Seminary Manor

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.

63.5% 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 426 Medicare stays in Oct 2022–Sep 2024, and CMS’s own comparison — not ours.

Met the expected recovery: 69.0% 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 197 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 0.26 therapist hours per resident per day in 2026Q1 — more than 37% of the 13,892 homes that report any therapy hours at all.

Weekend therapy: weekend therapy hours are 13% of this home’s weekday level — it runs some therapy at the weekend, at a lower level than on weekdays. The median home that reports therapy runs 13% — weekday-focused therapy is the industry norm, not a shortfall. But recovery does not pause on a Saturday: ask what the weekend actually looks like here.

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

Staffing

How full it usually is: this home is certified for 121 beds and averages 94.1 residents a day — about 78% occupied, or roughly 27 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 4.25 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 0.60 is at or above the 0.55-hour RN benchmark and nurse-aide staffing of 2.89 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 3.78 hrs/resident/day on weekends vs 4.45 on weekdays — 15% thinner on weekends. RN hours go from 0.66 to 0.44 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)

This home’s total nursing-staff turnover of 42% is about the same as the national median of 45%. 3 administrators have left in the past year — frequent leadership churn is a warning sign families often miss.

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.

24 citations, most serious first. The 15 most serious are shown; the remaining 9 are one tap away and print in full.

• Actual harm · Gcited before2026-04-29 · tag F0600 — failed to protect residents from abuse and neglect — isolated
  Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review the facility failed to prevent employee to resident mental abuse for one (R1) resident out of seven reviewed for abuse. This failure caused R1 to feel blindsided, dumbfounded, and embarrassed. Findings include:The facility policy, Abuse Prohibition and Reporting (elder Justice Act), revised 11/28/19, documents not in its entirety, To protect residents from any kind of abuse such as verbal, sexual, mental, physical, including corporal punishment, involuntary seclusion, neglect, misappropriation of property, exploitation and any physical or chemical restraint not required to treat the resident's symptoms.Shift coordinators and shift nurses, will be instructed to be aware of inappropriate staff behavior and take the necessary procedure for correction of these behaviors. They would include, but not limit to derogatory language, rough handling, ignoring resident requests, and not observing appropriate safety measures that would endanger resident.Facility employee or agent who…

  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 · G2025-09-18 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolated
  Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview and record review the facility failed to provide staff supervision during toileting for a resident that was assessed as requiring toileting assistance (R2), one of three residents reviewed for falls, in a sample of 3. This failure resulted in R2 being left unsupervised, falling from a toilet resulting in a head laceration, extensive bruising and fractured ribs. FINDINGS INCLUDE:R2's facility Resident Face Sheet documents that R2 was admitted to the facility on [DATE] with the following diagnoses: History of Falls, Displaced Fracture of Greater Trochanter of Left Femur, Need for Assistance with Personal Care, Weakness, Generalized Anxiety Disorder, Exudative Age-Related Macular Degeneration, right eye, Osteoarthritis, Asthma and Chronic systolic (congestive) heart failure.R2's Hospital History and Physical Transfer Notes document, (R2) has a past medical history significant for congestive heart failure (CHF), a fall, hypertension (HTN), hyperlipidemia, atrial fibrillation (a-fib),…

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

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Actual harm · G2025-02-11 · tag F0686 — failed to prevent and treat pressure sores (bedsores) — isolated
  Provide appropriate pressure ulcer care and prevent new ulcers from developing.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review the facility failed to develop and implement pressure relieving interventions to prevent pressure ulcer development and worsening, conduct a pressure ulcer risk assessment once a week for four weeks after admission, obtain a treatment for a newly identified pressure ulcer, and accurately and thoroughly assess pressure ulcers weekly for two of three residents (R1 and R2) reviewed for facility acquired pressure ulcers in the sample of five. These failures resulted in R1 developing an unstageable pressure ulcer to the left heel six days after admission to the facility and R2 developing a stage three pressure ulcer to the right heel and an unstageable pressure ulcer to the inner ankle that required autolytic debridement (using own body's enzymes to remove dead tissue) and caused R2 severe pain. Findings include: The facility's Pressure Injury/Pressure Ulcer Prevention and Treatment Protocol dated 10-24-22 documents Objective and Purpose: To ensure that measures are…

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

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Actual harm · Gcited before2025-02-11 · tag F0695 — failed to provide proper breathing / tracheostomy care — isolated
  Provide safe and appropriate respiratory care for a resident when needed.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review and interview, the facility failed to monitor the level of Oxygen in a portable Oxygen tank for a resident diagnosed with Congestive Heart Failure, ensure a continuous Oxygen supply was administered as ordered by the Physician, and failed to perform an assessment after a resident went without Oxygen and experienced respiratory distress and a low pulse oximetry reading for one of three residents (R1) reviewed for Oxygen use in the sample of five. These failures resulted in R1 being without oxygen for 20 minutes on one occurrence and 10 minutes on second occurrence, which caused R1 to experience chest pain, shortness of breath, feelings of being smothered and imminent death. Findings include: The facility's Oxygen Therapy and Safety policy dated 4-9-20 documents Area: Nursing. It is the policy of this facility to provide a safe environment for residents, staff, and the public. Purpose: To provide a source of oxygen to persons experiencing an insufficient supply of same and to address 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.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Actual harm · G2024-01-03 · tag F0690 — failed to manage incontinence, catheters, and urinary infections — isolated
  Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review the facility failed to immediately notify the physician to obtain a treatment for a UTI (Urinary Tract Infection) for one of three residents (R1) reviewed for UTI's in the sample of three. These failures resulted in R1's UTI being left untreated for 12 days and R1 experiencing increased moaning, pain, and discomfort. This resulted in R1 being sent to the emergency room and admitted to the local hospital for four days to receive treatment with intravenous antibiotics for the diagnosis of Sepsis secondary to a UTI. Findings include: The facility's Lab/Diagnostics Policy dated 11-28-17 documents, Policy: It is a policy of the facility to provide means of quality diagnostic lab services for the residents. Purpose: To provide residents a means of diagnostic service promptly and conveniently. Procedure: 1.Provision for Diagnostic Services: d. Any abnormal lab results upon receipt by the facility nurse will be promptly reported to the to the ordering Physician,…

  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 · D2026-06-22 · 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

  Based on interview and record review the facility failed to notify the Health Care Power of Attorney of a change of condition for one (R1) of three residents reviewed for notification of changes. Findings include:On 6/20/26 at 10:15 AM V4 (R1's Health Care Power of Attorney) stated that he was not notified of R1's wounds on his heels. I had to find them myself on 5/13/26 when I was clipping his toenails. Someone should have called me and let me know that he had wounds. R1's Medical Record documents that R1 had bogginess (physical finding where tissue feels soft, spongy, or mushy upon palpation) noted to his left heel on 4/17/26.R1's Medical Record documents that he had an intact blister to his right heel discovered on 4/25/26. R1's notes included physician notification and new treatment orders for each wound.R1's Medical Record did not contain any documentation that V4 (R1's Health Care Power of Attorney) was notified of either wound finding (4/17/26 and 4/25/26.) On 6/22/26 at 9:00 AM V2 (Director of Nursing) confirmed that R1's Medical Record did not contain any documentation that…

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

  Resident Rights Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2026-04-29 · tag F0607 — failed to have anti-abuse policies — isolated
  Develop and implement policies and procedures to prevent abuse, neglect, and theft.
  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 report an allegation of abuse to the Abuse Coordinator for one (R1) of seven residents in a sample of seven reviewed for abuse. Findings include:The facility policy, Abuse Prohibition and Reporting (elder Justice Act), revised 11/28/19, documents not in its entirety, To protect residents from any kind of abuse such as verbal, sexual, mental, physical, including corporal punishment, involuntary seclusion, neglect, misappropriation of property, exploitation and any physical or chemical restraint not required to treat the resident's symptoms.Shift coordinators and shift nurses, will be instructed to be aware of inappropriate staff behavior and take the necessary procedure for correction of these behaviors. They would include, but not limit to derogatory language, rough handling, ignoring resident requests, and not observing appropriate safety measures that would endanger resident.Facility employee or agent who becomes aware of alleged abuse or neglect of a…

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

  Freedom from Abuse, Neglect, and Exploitation Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2026-04-29 · 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

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review the facility failed to thoroughly investigate an allegation of abuse for one (R1) of seven residents in a sample of seven reviewed for abuse. Findings include:The facility policy, Abuse Prohibition and Reporting (elder Justice Act), revised 11/28/19, documents not in its entirety, To protect residents from any kind of abuse such as verbal, sexual, mental, physical, including corporal punishment, involuntary seclusion, neglect, misappropriation of property, exploitation and any physical or chemical restraint not required to treat the resident's symptoms.Shift coordinators and shift nurses, will be instructed to be aware of inappropriate staff behavior and take the necessary procedure for correction of these behaviors. They would include, but not limit to derogatory language, rough handling, ignoring resident requests, and not observing appropriate safety measures that would endanger resident.Facility employee or agent who becomes aware of alleged abuse or neglect of a resident…

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

  Freedom from Abuse, Neglect, and Exploitation Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Dcited before2026-03-18 · tag F0600 — failed to protect residents from abuse and neglect — isolated
  Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review, the facility failed to ensure a resident was free from sexual harassment by another resident, for one of three residents (R2), reviewed for abuse, in a sample of three.Th facility policy, Abuse Prohibition and Reporting, dated (revised) 11/28/19 directs staff that the facility prohibits abuse. The purpose of the policy is to protect residents from any kind of abuse such as verbal, sexual, mental, physical. The facility's definition of sexual abuse includes, but is not limited to, sexual harassment, sexual coercion or sexual assault.R1's current Physician Order Sheet, dated March 2026 documents that R1 was admitted to the facility on [DATE].R1's current Minimum Data Seat Assessment, dated 11/29/25 documents R1's cognitive status as 10 out of 15 (moderate impairment).R1's current Care Plan includes the following Problem Areas: (R1) has a history of displaying multiple behaviors including exit seeking, physical and verbal behaviors directed towards others and rejection of care,…

  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 · F2025-08-21 · tag F0569 — widespread
  Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review and interview, the facility failed to: (1) return resident trust fund balances for 46 residents (R1, R5-R49) reviewed for trust fund balances after being discharged /expired 30 days; and, (2) provide notification or trust fund balances reaching $200 less than the SSI/Supplemental Security Income resource limit for three residents (R2, R3, and R4), of 111 residents, reviewed for trust fund account balances, in a total sample of 111 residents. FINDINGS INCLUDE: 1) The facility admission Contract document: V. Deposits and Refunds: The Facility hereby acknowledges receipt of the deposit, if any, noted at the beginning of the contract. Any refund owed to the Resident for advance payments shall be paid by the Facility within forty-five (45) days after discharge or transfer or within the time frame required by State law. In the case of Medicaid residents, any such refund will be paid within thirty (30) days of the Facility's receipt of the final Medicaid payment for care of the Resident or as…

  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 · F2025-05-16 · tag F0868 — widespread
  Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
  What the surveyor found here — the official record, unedited, may be distressing

  Based on interview and record review, the facility failed to conduct quarterly QAPI/Quality Assessment Plan Improvement meetings. This has the potential to affect all 97 residents living in the facility. Findings include: Facility QAPI Plan, dated 3/31/25, documents The Committee is responsible for meeting on a quarterly basis. Facility provided QAA sign in sheets dated 3/6/25 and 4/24/25. No other QAA sign in sheets were available to review after the previous survey date of 8/7/24. On 5/13/25 at 12:53PM, V1 Administrator provided two QAA sign in sheets for the past year of QAA meetings. At that same time, V1 stated she cannot find any QAA sign in sheets prior to March 2025. V1 stated when V1 temporarily left in July 2024, QA meetings were not being held in her absence. Centers for Medicare and Medicaid Services (CMS) form 671 Long-term Care Facility Application for Medicare and Medicaid, dated 5/13/2025, signed by V1, document 97 residents reside in the facility.

  Administration Deficiencies · Deficient, Provider has date of correction
• Potential for harm · F2025-05-16 · tag F0881 — failed to use antibiotics responsibly — widespread
  Implement a program that monitors antibiotic use.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on interview and record review, the facility failed to identify, monitor and review antibiotic use for five of five residents (R25, R40, R47, R74, R297) reviewed for antibiotic stewardship in the sample of 44 residents. This failure has the potential to affect all residents who reside in the facility with a current census of 97 residents. Findings include: The Infection Control policy revised 12/17/19 documents the Infection Control Committee shall be responsible for surveillance or known nursing home potential infections, the review and analysis of actual infections, the promotion of a preventative and corrective program designed to minimize infection hazards. Follow the Antibiotic Stewardship Program and develop a practical system of reporting, evaluating and keeping records of infections in order to provide an indication of an outbreak level of nosocomial infections and trace the source. The Infection Control Committee reviews the system for reporting, evaluation and keeping records of infections among residents in order to provide an indication of the endemic level of all…

  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 · D2025-05-16 · tag F0605 — failed to not use drugs as a restraint — isolated
  Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
  What the surveyor found here — the official record, unedited, may be distressing

  Based on interview and record review, the facility failed to discontinue a PRN/as needed medication for one resident (R237) of 20 residents reviewed for unnecessary drugs in a sample of 44. Findings include: Facility Pharmaceutical Procedures, revised 1/5/23, documents It is the policy of the facility to review resident's medication on a regular basis in order to provide residents with only the necessary medication for their health needs. Facility Behavior Management Committee, revised 6/1/22, documents To ensure that each residents medication regimen is free of unnecessary medications. R237's current May 2025 physician orders documents Alprazolam 0.5 mg/milligrams tablet twice a day PRN for generalized anxiety with an order date of 3/12/25. R237's medical record documents the last time R237 received Alprazolam was on 4/9/25. On 5/15/25 at 2:45 PM, V2 DON/Director of Nursing verified R237's medical record had Alprazolam ordered PRN and needed to be discontinued.

  Freedom from Abuse, Neglect, and Exploitation Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Dcited before2025-05-16 · tag F0656 — failed to write and follow a full care plan — isolated
  Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on interview and record review, the facility failed to develop a Care Plan to include a blood thinner and Insulin for one resident (R235) of 20 residents reviewed for Care Plan development in a total sample of 44. Findings include: Facility Care Plan Policy, revised 6/1/22, documents It is the policy of this facility to develop a Comprehensive Person-Centered Care Plan as appropriate for each resident to meet a residents medical and nursing needs. R235's May 2025 Physician Orders include orders for Eliquis 5 mg/milligrams twice a day for Atrial Fibrillation, and Humalog Insulin per sliding scale four times a day for Diabetes. R235's May 2025 Medication Administration Record/MAR documents R235 is currently receiving his Eliquis and Humalog Insulin. R235's current Care Plan for May 2025 does not include R235's Atrial Fibrillation diagnosis or Eliquis, and does not include R235's diagnosis for Diabetes or Insulin. On 5/15/25 at 1:35 PM, V13 Care Plan Coordinator stated if the Eliquis and Atrial Fibrillation along with the Insulin and Diabetes was not on the Care Plan then she…

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

  Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2025-05-16 · 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

  Based on observation, interview, and record review, the facility failed to apply leg compression stockings for one resident (R69) of one residents reviewed for compression stockings in a sample of 44. Findings include: Facility Staff Nurse job description, revised 6/2012, documents Responsible for working in a team approach with the nurse aides to ensure residents are receiving said services. Prepares and documents treatments which are administered to residents as prescribed by the residents physician. R69's May 2025 Physician orders documents Tubi Grips (compression stockings) BLE/bilateral lower extremities on in the AM, and off at HS/bedtime. R69's May 2025 Treatment Administration Record documents R69 has her Tubi Grips on. On 5/15/25 at 1:35 PM, R69 was up in the activity area with her bilateral pant legs pulled up with no Tubi Grips, socks, or shoes on. At that same time, V11 CNA/Certified Nurse Aid stated they got R69 up today, are responsible for putting on R69's Tubi Grips, and verified R69 did not have on her Tubi Grips and should have them on her legs. V11 then went to…

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

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction

“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

$41,300 in federal fines across 1 penalty.

• $41,300 — penalty dated 2026-04-29

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 UNLIMITED DEVELOPMENT, INC. — 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 9 rows in the source record cover these 8 parties — each is shown once here with every role it holds. Nothing is omitted.

2 organizational owners listed — a facility can be part of a larger chain. CMS ownership data is known to under-report private-equity and REIT ties; treat as a starting point.

Follow the money — this home’s finances

Where a nursing home’s revenue comes from and where it goes — including money paid to companies under the same ownership. Most consumer sites never show this; we reproduce it straight from the Medicare cost report.

This home reported $845K paid to related parties (affiliated landlords or management companies) in its most recent cost report. A reported operating loss is common in this industry and is not by itself a sign of trouble — but paired with large related-party payments it can mean profit is being taken elsewhere in the ownership structure.

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

Cost & finances

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 IL