Lutheran Living Senior Campus

Location & what’s nearby

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

Quality measures — how residents actually fare

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

Short-stay rehab — if you are coming here from a hospital

Arriving from a hospital right now? Read the discharge guide → — your appeal rights, how to slow a rushed discharge, and what to ask about the numbers below.

59.1% of the Medicare patients who left this home got back to the community and stayed there for at least 31 days — CMS rates that better than the national rate. This is CMS’s risk-adjusted rate over 192 Medicare stays in Oct 2022–Sep 2024, and CMS’s own comparison — not ours.

Met the expected recovery: 65.4% 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 78 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 0.12 therapist hours per resident per day in 2026Q1 — more than 8% of the 13,892 homes that report any therapy hours at all.

Weekend therapy: weekend therapy hours are 5% of this home’s weekday level — it runs therapy on weekdays, with essentially none at the weekend. The median home that reports therapy runs 13% — weekday-focused therapy is the industry norm, not a shortfall. But recovery does not pause on a Saturday: ask what the weekend actually looks like here.

This section is about rehab stays, not living here. Most of this page — the stars, the quality measures, the inspection record — describes the home the way a permanent resident experiences it. These figures describe the short Medicare stay after a hospital discharge: a hip, a stroke, a bad infection, six weeks and home. They are different residents, different staff, often a different wing. Therapy hours are per resident in the building, not per rehab patient — the count includes every long-stay resident, and they mostly get no therapy at all. So a home with a small rehab wing inside a large nursing population reads low here even if its rehab patients get plenty of therapy, and a mostly-rehab home reads high. Use it to compare homes doing similar work, ask what a rehab resident actually gets in a day, and remember that CMS does not publish therapy minutes per patient — nobody does.

Staffing

How full it usually is: this home is certified for 155 beds and averages 121.3 residents a day — about 78% occupied, or roughly 34 beds typically open. It usually has some room. This is a CMS average, not live availability — no public source publishes real-time vacancies, and a home can be full the day you call. Confirm with the home, and if you need a Medicaid bed specifically, ask about that separately: a home with open beds may still not have an open Medicaid bed.

Against a benchmark — not a legal minimum. In May 2024 CMS finalized the first federal staffing floor for nursing homes: 3.48 total nurse hours per resident per day, including 0.55 RN hours and 2.45 nurse-aide hours. Its hour requirements never took effect and are no longer on the books. Homes had until 2026 (2027 if rural) to comply, and that deadline never arrived: a federal court vacated the hour requirements in April 2025 (CMS has appealed), Congress then barred enforcement until 2034, and CMS formally repealed them by rule effective February 2026. This home is not required to meet these numbers, and is not violating anything by missing them. We still show the comparison because the figures are CMS’s own published estimate of adequate staffing, which makes them a useful yardstick — but they are our benchmark, not federal law: this home’s total nurse staffing of 3.85 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 0.44 is below the 0.55-hour RN benchmark and nurse-aide staffing of 2.36 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 3.43 hrs/resident/day on weekends vs 4.02 on weekdays — 15% thinner on weekends. RN hours go from 0.49 to 0.32 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)

This home’s total nursing-staff turnover of 43% is about the same as the national median of 45%.

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

Inspection trend

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

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.

43 citations, most serious first. The 17 most serious are shown; the remaining 26 are one tap away and print in full.

• Immediate jeopardy · J2025-08-07 · tag F0740 — failed to provide behavioral / mental-health care — isolated
  Ensure each resident must receive and the facility must provide necessary behavioral health care and 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 clinical record review, facility self report, State of Iowa Administrative Hearings Findings, and staff interviews, the facility failed to perform behavioral health assessments for Resident #1 after he was served a 30 day involuntary discharge notice following an alleged assault on another resident. Resident #1 had a documented history of major depressive disorder and suicidal ideation and was placed on one to one (1:1) supervision after the alleged assault. On [DATE] the 1:1 supervision was discontinued to address a staffing shortage without Resident #1 being assessed. During the early morning hours of [DATE], with no 1:1 supervision, Resident #1 used items within reach and committed suicide hours before his scheduled discharge from the facility. The facility reported a census of 124 residents. On [DATE] at 5:00 pm, the State Survey Agency informed the facility of the failure to perform behavioral health assessments following notification of an involuntary discharge created an Immediate Jeopardy…

  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
• Immediate jeopardy · J2025-08-07 · tag F0741 — failed to have staff trained for behavioral health — isolated
  Ensure that the facility has sufficient staff members who possess the competencies and skills to meet the behavioral health needs of residents.
  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 clinical record review, facility self report, State of Iowa Administrative Hearings Findings, staff and family interviews, and facility policy review, the facility failed to recognize and address potential statements and behaviors that indicated Resident #1's self harm risk after he was served a 30 day involuntary discharge notice following an alleged assault on another resident. Resident #1 had a documented history of major depressive disorder and suicidal ideation and was placed on one to one (1:1) supervision after the alleged assault. In the days leading up to his discharge, multiple staff members stated they observed Resident #1's potential signs of worsening depression or heard him verbalize comments of potential self-harm but did not report these concerns to facility management. During the early morning hours of [DATE], without 1:1 supervision in place, Resident #1 used items within reach and committed suicide hours before his scheduled discharge from the facility. The facility reported a census…

  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
• Immediate jeopardy · Jcited before2024-09-30 · 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 clinical record review, observations, facility video and staff interviews, the facility failed to ensure a resident with exit seeking behavior did not exit the facility without staff knowledge. (Resident #4) The facility reported census was 125. The State Agency informed the facility of the Immediate Jeopardy (IJ) on 9/17/24 at 3:30 pm. The IJ began on August 4, 2024. Facility staff removed the Immediate Jeopardy on 9/24/24 through the following actions: - Resident placed on 1:1 observation on 8/4/24 until he was moved to the locked Memory Care Unit on 8/5/24. - Neuro checks initiated, witness statement obtained, and notifications made on 8/4/24. - Elopement assessment and care plan updated 8/5/24. - Staff education on elopement and documentation began 8/4/24. - Residents wander guard immediately checked for functionality on 8/4/24. - Staffing was reviewed for time of incident and determined not to be a contributing factor. How will you identify other residents who are at risk for being affected by this…

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

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Immediate jeopardy · Jcited before2024-07-31 · 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 clinical record review, personnel records, medical examiner interview and staff interviews, the facility failed to provide adequate staff and supervision to assist a resident who called out for help in a timely manner for 1 of 5 residents (Resident #1) reviewed for safety. Per staff interview, Resident #1 called out for help on [DATE] at approximately 4:30 AM, and staff were unable to respond for up to 10 minutes. The resident subsequently found face down in bed, feet on the floor, unresponsive. The facility reported a census of 129 residents. The State Agency informed the facility of the Immediate Jeopardy (IJ) on [DATE] at 5:35 p.m. The IJ began on February 11, 2024, when Resident #1 found unresponsive. Facility staff removed the Immediate Jeopardy on [DATE] through the following actions: a. The Director of Nursing (DON) or designee will educate On-Call Clinical Staff on responsiveness to staffing calls. b. The DON or designee will educate direct care Licensed Nurses prior to working their next shift…

  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
• Immediate jeopardy · J2023-10-05 · tag F0603 — failed to not confine residents against their will — isolated
  Protect each resident from separation (from other residents, his/her room, or confinement to his/her room).
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on interviews, clinical record review, facility policy review and facility investigation review, the facility failed to ensure a resident was not subjected to involuntary seclusion when a staff member had used verbal threats to impose the understanding to a resident that she was not allowed to leave her room. This deficient practice resulted in Resident #385 displaying behaviors of anxiety, tearfulness, and fear of the staff member that imposed the involuntary seclusion to the residents room for one of four residents reviewed for abuse (Resident #385). This deficient practice resulted in an Immediate Jeopardy (IJ) to the health and safety of a resident who resided at the facility. The facility reported a census of 140 residents. Findings Include: On 10/4/23, the Iowa Department of Inspections and Appeals staff contacted the facility staff to notify them the Department staff determined an Immediate Jeopardy situation existed at the facility. The Immediate Jeopardy had a start date of 5/16/23. The facility staff removed the immediacy on 10/5/23 at 2:55 PM, and decreased 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.

  Freedom from Abuse, Neglect, and Exploitation Deficiencies · Deficient, Provider has date of correction
• Immediate jeopardy · J2023-10-05 · tag F0610 — failed to investigate and act on abuse reports — isolated
  Respond appropriately to all alleged violations.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on clinical record review, staff interview, Facility Investigation Review and facility policy review the facility failed to thoroughly and timely investigate a resident's allegations of mean/aggressive treatment and involuntary seclusion by a facility staff member, failed to separate residents from an alleged perpetrator after staff had become aware of allegations, and failed to maintain thorough documentation regarding investigation into the resident's allegations for one of four residents reviewed for abuse (Resident #385). This deficient practice resulted in an Immediate Jeopardy to the health and safety of a resident who resided at the facility. The Facility had a census of 140. Findings Include: On 10/4/23 at 3:55 PM, the Iowa Department of Inspections, Appeals, and Licensing staff contacted the facility staff to notify them the Department staff determined an Immediate Jeopardy situation existed at the facility. The Immediate Jeopardy had a start date of 5/16/23. The facility staff removed the immediacy on 10/5/23 at 2:55 PM, and decreased the scope J to D level after 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.

  Freedom from Abuse, Neglect, and Exploitation Deficiencies · Deficient, Provider has date of correction
• Actual harm · Hcited before2023-10-05 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — pattern
  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 5. The Quarterly Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #60 scored 15 out of 15 on a Brief Interview for Mental Status (BIMS) exam, which indicated cognition intact. The MDS documented the resident needed extensive assistance with two plus person physical assist for bed mobility, transfers, and dressing. The MDS revealed medical diagnosis of heart failure, hypertension, and hemiplegia/hemiparesis. The Care Plan identified a focus problem of skin integrity for actual complications with impaired skin integrity including skin tears, bruising and pressure related to current medical and physical status with initiated date of 9/13/22. The interventions were listed as follows; documented medications, labs, and treatments as ordered; and observe skin with AM/PM cares and with toileting for redness, rashes, open areas, pain, swelling and report them to team leader with weekly skin checks. The Care Plan identified a focus problem of Activities of Daily Living (ADL's): Potential for complications…

  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 · D2026-02-13 · tag F0552 — isolated
  Ensure that residents are fully informed and understand their health status, care and treatments.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on clinical record review, facility policy review, resident representative interview and staff interview, the facility failed to ensure residents and/or their representatives were fully informed of the risks and benefits of taking psychotropic (medications that affect thought processes or behaviors) before the resident started taking the medication and when changes occurred for 2 of 5 residents (Residents #3 and Resident #47) reviewed for unnecessary medications. The facility reported a census of 117 residents.Findings include:1. Review of the Minimum Data Set (MDS) assessment, dated 12/10/25, revealed Resident #3 had a Brief Interview for Mental Status (BIMS) score of 15 out of 15 which indicated intact cognition. The MDS identified the resident did not display any behaviors and had signs and symptoms of minimal depression. The list of diagnoses included depression, anxiety, bipolar disorder and an intellectual disability. The MDS indicated the resident medications prescribed in the high-risk classes of antipsychotic, antidepressant and antianxiety. Review of the electronic…

  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 · D2026-02-13 · 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 observations, clinical record review, facility policy review, family, resident and staff interviews, the failed to make repairs of damaged flooring and walls in a timely manner for 2 of 4 (Resident #53 and Resident #81) resident rooms sampled; and failed to dispose of an empty cleaning spray bottle from 1 of 4 (Resident #81) resident rooms. The facility reported a census of 117 residents.Findings include:1. Review of the Minimum Data Set assessment for Resident #53, dated 1/28/26, revealed the resident admitted to the facility on [DATE]. The Brief Interview for Mental Status (BIMS) score of 8 out of 15 indicated a moderate cognitive impairment. The list of diagnoses included dementia. The MDS indicated Resident #53 required substantial/maximal assistance for transfers, and repositioning. Review of the electronic health record (EHR) revealed Resident #53 resided in their current room since 12/19/24. During an observation on 2/5/26 at 8:42 AM, a fist sized area with a dent and crack noted on the wall…

  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 · D2026-02-13 · 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

  Based on observations, clinical record review, facility policy review and staff interview, the facility failed to ensure staff completed hand hygiene and utilized Enhanced Barrier Precautions in an attempt to prevent the transmission of infections during resident care for 3 of 8 (Resident #2, Resident #3, and Resident #91) residents reviewed for infection control. The facility reported a census of 117. Findings include:1. Review of the Minimum Data Set (MDS) assessment for Resident #2, dated 12/10/25, revealed a list of diagnoses which included traumatic brain injury, seizure disorder and quadriplegia. The MDS indicated Resident #2 utilized a feeding tube (a surgical opening in the abdominal wall for the delivery of nutrition, hydration and medications) and a tracheostomy (a surgical opening in the throat to provide an alternate airway for breathing). Review of the Care Plan for Resident #2, revised 2/8/26, revealed a Focus area to address Enhanced Barrier Precautions (EBP) for trach and PEG tube (a type of feeding tube). The Intervention directed Enhanced Barrier Precautions are 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.

  Infection Control Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2025-08-07 · tag F0553 — failed to let residents help plan their care — isolated
  Allow resident to participate in the development and implementation of his or her person-centered plan of care.
  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 clinical record review, family and staff interviews, and policy review, the facility failed to conduct quarterly Care Conferences (CC) for 1 of 3 residents reviewed (#4). The facility reported a census of 124 residents. Findings include: The Minimum Data Set (MDS) assessment for Resident #4 dated 3/26/25 did not include a Brief Interview for Mental Status (BIMS) score; however, an MDS assessment dated [DATE] revealed a BIMS score of 06 out of 15, which indicated severely impaired cognition. The MDS dated [DATE] included diagnoses of coronary artery disease (CAD), congestive heart failure (CHF), Alzheimer's Disease, non-Alzheimer's dementia, venous insufficiency, and seborrheic dermatitis (a common skin condition that causes a scaly, flaky, itchy rash, often on the scalp, face, and body folds). The Care Plan dated 2/24/23 indicated the resident had potential for complications with impaired skin integrity including skin tears, bruising AND/OR pressure related to current medical and physical status and had…

  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 · Dcited before2025-08-07 · tag F0580 — failed to tell family and doctor about changes — isolated
  Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on clinical record review, family and staff interviews, and policy review, the facility failed to provide timely physician and family notification for 1 of 3 residents (Resident #4) who experienced a newly documented open wound. The facility reported a census of 124 residents. Findings include: The Minimum Data Set (MDS) assessment for Resident #4 dated 3/26/25 did not include a Brief Interview for Mental Status (BIMS) score; however, an MDS assessment dated [DATE] revealed a BIMS score of 06 out of 15, which indicated severely impaired cognition. The MDS dated [DATE] included diagnoses of coronary artery disease (CAD), congestive heart failure (CHF), Alzheimer's Disease, non-Alzheimer's dementia, venous insufficiency, and seborrheic dermatitis (a common skin condition that causes a scaly, flaky, itchy rash, often on the scalp, face, and body folds). It also revealed the resident was independent with rolling left-to-right, sit-to-lying, and lying-to-sitting on the side of the bed, and required supervision…

  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 · Dcited before2025-08-07 · 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 clinical record review, family and staff interviews, the facility failed to provide timely interventions for 1 of 3 residents who experienced a newly documented open wound (#4). The facility reported a census of 124 residents. Findings include: The Minimum Data Set (MDS) assessment for Resident #4 dated 3/26/25 did not include a Brief Interview for Mental Status (BIMS) score; however, an MDS assessment dated [DATE] revealed a BIMS score of 06 out of 15, which indicated severely impaired cognition. The MDS dated [DATE] included diagnoses of coronary artery disease (CAD), congestive heart failure (CHF), Alzheimer's Disease, non-Alzheimer's dementia, venous insufficiency, and seborrheic dermatitis (a common skin condition that causes a scaly, flaky, itchy rash, often on the scalp, face, and body folds). It also revealed the resident was independent with rolling left-to-right, sit-to-lying, and lying-to-sitting on the side of the bed, and required supervision with all other mobility. It further revealed,…

  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 before2025-03-06 · tag F0580 — failed to tell family and doctor about changes — isolated
  Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on clinical record review, legal guardian interview, and staff interviews, the facility failed to notify the resident's guardian in a timely manner after a fall resulting in injury and transfer to the hospital for 1 of 3 residents reviewed. (Resident #1). The facility reported census was 120. Findings include: According to the Minimum Data Set, dated [DATE], Resident #1 had a Brief Interview for Mental Status score of 3, indicating a severely impaired cognitive status. Resident #3 was independently mobile with using her wheel walker and required moderate assistance with dressing, toilet use and personal hygiene needs. Resident #1's diagnoses included Alzheimer's, age related osteoporosis w/o (without) current pathological fracture, and chronic obstructive pulmonary disease, malnutrition. According to an Incident Report dated 2/13/25 at 6:10 p.m., written by Staff H, Resident #1 was in her bedroom with Staff F, Certified Nursing Assistant, preparing for bed, when Resident #1 tripped and fell onto her right…

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

  Resident Rights Deficiencies · Deficient, Provider has date of correction
• Potential for harm · E2024-12-12 · tag F0804 — failed to serve food at safe, palatable temperature — pattern
  Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observation, resident and staff interviews, and temperature testing, the facility failed to serve food at a palatable temperature for one dinner meal observed and for several residents served room trays on the evening meal in the rooms on the 600 Hall. The facility reported a census of 124 residents. Findings include: During an interview on 12/10/24 at 12:26 PM, Staff D, Dietary Aid stated food temperatures are taken once the food has been placed in the steam table and before the first resident is served. Staff D was asked how they keep the room trays hot when taking meal trays to the resident rooms. She advised the plates and food covers are not heated prior to plating. She reported they typically try to get the meals to the resident rooms as soon as possible after they have been plated. When queried Staff D, stated she has heard a few random complaints that sometimes the food is not hot enough. Once the food is delivered to her it is placed in the steam table and temperature taken and logged into a log book prior to starting meal service. The log book was observed 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.

  Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Dcited before2024-12-12 · tag F0609 — failed to report abuse allegations — isolated
  Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review, interviews, and the facility policy, the facility failed to report an alleged abuse incident for 1 of 1 residents reviewed for abuse (Resident #52). The facility reported a census of 124 residents. Findings include: The Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #52 scored an 8 out of 15 on the Brief Interview for Mental Status (BIMS) exam, which indicated cognition moderately impaired. The MDS revealed the resident required partial/moderate assistance with toileting hygiene, upper and lower body dressing; sit to lying; lying to sitting; sit to standing; chair/bed to chair transfer; and toilet transfer. The MDS revealed the resident frequently incontinent of urine and occasionally incontinent of bowel. The MDS revealed medical diagnoses of anxiety disorder and depression. The Care Plan revealed a focus area dated 4/15/19 for risk of side effects of psychotropic medications related to anxiolytic and antidepressant medication therapy. Resident had a diagnosis of major…

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

  Freedom from Abuse, Neglect, and Exploitation Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2024-12-12 · tag F0623 — isolated
  Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal 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 clinical record review, staff interview, and facility policy review the facility failed to ensure the Ombudsman notified of resident transfers to the hospital for 2 of 2 residents reviewed for hospitalization (Resident #37, Resident #110). The facility reported a census of 124 residents. Findings include: 1. The Minimum Data Set (MDS) dated [DATE] revealed Resident #110 scored 15 out of 15 on a Brief Interview for Mental Status (BIMS) exam, which indicated intact cognition. Review of the Progress Note dated 9/20/24 at 11:12 AM revealed, in part, The ambulance was called, and the resident left the facility via non-emergency ambulance at 2022. Review of Ombudsman Notification provided by the facility did not include notification of Resident #110's transfer to the hospital on 9/20/24. 2. The MDS assessment dated [DATE] revealed Resident #37 scored a 13 out of 15 on the BIMS exam, which indicated cognition intact. The MDS revealed medical diagnoses of neurogenic bladder, diabetes mellitus, and heart…

  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

“Cited before” means this same F-tag appears on at least one other survey date in the record we hold — counting complaint investigations as well as standard surveys, with no time limit. It is our own read of the data, not CMS’s: CMS uses repeat deficiency as a formal term tied to consecutive standard surveys, and that is a narrower test than this one. A tag marked here may or may not meet it.

Fines & penalties

$253,886 in federal fines across 3 penalties. 1 Medicare payment denial on record.

• $92,203 — penalty dated 2025-08-07
• $134,971 — penalty dated 2024-07-31
• $26,712 — penalty dated 2023-10-05
• Medicare payment denial — starting 2024-09-04 for 46 days

Dates are the dates CMS records the penalty, not the date of the conduct behind it. CMS publishes penalties on a rolling window, so this is what is currently on the public file — not the home’s lifetime history, and an older fine may attach to a problem that has since been corrected. The amounts are as imposed: the CMS file does not record whether a penalty was appealed, reduced, or paid, so we don’t say. Ask the home what each one was for and what changed since.

Part of a chain

This home belongs to HEALTH DIMENSIONS GROUP — 10 facilities. Here is how its ratings compare with the chain’s average across all its homes: See the whole chain — ratings, flags, fines and finances →

A home rated well below its chain’s average can signal local problems; a chain with a low average across the board is a bigger pattern worth researching. CMS chain data under-reports private-equity and REIT ownership, so treat this as a floor, not the full picture.

Who owns this facility

CMS files one row per role, so the 39 rows in the source record cover these 18 parties — each is shown once here with every role it holds. Nothing is omitted. The source lists no ownership percentage for any of them — PECOS records a share only for equity interests, not for board or management roles.

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.

A reported operating loss is common in this industry and is not by itself a sign of trouble — but paired with large related-party payments it can mean profit is being taken elsewhere in the ownership structure.

Source: CMS Healthcare Provider Cost Reporting Information System (HCRIS), Medicare cost report Form CMS-2540 · fiscal year 2023. Facilities self-file these reports; figures are unaudited and a year or two behind. A home with no Medicare cost report on file shows no figures here.

Cost & finances

Straight from this home’s Medicare cost report (CMS, FY2023). These are its operating economics — what it costs to run per resident-day and what it collects on average across Medicare, Medicaid, and private pay — not a private-pay quote. Your out-of-pocket cost depends on payer and room type, so ask the facility directly; a higher operating cost can reflect richer staffing or a sicker population. The cost-of-care planner shows regional benchmarks by care type.

What families pay in IA