the current level of pain control. Resident #358 was admitted on [DATE] with diagnoses of Muscle Wasting, Type 2 Diabetes, and Muscle Weakness. The 5-day Minimum Data Set, dated [DATE] revealed that Resident #358 had a Brief Interview of Mental Status (BIMS) score of 15, which is cognitively…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2024-08-08 · tag F0806 — failed to honor food preferences — isolatedEnsure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, interviews, and record review, the facility failed to provide food that accommodates resident preferences and appealing options of similar nutritive value to residents who choose not to eat food that is initially served or who request a different meal choice for 2 of 8 residents sampled for nutrition (Resident #88 and Resident #172). The findings included: A review of the facility ' s policy titled Nutritional Management, revised on 09/2022, revealed the following: Interviewing the Resident and Resident representative to determine if their personal goals and preferences are being met. ii. Directly observing the Resident. iii. Interviewing the direct care staff to gain information about the Resident, the interventions currently in place, their responsibilities for reporting on these interventions, and possible suggestions for changes if necessary. 1. A record review revealed that Resident #88 was admitted to the facility on [DATE] with diagnoses of Underweight, Muscle Wasting, 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.
- Potential for harm · Dcited before2024-08-08 · tag F0808 — failed to follow doctor-ordered diets — isolatedEnsure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview, observation, and record review the facility failed to effectively communicate, and educate Staff regarding fluid restriction, failed to ensure supervision, communication, and education of a resident about the allowable amount of liquids for fluid restriction, and failed to document the amount of provided liquid per shift based on the guidelines of a medically prescribed order for fluid restriction for 1 of 1 sampled resident (Resident # 172). The Findings included: Resident #172 was re-admitted to the facility on [DATE] with the diagnoses of Type 2 Diabetes Mellitus, End Stage Renal Disease, Kidney Transplant Failure, Unspecified Protein-Calorie Malnutrition and Acute Pulmonary Edema. His initial admission was on 01/27/2024 with diagnoses of Muscle wasting, Acute Respiratory Distress Syndrome, Pleural Effusion, Atherosclerotic Heart Disease, and Dependence on Renal Dialysis. Record review of MDS (Minimum Data Set) Section C revealed a BIMS (Brief Interview of Mental Status ) score of 12…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · E2023-05-17 · tag F0584 — failed to keep a safe, clean, comfortable home — patternHonor 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 2. Record review for Resident #96 revealed the resident was admitted to the facility on [DATE] with diagnoses that included: Diabetes, Major Depressive Disorder, and Anxiety Disorder. Review of the Minimum Data Set (MDS) for Resident #96 dated 05/06/23 revealed in Section C the resident had a Brief Interview of Mental Status (BIMS) score of 15 indicated the resident had an intact cognitive response. During an observation conducted on 05/14/23 between 11:00 AM to 1:00 PM the exterior door located at the East end of E-wing unit was opened 15 times with a very loud alarm sounding each time the door was opened. An interview was conducted on 05/14/23 at 12:59 PM with Resident #96 who was awake and lying in her bed. When asked if the East E-wing exterior door alarm disturbs her, she said sometimes it does at night. It happens so often that I do not jump every time it goes off like I used to. 3. Record review for Resident #2 revealed the resident was admitted to the facility on [DATE] with diagnoses that included:…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · E2023-05-17 · tag F0805 — failed to prepare food in a form residents can eat — patternEnsure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
What the surveyor found here — an excerpt from the official record, may be distressing
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 prepare pureed foods in a safe and proper form for 7 of 31 sampled residents on puree diets (Residents #83, #110, #114, #120, #132, 135, and #248) and failed to provided thickened liquids as per physician order for Resident #120. The findings included: 1) Observation of the approved menu for the lunch meal of 05/16/23 noted Pureed Diet (PU4) were to receive 4 oz Pureed [NAME] (PU4) and 4 oz of Pureed Vegetables (PU4) . During the observation of the lunch meal in the main kitchen on 5/16/23 at 11:45 AM , it was noted that the Pureed [NAME] and Pureed Vegetable to be sticky, grainy, and to have pieces of food that were visible to the naked eye. At the request of the surveyor the pureed rice and vegetables were tasted to ensure a smooth consistency. The test revealed that there were large pieces of the rice grain and vegetables in the pureed mixture. Interview with key staff noted that the cook (Staff H) failed 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.
- Potential for harm · E2023-05-17 · tag F0880 — failed to prevent and control infections — patternProvide and implement an infection prevention and control program.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on interview and record review the facility failed to conduct appropriate infection surveillance testing of staff for Covid-19 in accordance with national standards and facility's policy during current outbreak of Covid-19. The findings included: Review of the facility's policy titled Coronavirus Testing with a revised date of 03/06/23 included the following: The facility will implement testing of facility residents and staff, including individuals providing services under arrangement and volunteers, for Covid-19. Individuals with signs and symptoms of Covid-19 should be prioritized first when tested, then perform testing triggered by an outbreak investigation as follows: Testing Trigger - Newly identified Covid-19 positive staff or resident in a facility that is unable to identify close contacts. Staff - Test all staff, regardless of vaccination status, facility wide or at a group level if staff are assigned to a specific location where the new case occurred (e.g., unit, floor, or other specific area(s) of the facility). Under the heading of Testing of Staff and Residents in…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · Dcited before2023-05-17 · tag F0550 — failed to protect resident dignity and rights — isolatedHonor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, interviews, and record reviews, the facility failed to provide dining in a dignified manner during multiple observations conducted on Unit G (lockdown unit). The findings included: In an observation conducted on 05/14/23 at 1:50 PM, in Unit G (lockdown), in the Atrium,15 residents were sitting waiting on their lunch trays. The first table had 4 residents with 1 resident eating; the second table had 4 residents with only 1 resident eating, the third table had 4 residents with 2 residents eating, and the fourth table had 3 residents with 3 residents eating. At 2:02 PM (12 minutes later), the first table had 3 residents waiting on their lunch trays, the second had 2 residents still waiting on their lunch meal, and the third had 3 residents still waiting on their lunch meal. Continued observation at 2:10 PM, 20 minutes later, showed that the first table had 3 residents still waiting on their lunch meal, the second table had 1 resident eating and 2 residents waiting on their lunch meal. The…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2023-05-17 · tag F0583 — failed to protect personal privacy — isolatedKeep residents' personal and medical records private and confidential.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, interviews and record review, the facility failed to secure residents' records for 3 of 45 sampled residents (Residents #9, #34, and #83). The findings included: Review of the facility's policy titled Confidentiality of Personal and Medical Records with no date implemented, no date revised, included the following: This facility honors the resident's right to secure and confidential personal and medical records. This includes the right to confidentiality of all information contained in a resident's records, regardless of the form of storage or location of the record. Personal and medical records include all types of records the facility might keep on a resident, whether they are medical, social, fund accounts, automated, or other. Keep confidential is defined as safeguarding the content of information including written documentation, video, audio, or other computer stored information from unauthorized disclosure without the consent of the individual. Paper notes or reminders with resident'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.
- Potential for harm · D2023-05-17 · tag F0676 — failed to keep up residents' daily-living abilities — isolatedEnsure 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 based on their comprehensive assessment that the facility failed to provide necessary care, services and adaptive eating equipment to maintain independence in self feeding for 2 (Resident' #75, and #83) of 11 residents sampled for nutrition review. The findings included: 1) During the observation of the lunch meal on 5/14/23 and 05/16/23 it was noted Resident #75 was being totally fed by CNA (Certified Nursing Assistant) Staff. Observation of the resident noted that she was awake and answering question with some cognitive deficit. The CNA designated the resident as a total feed. A review of the resident's meal tray ticket documented: Soft & Bite Sized Diet - Plate Guard & Right Curved Utensil. The CNA further stated that the adaptive eating equipment is not being used for the resident. The issues was brought to the attention of the Director of Skilled Therapy who stated that the resident would be assessed for the use of adaptive eating…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · Dcited before2023-05-17 · tag F0677 — failed to help fully-dependent residents with daily care — isolatedProvide care and assistance to perform activities of daily living for any resident who is unable.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review, the facility failed to assist during dining for 2 of the 2 sampled residents reviewed for Activities of Daily Living (ADLs) (Resident #68 and Resident #142). The findings included: 1. In an observation conducted on 05/16/23 at 9:10 AM, Resident #68 was noted in her room. Closer observation showed Staff E, Certified Nursing Assistant (CNA), setting up the tray and cutting the food into smaller pieces for Resident #68. In this observation, Staff E stated that Resident #68 could eat independently. Continued observation at 10:30 AM showed that Resident #68 did not eat any of her breakfast tray. No staff was noted in the room. (Photographic evidence obtained). In an observation conducted on 05/17/23 at 9:10 AM, Resident #68 was noted in bed with the breakfast tray in front of her. Staff D, Certified Nursing Assistant, was observed cutting and setting up the breakfast tray for Resident #68. In this observation, Staff D stated that Resident #68 is blind and needs help…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2023-05-17 · tag F0684 — failed to provide proper treatment and quality of care — isolatedProvide 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 interview, record review and facility policy review, the facility failed to follow through with physician's order for blood sugar monitoring for 1 of 1 resident reviewed (Resident #162), and facility failed to provide wound care as ordered for 1 of 2 residents reviewed for wound care (Resident #167). The findings included: 1. The facility's policy, titled 'Residents' Rights Regarding Treatment and Advance Directives', implemented on 05/09/23, documented the following: 11. Should the resident refuse treatment of any kind, the facility will document the following in the resident's chart: a. What the resident refused. b. The reason for the refusal. c. The advice given to the resident about the consequences of refusing. d. The offering of alternative treatments. e. The continuation of providing all other services. 12. Any servics that would be otherwise required, but are refused, will be documented in the resident's comprehensive care plan. Resident #162 was admitted to the facility on [DATE]. According 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.
- Potential for harm · D2023-05-17 · tag F0712 — isolatedEnsure that the resident and his/her doctor meet face-to-face at all required visits.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review the facility failed to ensure that residents are seen by a physician at least every 60 days for 2 residents reviewed for physician's services (Resident #69 and #145). The findings included: 1. Record review for Resident #69 revealed the resident was admitted to the facility on [DATE] with diagnoses that included: Ulcerative Colitis, Anxiety Disorder, Bipolar Disorder, Major Depressive Disorder, Generalized Anxiety Disorder, Insomnia, Acute Pain Due to Trauma, and Dysphagia. Review of the Minimum Data Set (MDS) for Resident #69, dated 04/27/23 revealed in Section C a Brief Interview of Mental Status (BIMS) score of 13 indicating the resident had an intact cognitive response. Record review for Resident #69 revealed the resident was not seen by a physician, physician assistant, nurse practitioner, or clinical nurse specialist from 01/11/23 to 04/24/23 (greater than 60 days). 2. Record review for Resident #145 revealed the resident was admitted to the facility on [DATE] with…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2023-05-17 · tag F0761 — failed to label and store drugs safely — isolatedEnsure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, record and policy review, the facility failed to store and dispose of medication in a secure manner affecting 2 of 7 residents observed during medication administration (Residents #46 and #116). The findings included: The facility's policy titled Storage of Medications and Biological Products dated 3/22 stated All medications and biological products will be stored in locked compartments under proper temperature controls. The facility's policy titled Destruction of Expire or Discontinued Medications dated 7/21 and revised 3/22 stated Wasted single doses of medication for disposal should be disposed of in a manner that limits access to them by unauthorized personnel or residents. On 05/14/23 at 9:53 AM, Staff A, Registered Nurse (RN) was observed during a medication administration pass. As Staff A was preparing medication for Resident #116, a Lasix 20 milligram (mg) pill popped out of the bingo card and fell onto the top of medication cart. Staff A picked up the Lasix pill 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.
- Potential for harm · D2023-05-17 · tag F0804 — failed to serve food at safe, palatable temperature — isolatedEnsure food and drink is palatable, attractive, and at a safe and appetizing temperature.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observation, interview, and record review, it was determined that the facility failed to prepare pureed foods by methods that conserve nutritive value, flavor, and appearance that potentially affected 7 of 31 residents with physician ordered Pureed Diet (Residents #83, #110, #114, #120, #132, 135, and #248). The findings included: During the initial kitchen/food service conducted on 05/14/23 at 8:45 AM accompanied with the [NAME] (Staff H), it was noted numerous pans of cooked left over foods were in Reach-in refrigerator #1 that included: Third Pan Pureed Vegetables: 30 portions : Soupy Consistency (Dated 05/14/23). Half Pan of Cooked Spaghetti- 30 portions (Dated 05/11/23). Half Pan Cooked Chicken Legs - 20 portions (No date). Half Pan of Cooked French Toast - 20 portions (Dated 05/14/23). Half Pan Cooked Scrambled Eggs - 25-30 portions (Dated 05/14/23). Half Pan Cooked Hamburger Patties: 20 portions (Dated 05/12/23). 1) Further observation and interview with Staff H noted the pan of vegetables to be slightly warm. Staff H stated that the pan consisted of Pureed Broccoli…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · Dcited before2023-05-17 · tag F0808 — failed to follow doctor-ordered diets — isolatedEnsure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law.
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 follow physician orders for 2 (Resident's 147 and #248) of 2 residents with physician ordered Fluid Restriction diets (Residents #142 and #248). The findings included: 1) Observation of the breakfast meal on 5/16/23 at 8 AM, noted the meal tray served to the room of Resident #147. Review of the meal tray ticket at the time of the observation noted Renal/Diabetic Diet. Further observation noted that the tray was to include Apple Juice (4 ounces) and Whole Milk (8 ounces), however the fluids were not included on the tray and no water was noted to be at bedside. Further review noted that the meal tray ticket did not document a physician ordered Fluid Restriction. Interview with the Certified Nursing Assistant in the room stated the resident received dialysis and the fluids were taken off the tray. The issues was discussed with the D Wing Charge Nurse who stated she was unaware that the tray fluids were being removed…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
“Cited before” means this same F-tag appears on at least one other survey date in the record we hold — counting complaint investigations as well as standard surveys, with no time limit. It is our own read of the data, not CMS’s: CMS uses repeat deficiency as a formal term tied to consecutive standard surveys, and that is a narrower test than this one. A tag marked here may or may not meet it.
- Long-Term Care Ombudsman — a free, confidential advocate for the resident. They act only with the resident’s consent and work to resolve the problem. Find yours at theconsumervoice.org/get_help.
- Adult Protective Services — the state agency that investigates suspected abuse, neglect, or exploitation of a vulnerable adult. Not sure of your state’s APS number? The federal Eldercare Locator will route you: 1-800-677-1116 or eldercare.acl.gov.
- State survey agency — the regulator that licenses and inspects the home. Every state has an official nursing-home complaint line and most take complaints online; the Ombudsman or Eldercare Locator can connect you.
Fines & penalties
No federal fines in the current CMS record.
Part of a chain
This home belongs to MICHAEL FEIST — 7 facilities. Here is how its ratings compare with the chain’s average across all its homes: See the whole chain — ratings, flags, fines and finances →
| Rating | This home | Chain avg | |
|---|---|---|---|
| Overall | 4 of 5 | 3.6 | +0.4 vs chain |
| Health inspection | 3 of 5 | 3.1 | -0.1 vs chain |
| Staffing | 4 of 5 | 3.3 | +0.7 vs chain |
| Quality measures | 5 of 5 | 4.3 | +0.7 vs chain |
The other 6 homes this chain runs (chain average 3.6★, 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 / manager | Type | Role | Share | Since |
|---|---|---|---|---|
| SUNRISE NURSING HOME OPERATIONS COMPANY HOLDINGS LLC | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | since 01/11/2022 |
| FEIST, MICHAEL | Individual | 5% OR GREATER INDIRECT OWNERSHIP INTEREST; CORPORATE OFFICER; OPERATIONAL/MANAGERIAL CONTROL | 100% | since 01/12/2022 |
| BOWES-FINEGAN, CHARMAINE | Individual | W-2 MANAGING EMPLOYEE | — | since 04/01/2022 |
CMS files one row per role, so the 5 rows in the source record cover these 3 parties — each is shown once here with every role it holds. Nothing is omitted.
1 organizational owner listed — a facility can be part of a larger chain. CMS ownership data is known to under-report private-equity and REIT ties; treat as a starting point.
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.
This home reported $6.4M paid to related parties — landlords or management companies under common ownership — equal to about 21% of its total expenses. Money routed to affiliated companies can leave a home’s own books looking lean while owners still profit; it is the mechanism regulators watch most closely in private-equity and REIT deals.
Source: CMS Healthcare Provider Cost Reporting Information System (HCRIS), Medicare cost report Form CMS-2540 · fiscal year 2023. Facilities self-file these reports; figures are unaudited and a year or two behind. A home with no Medicare cost report on file shows no figures here.
Cost & finances
Straight from this home’s Medicare cost report (CMS, FY2023). These are its operating economics — what it costs to run per resident-day and what it collects on average across Medicare, Medicaid, and private pay — not a private-pay quote. Your out-of-pocket cost depends on payer and room type, so ask the facility directly; a higher operating cost can reflect richer staffing or a sicker population. The cost-of-care planner shows regional benchmarks by care type.
What families pay in FL
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.
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 2026-09-01 — CMS provider number 105441. CMS refreshes its data monthly, and the star rating rests on the last standard inspection — dated 2026-02-26, 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.