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Carmel Health & Living Community

118 Medical Dr, Carmel, IN 46032 · Government - County · 188 certified beds · (317) 844-4211 Medicare & Medicaid certified

Call the home — (317) 844-4211 Need help choosing, fast? Free, unbiased: Eldercare Locator 1-800-677-1116
2 actual-harm citations$14,015 in federal fines
Insights

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

In its favor
  • fewer deficiencies at its most recent standard inspection than at the one before — a sign of improvement
Worth asking about
  • it has 2 actual-harm citations
  • a high number of inspection citations overall (30) — worth reading through, though larger and more-often-surveyed homes tend to accrue more lower-severity tags
  • the CMS record shows $14,015 in federal fines (most recent 2025-11-13)
  • its independent health-inspection rating is low (2/5)
  • its payroll-based staffing rating is low (2/5)
  • nursing-staff turnover (70%) runs well above the national median (45%)
  • about 28% 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.

2/5
CMS overall
2 of 5
Health inspectionSurveyor-assigned, ranked within your stateInspector-verified 2 of 5
StaffingFrom payroll records (PBJ) 2 of 5
Quality measuresSelf-reported by the facility 3 of 5

Location & what’s nearby

Hospital
★★★★ 4/5 CMS · Emergency dept. usually open 24/7 · ER 24/7
Urgent care / clinic
1421 S RANGE Line Rd · (317) 844-2775 · Call to confirm hours
Pharmacy
1421 S Rangeline Rd · (317) 844-2775 · Call to confirm hours
Grocery
1392 S Rangeline Rd · (317) 991-7027 · Call to confirm hours
Park
Monon Trl · Typically dawn to dusk
Place of worship
40 Executive Dr · (317) 728-5736

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 3 of 5
Long-stay residentspeople who live here 3 of 5
Short-stay residentsrehab / post-hospital 3 of 5

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

Trend — is this home getting better or worse?

Over 2025-02 to 2026-06, this home’s CMS overall rating held steady at 2 stars. From monthly CMS archive snapshots.

Horizontal axis runs 2025-02 to 2026-06. That is where CMS’s monthly archive ends, so the right-hand edge of each line is that month — not today.

Overall rating2★
Inspection scorelower = better
See all quality measures vs. state & national benchmarks
MeasureThis homeState avgTypical statevs typical state
Long-stay residents whose need for help with daily activities increased14.0%11.0%15.4%typical
Long-stay residents who lose too much weight4.6%5.5%5.4%better
Long-stay residents with a catheter left in their bladder0.2%0.4%0.9%better than state — see note marked double-dagger below the table
Long-stay residents with a urinary tract infection2.6%1.1%2.0%worse
Long-stay residents with depressive symptoms4.0%25.2%6.5%better than state — see note marked double-dagger below the table
Long-stay residents who were physically restrained0.0%0.0%0.1%better than state — see note marked double-dagger below the table
Long-stay residents with falls causing major injury4.1%3.9%3.3%worse
Long-stay residents whose ability to walk worsened11.3%11.9%16.1%better
Long-stay residents on antianxiety or hypnotic medication22.3%23.5%18.9%worse
Long-stay residents given the seasonal flu vaccine94.0%95.4%95.3%typical
Long-stay residents with pressure ulcers6.1%3.6%4.7%worse
Long-stay residents with worsening bladder/bowel control27.2%23.3%21.2%worse
Long-stay residents who got an antipsychotic medication — see the note below the table16.1%13.6%17.1%typical
Short-stay residents who newly got an antipsychotic medication0.8%1.2%1.4%better
Short-stay residents given the seasonal flu vaccine82.2%79.0%79.4%typical
Short-stay residents rehospitalized after admission29.0%22.2%22.6%worse
Short-stay residents with an outpatient ER visit10.6%10.8%12.0%better
Long-stay hospitalizations per 1,000 resident days2.501.611.67worse
Long-stay outpatient ER visits per 1,000 resident days1.161.441.80better

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

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

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

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

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

50.9% 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 93 Medicare stays in Oct 2022–Sep 2024, and CMS’s own comparison — not ours.

50.9%U.S. median 51.5%
Got home and stayed home
11.4%U.S. median 10.7%
Went back to hospital
62.7%U.S. median 56.6%
Met the expected recovery
0.35U.S. median 0.31
Therapy hours / resident / day
0.13hours / resident / day
Physical therapy
0.11hours / resident / day
Occupational therapy
0.10hours / resident / day
Speech therapy

Met the expected recovery: 62.7% of this home’s Medicare short-stay residents left it at or above the ability to care for themselves and move around that CMS predicted for them, across 59 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 0.35 therapist hours per resident per day in 2026Q1 — more than 59% of the 13,892 homes that report any therapy hours at all.

Weekend therapy: weekend therapy hours are 21% of this home’s weekday level — it runs some therapy at the weekend, at a lower level than on weekdays. The median home that reports therapy runs 13% — weekday-focused therapy is the industry norm, not a shortfall. But recovery does not pause on a Saturday: ask what the weekend actually looks like here.

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

See every short-stay measure CMS publishes for this home
MeasureThis homeU.S. medianPeriod coveredCMS’s call
Got home and stayed homeRate of successful return to home or community from a SNF50.9%CMS range 38.6–66.251.5%Oct 2022–Sep 2024no different from U.S.
Went back to hospitalRate of potentially preventable hospital readmissions 30 days after discharge from a SNF11.4%CMS range 8.5–15.010.7%Oct 2022–Sep 2024no different from U.S.
Met the expected recoveryPercentage of residents who are at or above an expected ability to care for themselves and move around at discharge62.7%56.6%Oct 2024–Sep 2025CMS makes no comparison for this measure
Self-care at dischargePercentage of residents who are at or above an expected ability to care for themselves at discharge42.4%52.8%Oct 2024–Sep 2025CMS makes no comparison for this measure
Moving around at dischargePercentage of residents who are at or above an expected ability to move around at discharge52.5%50.0%Oct 2024–Sep 2025CMS makes no comparison for this measure
Medication problems followed upPercentage of residents whose medications were reviewed and who received follow-up care when medication issues were identified97.5%98.7%Oct 2024–Sep 2025CMS makes no comparison for this measure
Medication list to the next providerPercentage of residents where the SNF provided a current medication list to the next health care setting100.0%100.0%Oct 2024–Sep 2025CMS makes no comparison for this measure
Medication list to the familyPercentage of residents where the SNF provided a current medication list to the resident, family, and/or caregiver at final discharge100.0%98.7%Oct 2024–Sep 2025CMS makes no comparison for this measure
Falls with major injuryPercentage of SNF residents who experience one or more falls with major injury during their SNF stay1.3%0.0%Oct 2024–Sep 2025CMS makes no comparison for this measure
New or worsened pressure ulcersPercentage of residents with pressure ulcers/pressure injuries that are new or worsened3.8%1.9%Oct 2024–Sep 2025CMS makes no comparison for this measure
Infections that led to hospitalPercentage of infections residents got during their SNF stay that resulted in hospitalization9.9%CMS range 6.1–15.37.1%Oct 2023–Sep 2024no different from U.S.
Medicare spending per stayMedicare Spending Per Beneficiary (MSPB) for residents in SNFs1.091.02Oct 2022–Sep 2024CMS makes no comparison for this measure

From the CMS Skilled Nursing Facility Quality Reporting Program — Medicare short-stay outcomes, which is a different dataset from the long-stay quality measures above and describes a different set of residents. Where CMS risk-adjusts a measure we show its adjusted rate, and the CMS range beside it is the confidence interval CMS publishes: a home whose range is wide is a home with few stays, where one patient moves the number several points. Read the period column. These measures do not share a window — the claims-based ones (getting home, readmission, spending) lag by a year or more, because a stay has to finish and its claims settle before it can be counted. CMS’s call is CMS’s, not ours: it is the only place anyone tests whether this home differs from the national rate at all, and most homes on most measures do not. Two caveats on it. CMS tests only three of these measures — getting home, readmission, and infections that led to hospital; on the other nine it publishes a rate and no comparison, and rather than compute a verdict CMS declined to make, we say so in the column. And on readmission almost every home in the country lands on “no different”, so that row separates homes far less than getting-home does — which is why met the expected recovery, a measure CMS does not test but which spreads across the whole range, is called out above the table rather than left in this list. The U.S. median column is our own, taken across every home CMS publishes that measure for in this same file; it is not a CMS-published benchmark. Homes CMS gives no rate for are left out of it rather than counted as zero. Medicare spending per stay is a ratio, not a percentage — 1.00 means this home’s Medicare spending for a stay matched the national figure CMS compares it against, and it measures cost to Medicare, not quality of care.

Staffing

0.47
RN hours/ resident / day
1.16
LPN hours/ resident / day
2.01
Aide hours/ resident / day
3.64
Total nurse hours/ resident / day
0.26
RN hoursweekends
69.8%
Total nursing turnover
60.7%
RN turnover

How full it usually is: this home is certified for 188 beds and averages 138.9 residents a day — about 74% occupied, or roughly 49 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 3.64 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 0.47 is below the 0.55-hour RN benchmark and nurse-aide staffing of 2.01 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 3.15 hrs/resident/day on weekends vs 3.84 on weekdays — 18% thinner on weekends. RN hours go from 0.56 to 0.26 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)

This home’s total nursing-staff turnover of 70% is well above the national median of 45%.

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

Inspection trend

8
deficiencies at the latest standard inspection (2025-09-25)
11
at the previous standard inspection (2024-11-04)

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

Inspection deficiencies

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

ABCDEFGHIJKL

Each letter is a CMS scope-severity level; highlighted ones are where this home has citations. A–C = no harm found; D–F = potential for harm; G–I = actual harm; J–L = immediate jeopardy. Within each band the later letter is the more widespread finding (an isolated G is one resident; a widespread I is a pattern), so rightward and downward is worse.

30 citations, most serious first. The 12 most serious are shown; the remaining 18 are one tap away and print in full.

  • Actual harm · Gcited before2025-11-13 · 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

    Based on interview and record review, the facility failed to ensure a resident received supervision during incontinence care to prevent the resident from being rolled off the bed onto the floor for 1 of 3 residents reviewed for accidents. (Resident B) This deficient practice resulted in Resident B being hospitalized with an eight-millimeter frontal subdural hematoma.Findings include:During an interview, on 11/12/25 at 2:31 p.m., a family member of Resident B indicated she received a telephone call, on 10/1/25 at 6:00 a.m., Resident B had rolled out of bed when an aide was in the room. Typically, there were two staff members with her when care was provided due to Resident B's weight. She did not know where the other person was at the time of the fall. The resident was admitted to the hospital with a traumatic brain injury and bleeding on the brain.The clinical record for Resident B was reviewed on 11/13/25 at 11:50 p.m. The diagnoses included, but were not limited to, cerebral infarction, hemiplegia and hemiparesis following a cerebral infarction which affected the left non-dominant…

    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 · G2025-09-25 · tag F0760 — failed to prevent significant medication errors — isolated
    Ensure that residents are free from significant medication errors.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on interview and record review, the facility failed to ensure a resident was free from a significant medication error for 1 of 1 resident reviewed for medication errors. (Resident 7) This deficient practice resulted in Resident 7 being hospitalized for toxic metabolic encephalopathy due to a high dose of medication and her end stage renal disease.Findings include:During an interview, on 9/24/25 at 11:52 a.m., Resident 7 indicated she went to the hospital after receiving medication which caused her to see things that were not there. She did not remember a lot about the occurrence, but her daughter became very concerned and insisted she be sent to the hospital.The clinical record for Resident 7 was reviewed on 9/23/25 at 1:17 p.m. The diagnoses included, but were not limited to, end stage renal disease, dependent on renal dialysis, toxic encephalopathy, zoster without complications, and adverse effect of drug medication.A care plan, dated 9/9/22, indicated Resident 7 received hemodialysis due to end stage renal disease.A nursing progress note, dated 7/4/25 at 11:56 a.m.,…

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

    Pharmacy Service Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Ecited before2025-09-25 · tag F0755 — failed to provide safe pharmacy services — pattern
    Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview and record review, the facility failed to ensure narcotic reconciliation was documented as completed, medications were available without interruptions in administration, and to ensure accurate administration documentation and destruction by obtaining two nurse's signatures for 3 of 3 medication carts (500 Unit, 700-1 Unit, 800 Unit) and 2 of 2 residents (Resident 138 and 55) reviewed for pharmacy services.Findings include:1. A facility narcotic reconciliation document, for the 500 Unit, was missing signatures to indicate the narcotic reconciliation was completed on 9/10/25 for the on-coming night shift, on 9/13/25 for the on-coming night shift, on 9/15/25 for the on-coming and off-going evening shift, and on 9/17/25 for the on-coming night shift. During an interview, on 9/23/25 at 8:27 a.m., LPN 6 indicated the nurses were to sign on/off on the narcotic count sheet every shift. 2. A facility narcotic reconciliation document, for the 700-1 Unit, was missing signatures to indicate…

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

    Pharmacy Service Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Ecited before2025-09-25 · tag F0761 — failed to label and store drugs safely — pattern
    Ensure 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

    Based on observation, interview and record review, the facility failed to ensure medications were dated when opened, were stored in the original pharmacy packaging, and a medication administration record matched the pharmacy label for a narcotic pain medication for 3 of 5 medication carts (500 Unit, 300 Unit and 700 Unit), 1 of 3 medication storage refrigerators (300 Unit), and 1 of 1 resident (Resident 55) reviewed for drug labeling and storage.Findings include:1. During an observation, on 9/23/25 at 8:17 a.m., with LPN 5 in attendance, the 500 Unit medication cart was found to have the following: a. One 30 milliliter (ml) bottle of morphine with approximately 15 ml left was found without an open date. b. Two 30 ml bottles of morphine with approximately 16 ml left in both bottles were found without an open date. One bottle had a damaged label. 2. During an observation, on 9/23/25 at 11:23 a.m., with LPN 7 in attendance, the 300 Unit medication cart was found to have the following: a. In the drawer of the cart was a clear plastic pouch with the name and room number of Resident 3…

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

    Pharmacy Service Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2025-09-25 · tag F0554 — isolated
    Allow residents to self-administer drugs if determined clinically appropriate.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, interview and record review, the facility failed to ensure the interdisciplinary team (IDT) determined self-administration of medications was clinically appropriate and notation of the determinations were documented in the resident's medical record and care plan for 1 of 1 resident reviewed for self-administration of nebulizer treatments. (Resident 113)Findings include:During an observation and interview, on 9/19/25 at 9:54 a.m., Resident 113 was observed to be in her room. She had a nebulizer machine with fluid in the nebulizer medicine cup. Resident 113 indicated the nebulizer was set up for her and she forgot to do it. The clinical record for Resident 113 was reviewed on 9/19/25 at 10:04 a.m. The diagnoses included, but were not limited to, chronic obstructive pulmonary disease (COPD), pneumonia, and generalized anxiety disorder.A physician's order, dated 7/8/25, indicated to administer 3 milliliters of albuterol sulfate 2.5mg/3mL (0.083 %) solution via inhalation upon rising between 7:00 a.m. and before bedtime between 6:00 p.m. and 10:00 p.m.The 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.

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2025-09-25 · 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 interview and record review, the facility failed to ensure blood pressure medications were held according to the physician's orders for 2 of 3 residents reviewed for quality of care. (Resident 13 and 96)Findings include:1. The clinical record for Resident 13 was reviewed on 9/22/25 at 3:09 p.m. The diagnoses included, but were not limited to, hypotension (low blood pressure), repeated falls, weakness, unsteadiness on feet, hypertensive heart disease without heart failure, and essential primary hypertension. A physician's order, dated 6/3/25, indicated to administer midodrine (a medication used to raise blood pressure) 5 milligrams (mg) every 8 hours with special instructions to hold the medication for a systolic blood pressure greater than 140. A Medication Administration Record (MAR), dated August 2025, indicated the midodrine was administered with systolic blood pressure greater than 140 on the following dates and times:On 8/3/25 at 8:00 a.m., with a systolic blood pressure of 152.On 8/17/25 at 4:00 p.m., with a systolic blood pressure of 142. On 8/27/25 at 4:00 p.m.,…

    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 before2025-09-25 · 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

    Based on observation, interview and record review, the facility failed to ensure oxygen and nebulizer tubing lines were dated and a physician order was in place for the use of oxygen for 3 of 5 residents reviewed for respiratory care. (Resident 12, 113 and 138)Findings include: 1. During an observation, on 9/18/25 at 10:21 a.m., Resident 12 was receiving oxygen via nasal cannula. The oxygen line did not have a date to show when it was last changed. The resident had a nebulizer machine on a gray plastic dresser. The nebulizer was not in use, and the mask was observed to be stored next to the machine and not in a storage bag. The clinical record for Resident 12 was reviewed on 9/24/25 at 3:23 p.m. The diagnoses included, but were not limited to, chronic obstructive pulmonary disease (COPD), cough, and age-related debility. A physician's order, dated 9/15/23, indicated to change and date the oxygen tubing, humified bottle, and the nebulizer tubing every week on Sunday and as needed. During an interview, on 9/18/25 at 10:28 a.m., QMA 4 indicated the oxygen line, and the nebulizer line…

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

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2025-09-25 · tag F0698 — failed to provide proper dialysis care — isolated
    Provide safe, appropriate dialysis care/services for a resident who requires such services.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, interview and record review, the facility failed to ensure an active physician's order for hemodialysis and monitoring before and after dialysis was obtained for 1 of 1 resident reviewed for dialysis. (Resident 7)Findings include:During an observation, on 9/19/25 at 9:39 a.m., Resident 7 was not in her room, and a staff member indicated the resident had gone to dialysis.During an observation, on 9/22/25 at 9:10 a.m., Resident 7 was not in her room, and a staff member indicated the resident had gone to dialysis.During an observation and interview, on 9/24/25 at 11:52 a.m., Resident 7 was in her room and had just finished eating her lunch after returning from dialysis. She indicated she had been receiving dialysis for a few years.The clinical record for Resident 7 was reviewed on 9/23/25 at 1:17 p.m. The diagnoses included, but were not limited to, end stage renal disease (ESRD), chronic kidney disease stage 3, and dependence on renal dialysis.A care plan, dated 9/9/22, indicated Resident 7 received hemodialysis due to end stage renal disease.A physician's order,…

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

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2025-09-25 · tag F0757 — failed to avoid unnecessary drugs — isolated
    Ensure each resident’s drug regimen must be free from unnecessary drugs.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on interview and record review, the facility failed to ensure the diagnosis used supported the adequate indications for use of the medication for 2 of 6 residents reviewed for unnecessary medications. (Resident 3 and 11)Findings include:1. The clinical record for Resident 3 was reviewed on 9/22/25 at 11:18 a.m. The diagnoses included, but were not limited to, constipation, anxiety disorder, and pain. A physician's order, dated 8/19/25, indicated to administer sennosides-docusate sodium (a medication used for constipation) tablet twice a day for unsteadiness on feet. A pharmacy Medication regimen review, dated 8/26/25, indicated Resident 3's medications were reviewed by the pharmacist with no recommendations. During an interview, on 9/24/25 at 10:21 a.m., the Director of Nursing (DON) reviewed Resident 3's medication orders and indicated the medication sennosides-docusate sodium did not have the correct supporting diagnosis. During an interview, on 9/24/25 at 10:36 a.m., Clinical Support Nurse 2 indicated the pharmacy reviewed medications, allergies, diagnoses, 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.

    Pharmacy Service Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2025-01-08 · tag F0755 — failed to provide safe pharmacy services — isolated
    Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on interview and record review, the facility failed to ensure a staff member followed the policy and procedure when administering narcotics for 2 of 2 residents reviewed for pharmaceutical services. (Resident F and G) Finding includes: A document, titled Indiana State Department of Health Survey Report System, dated 12/18/24 at 9:01 a.m., indicated Qualified Medication Aide (QMA) 5 reported to the facility a concern with RN 1. RN 1 was potentially taking residents' narcotic medications due to her signing the narcotic medications out in the count book but not documenting the administration of those narcotic in the residents' medical records. An investigation was initiated, and all the residents' narcotic medications were accounted for, and no discrepancies were found. RN 1 was terminated due to failure to follow facility policy and procedure. The following residents' medical records were reviewed, and their Electronic Medication Administration Record (EMAR) did not have the narcotic medication documented for the dates and times the narcotic count sheet indicated the medication…

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

    Pharmacy Service Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Ecited before2024-11-04 · tag F0684 — failed to provide proper treatment and quality of care — pattern
    Provide appropriate treatment and care according to orders, resident’s preferences and goals.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review, the facility failed to ensure staff followed physician's orders to hold medications, administer as needed (prn) medications according to the parameters, obtain daily weights, and failed to communicate with a urologist and a hospice provider for 5 of 5 residents reviewed for quality of care. (Residents G, H, F, 33 and 105) Findings include: 1. The clinical record for Resident G was reviewed on 10/30/24 at 11:05 a.m. The diagnoses included, but were not limited to, type 2 diabetes mellitus, essential primary hypertension, anxiety disorder, recurrent major depressive disorder, and moderate vascular dementia with psychotic disturbance. A care plan, dated 7/14/22 and edited 9/9/24, indicated the resident had the potential for hypoglycemia, hyperglycemia, and diabetic complications. The interventions included, but were not limited to, administer accuchecks and any insulin coverage per physician's order. A physician's order, dated 6/8/23, indicated to give 8 units of Humalog U-100…

    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 · D2024-11-04 · tag F0576 — isolated
    Ensure residents have reasonable access to and privacy in their use of communication methods.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on interview and record review, the facility failed to ensure mail was delivered unopened for 1 of 1 resident reviewed for resident rights. (Resident 135) Finding includes: During a resident council interview, on 10/30/24 at 1:05 p.m., Resident 135 indicated an item of her mail from Medicaid had been opened by the facility prior to being delivered. She indicated she had not given permission and did not want anyone from the facility to open her mail. The clinical record for Resident 135 was reviewed on 10/30/24 at 3:08 p.m. The diagnoses included, but were not limited to, cerebral palsy, type 2 diabetes mellitus, chronic viral hepatitis, atherosclerotic heart disease, and noninfective gastroenteritis and colitis. Resident 135 signed a Permission & Acknowledgment form, on 9/30/24 at 7:20 p.m. She selected NO to I authorize community personnel and/or volunteers to open the resident's mail and read it to the resident at times the resident is unable to do so and NO to If the resident applies for Medicaid, I authorize the designated community personnel to open the 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.

    Resident Rights Deficiencies · Deficient, Provider has date of correction
Show the remaining 18 citations
  • Potential for harm · D2024-11-04 · tag F0644 — isolated
    Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on interview and record review, the facility failed to ensure pre-admission screening and resident reviews (PASARR) were accurate and updated for 2 of 3 residents reviewed for PASARR. (Residents 87 and D) Findings include: 1. The clinical record for Resident 87 was reviewed on 10/30/24 at 8:49 a.m. The diagnoses included, but were not limited to, depression, borderline personality disorder, and age-related physical debility. A notice of PASARR Level I, dated 8/2/24, indicated Resident 87 did not take any mental health medications. A physician's order, with a start date of 9/23/24, indicated the resident was on Amitriptyline (an antidepressant medication) 50 milligrams once a day. During an interview, on 10/30/24 at 2:10 p.m., the Clinical Support nurse indicated Resident 87 was on Amitriptyline on admission. She should have had the medication listed on her Level I PASARR. During an interview, on 11/01/24 at 11:37 a.m., Social Services 14 indicated the social service department was responsible for the PASARRs and were the ones who made sure the Level I and Level II were up to…

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

    Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2024-11-04 · 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 ensure a comprehensive person-centered care plan was developed for a resident diagnosed and treated for insomnia for 1 of 31 residents reviewed for comprehensive person-centered care plans. (Resident F) Finding includes: The clinical record for Resident F was reviewed on 10/29/24 at 3:23 p.m. The diagnoses included, but were not limited to, senile degeneration of the brain (dementia), diastolic heart failure, and insomnia. A physician's order, dated 6/18/24, indicated Resident F was to receive a melatonin 10 milligram (mg) tablet, once a day, before bedtime for insomnia. A physician's order, dated 8/29/24, indicated Resident F was to receive a trazodone (an antidepressant medication) 50 mg tablet, once a day, before bedtime for insomnia. A physician's order, dated 10/24/24, indicated Resident F was to receive a Seroquel (an antipsychotic medication) 50 mg tablet, once a day, before bedtime for insomnia. The comprehensive care plan did not include Resident F's diagnosis of insomnia or the use of melatonin, trazodone and…

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

    Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2024-11-04 · 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

    Based on observation, interview and record review, the facility failed to ensure a resident did not have smoking articles in their room for 1 of 7 residents reviewed for accident hazards. (Resident 241) Finding includes: During an observation, on 10/28/24 at 12:00 p.m., Resident 241 had an electronic cigarette (e-cigarette) or vape in his room on his bedside table. During an observation and interview, on 10/28/24 at 12:05 p.m., CNA 20 walked in the resident's room with the resident's lunch. The resident slowly grabbed the vape and brought it towards his abdomen as CNA 20 came in the door. The vape was still visible in the resident's hand as the CNA placed his lunch tray down on the table. CNA 20 indicated she was not sure if residents could have vapes stored in their rooms or not. The clinical record for Resident 241 was reviewed on 10/30/24 at 10:57 a.m. The diagnoses included, but were not limited to, opioid dependence, drug induced constipation, unspecified pain, and anxiety disorder. During an interview, on 10/28/24 at 12:11 p.m., Unit Manager 4 indicated he did not believe…

    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 before2024-11-04 · 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

    Based on observation, interview and record review, the facility failed to ensure the correct amount of oxygen was administered as ordered by the physician for 2 of 3 residents reviewed for respiratory care. (Resident 10 and 37) Findings include: 1. During an observation, on 10/28/24 at 3:36 p.m., Resident 10's oxygen concentrator (a device used to provide supplemental oxygen therapy) was set on 3 liters per minute (L). During an observation, on 10/29/24 at 10:25 a.m., Resident 10's oxygen concentrator was set on 3L. During an observation, on 10/30/24 at 2:24 p.m., Resident 10's portable oxygen concentrator was set on 3L. During an observation, on 10/31/24 at 3:10 p.m., Resident 10's portable oxygen concentrator was set on 3L. During an observation, on 11/4/24 at 9:56 a.m., Resident 10's oxygen concentrator was set on 3L. The clinical record for Resident 10 was reviewed on 10/31/24 at 9:05 a.m. The diagnoses included, but were not limited to, heart failure, vascular dementia with mood disturbance, type 2 diabetes mellitus, chronic pulmonary embolism, shortness of breath, and acute…

    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 before2024-11-04 · tag F0755 — failed to provide safe pharmacy services — isolated
    Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, interview and record review, the facility failed to ensure the on-coming and off-going staff signed the narcotic count books each shift for 2 of 3 medication carts reviewed for drug reconciliation. (700-unit and 400-unit) Findings include: 1. During an observation, on 10/31/24 at 3:15 p.m., with Unit Manager 4 present, the October 2024 narcotic log count sheets for the 700-unit were observed. Book 1 was found to be missing 31 of 93 possible opportunities to sign the narcotic log sheet when staff were off-going and 28 of 93 possible opportunities to sign the narcotic log sheet when staff were on-coming. Book 2 was found to be missing 34 of 93 possible opportunities to sign the narcotic log sheet when staff were off-going and 33 of 93 possible opportunities to sign the narcotic log sheet when staff were on-coming. 2. During an observation, on 10/31/24 at 3:38 p.m., with LPN 19 present, the October 2024 narcotic log count sheets for the 400-unit were observed. The book was found to be missing 39 of 93 possible opportunities to sign the narcotic logs sheet when…

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

    Pharmacy Service Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2024-11-04 · tag F0761 — failed to label and store drugs safely — isolated
    Ensure 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

    Based on observation, interview and record review, the facility failed to ensure medications and supplements were labeled and dated, expired medications were removed from the cart and medications were stored safe and secured away from residents for 3 of 3 units and 2 of 2 residents reviewed for medication storage. (500-unit, 800-unit, 700-unit, Resident 80 and Resident 45) Findings include: 1. During an observation, on 10/31/24 at 11:55 a.m., with LPN 16 present, the 500-unit medication cart was found to have an open Lantus insulin pen, dated 9/24/24, without a resident name on the pen. An anesthetic oral gel was opened and stored alongside an opened bottle of ear drops. There was also a 30-ounce bottle of liquid protein found open and without a resident's name on the bottle. During an interview, on 10/31/24 at 11:55 a.m., LPN 16 indicated the insulin was expired. The oral gel and eye drops were not to be stored together. The liquid protein was used for whoever needed it. 2. During an observation, on 10/31/24 at 2:53 p.m., with LPN 17 present, the 800-unit medication cart was found…

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

    Pharmacy Service Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2024-11-04 · tag F0791 — failed to provide routine dental services — isolated
    Provide or obtain dental services for each resident.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, interview and record review, the facility failed to ensure a resident received dental services to repair or replace partial dentures for 1 of 1 resident reviewed for dental services. (Resident 122) Finding includes: During an observation, on 10/29/24 at 3:26 p.m., Resident 122 was well groomed with make-up on including lipstick with missing front teeth. During an observation, on 10/30/24 at 2:21 p.m., the resident was again well dressed, her hair was styled and make-up carefully applied. The clinical record for Resident 122 was reviewed on 10/30/24 at 11:11 a.m. The diagnoses included, but were not limited to, repeated falls, bipolar disorder, oral phase dysphagia, Alzheimer's dementia with behavioral disturbance, anxiety, depression, and impaired memory. An admission assessment, dated 2/2/24, indicated the resident had upper partial dentures. A physician's order, dated 2/2/24, indicated the resident may receive dentistry services as needed. A nursing progress note, dated 7/1/24 at 7:51 p.m., indicated the resident was found in her room holding two of her front…

    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 · D2024-11-04 · tag F0804 — failed to serve food at safe, palatable temperature — isolated
    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, interview and record review, the facility failed to ensure food was served at a safe and appetizing temperature for 1 of 1 room tray tested for food temperatures. (200 hall) Finding includes: During an interview, on 10/28/24 at 10:49 a.m., Resident E indicated the food was cold. During an interview, on 10/28/24 at 11:29 a.m., Resident D indicated the food was sometimes cold. During an interview, on 10/28/24 at 3:09 p.m., Resident B indicated the food was cold. During an interview, on 10/29/24 at 11:15 a.m., Resident C indicated the food did not have good flavor and it was cold. During a resident council meeting, on 10/30/24 at 1:05 p.m., the resident council indicated the food was sometimes cold, especially the room trays. During an observation and interview, on 10/31/24 at 11:46 a.m., a lunch tray was chosen at random to obtain food temperatures. The country fried steak temped at 100 degrees, the peas temped at 101 degrees, and the glazed carrots temped at 105 degrees. The Assistant Dining Services Supervisor indicated the hot food should be served at least…

    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 · D2024-11-04 · tag F0921 — failed to keep a safe, functional, sanitary building — isolated
    Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview and record review, the facility failed to ensure a safe, functional, sanitary, and comfortable environment was provided for 5 of 142 rooms reviewed for environment. (Rooms 314, 401, 428, 527, 719) Findings include: 1. During an observation, on 10/28/24 at 10:36 a.m., room [ROOM NUMBER] had brown stains on 6 ceiling tiles and a telephone outlet without a cover exposing a white wire and a blue wire. During an observation and interview, on 10/29/24 at 10:16 a.m., the wires were still exposed in room [ROOM NUMBER]. Unit Manager 19 indicated he was not sure why the outlet cover would be off. It should be covered. He was not sure what type of wires were exposed. 2. During an observation, on 10/29/24 at 2:15 p.m., room [ROOM NUMBER] had a large brown stain on a dry wall ceiling by the patio door and a kitchenette sink faucet with a constant drip. 3. During an observation, on 10/28/24 at 2:49 p.m., room [ROOM NUMBER] had an improperly fitted light switch cover, resulting in a visible hole…

    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.

    Environmental Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2024-03-01 · tag F0554 — isolated
    Allow residents to self-administer drugs if determined clinically appropriate.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, interview and record review, the facility failed to ensure the interdisciplinary team determined a resident was clinically appropriate to self-administer medications for 1 of 1 resident randomly observed for self-administration of medications. (Resident 2) Finding includes: During a random observation, on 2/29/24 at 10:34 a.m., LPN 1 was observed out in the hall, walking, when a staff member informed her Resident 2 was ready for treatment. Upon entering the room of Resident 2, the resident was found sitting in a chair. To her right on her bedside table, within the resident's reach, were two (2) clear medication cups with medications in both and one (1) nebulizer vial which had not been opened. There was no qualified staff with the resident in the room. The clinical record for Resident 2 was reviewed on 2/29/24 at 10:58 a.m. The diagnoses included, but were not limited to, syphilitic endocarditis, melena, and chronic heart failure. A Brief Interview for Mental Status (BIMS) assessment, dated 11/15/23, indicated the resident was cognitively intact at the time of…

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

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2024-03-01 · 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 observation, interview and record review, the facility failed to ensure infection control practices were maintained when a staff member failed to remove medication from the packaging in a sanitary manner for 1 of 5 residents reviewed for medication administration. (Resident 3) Finding includes: During an observation of the medication pass, on 3/1/24 at 8:57 a.m., LPN 2 was observed to use her fingers to remove an Acidophilus/Pectin capsule (a probiotic) from the medication bottle and place it in a medication cup for administration to Resident 3. The clinical record for Resident 3 was reviewed on 3/1/24 at 10:01 a.m. The diagnoses included, but were not limited to, vascular dementia, chronic kidney disease, and insomnia. A physician's order, initiated on 2/26/24, indicated to give Acidophilus-Pectin 75 million cells 100 mg (milligram), two (2) capsules once a day. During an interview, on 3/1/24 at 9:11 a.m., LPN 2 indicated she was not to use her fingers to remove medications from the bottle, she did have a spoon on the cart which could be used to remove the medication from…

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

    Infection Control Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2023-10-27 · tag F0578 — failed to honor advance directives / code status — isolated
    Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on interview and record review the facility failed to ensure code status was clearly indicated for 1 of 26 residents reviewed. (Resident 81). Findings include: Resident 81's record was reviewed on 10/24/23 at 3:02 PM. Diagnoses included cerebral infarction with cognitive, speech and language deficits, encephalopathy, disorientation, hemiplegia and hemiparesis following nontraumatic subarachnoid hemorrhage affecting left non-dominant side, and stage 3 chronic kidney disease, chronic diastolic (congestive) heart failure and malignant neoplasm of the female breast. Resident 81's current quarterly Minimum Data Set (MDS) assessment, dated 8/21/23, indicated her Basic Interview for Mental Status (BIMS) score was 5 (moderately impaired). The MDS indicated the resident required physical assistance of 1 person for personal hygiene. She received chemotherapy while a resident. A physician order dated 5/17/23 indicated Resident 81 had a Full code status. The current medical record ribbon indicated Resident 81 had a Do Not Resuscitate (DNR) code status. Resident 81's Continuity 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.

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2023-10-27 · tag F0583 — failed to protect personal privacy — isolated
    Keep 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 observation, interview, and record review the facility failed to ensure privacy was maintained for 3 of 11 residents reviewed (Resident 8, Resident 43, and Resident 64). Findings include: 1) During an observation on 10/23/23 at 10:57 AM, Housekeeper 6 was observed in the hallway of the 200 hall. She spoke loudly to another employee who was near the nurses' station using Resident 8's name and indicating Resident 8 had a bowel movement and it smelled bad. She indicated she had used spray and it still smelled bad. The surveyor was able to hear the statement in the hallway several doors away from where Housekeeper 6 stood. Resident 8's record was reviewed on 10/25/23 at 1:58 PM. Diagnoses included end stage renal disease, adjustment disorder with mixed anxiety and depressed mood, and multiple sclerosis. A review of Resident 8's current quarterly Minimum Data Set (MDS) dated [DATE] indicated her Basic Interview for Mental Status (BIMS) score was 15 (cognitively intact). The MDS indicated Resident 8 was…

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

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2023-10-27 · tag F0585 — failed to handle grievances — isolated
    Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review the facility failed to ensure the right to file a grievance without interference was maintained for 2 of 9 residents reviewed (Resident 36 and Resident 97). Findings include: During an interview on 10/25/23 at 9:45 AM, Resident 97 indicated he approached three nursing staff members seated at the nurses' station and requested assistance with a grievance form during the previous evening shift. He indicated the staff gave him a hard time and did not provide him a grievance form or help with filling out a form. He indicated he became frustrated and discussed his concern with Resident 36. He indicated Resident 36 approached the desk and requested assistance from the same staff. He indicated Resident 36 asked several times and became angry and adamant before they gave her a form. Resident 97's record was reviewed on 10/25/23 at 3:07 PM. Diagnoses included major depressive disorder, recurrent, unspecified, bipolar disorder, current episode, manic, severe with psychotic features, and…

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

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2023-10-27 · 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 follow physician orders for 2 of 6 residents reviewed. (Resident 4 and Resident 98) Findings include: 1)During an observation and interview, on 10/23/23 at 10:16AM, Resident 4 was in her room. An inhaler was observed in the bed with the resisdent. The inhaler had a pharmacy label with Resident 4's name and the drug name of fluticasone furoate-vilanterol. Resident 4 indicated she was not sure when she last administered the inhaler to herself. Resident 4 indicated nursing staff were aware the inhaler was on her bedside table. The inhaler was in open view from the door. Resident 4's record review began on 10/23/23 at 1:10PM. Resident 4 had an order for fluticasone furoate-vilanterol inhaler 1 puff daily. The order had the instructions Resident 4 was able to self-administer medication, but the medication was to be kept at nursing station. The inhaler was ordered on 7/12/23. During an observation with the DON (Director of Nursing) on 10/23/23 at 3:03PM the inhaler continued to be present on Resident 4's bedside…

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

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2023-10-27 · tag F0692 — failed to prevent malnutrition and dehydration — isolated
    Provide enough food/fluids to maintain a resident's health.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on record review, and interview, the facility failed to ensure weights weekly as ordered were obtained for 1 of 3 residents reviewed. (Resident 40). Findings include: Resident 40's record was reviewed on 10/24/23 at 2:54 PM. Diagnoses included osteomyelitis of vertebra, sacral and sacrococcygeal region with Proteus mirabilis and morganii infections, stage 4 pressure ulcer of sacral region, stage 3 pressure ulcer of right hip, right hand contracture, mixed receptive-expressive language disorder and nausea. Resident 40's current significant change Minimum Data Set (MDS) assessment, dated 10/6/23, indicated their Basic Interview for Mental Status (BIMS) score was 1 (severe impairment). The MDS indicated the resident had a weight loss of 5% or more in the last month or loss of 10% or more in last 6 months and was on a mechanically altered diet. The MDS indicated 1 stage 4 pressure ulcer, moderate hearing difficulty and had hearing aid or other hearing appliance. The facility indicated on 9/5/23 at 2:55 PM Resident 40's weight was 137.6 pounds. The facility indicated on 10/5/23 at…

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

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2023-10-27 · tag F0694 — isolated
    Provide 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

    Based on Observation, interview, and record review the facility failed to ensure consistent midline intravenous (IV) care for 1 of 1 resident reviewed with parenteral fluids. (Resident 40). Findings include: During an observation on 10/24/23 at 9:21 AM 5 milligram/milliliter (mg/ml) of metronidazole was infusing at 200 milliliter per hour (ml/hr) through Resident 40's upper left arm via a midline IV. The midline IV dressing was dated 10/7/23. During an observation on 10/25/23 at 9:50 AM 5 mg/ml of metronidazole was infusing at 200 milliliter ml/hr through Resident 40's upper left arm via a midline IV. The midline IV dressing was dated 10/7/23. Resident 40's record was reviewed on 10/24/23 at 2:54 PM. Diagnoses included osteomyelitis of vertebra, sacral and sacrococcygeal region with Proteus mirabilis and morganii infections, stage 4 pressure ulcer of sacral region, and stage 3 pressure ulcer of right hip. Resident 40's current significant change Minimum Data Set (MDS) assessment, dated 10/6/23, indicated their Basic Interview for Mental Status (BIMS) score was 1 (severe impairment).…

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

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2023-10-27 · tag F0697 — failed to manage pain — isolated
    Provide safe, appropriate pain management for a resident who requires such services.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, interview, and record review the facility failed to ensure pain interventions were initiated consistently for 2 of 6 residents reviewed. (Resident 238 and Resident 4) Findings include: 1) In an interview with Resident 238, on 10/23/23 at 12:03PM, she indicated pain medication was slow to be delivered. Resident 238 indicated it has taken over an hour to receive as needed narcotic medications. Resident 238 indicated she was not offered any non-pharmacological interventions prior to receiving as needed narcotic medications. Resident 238 indicated she was trying very hard to not use as needed medication. During an observation, on 10/24/23 11:06 AM, Resident 238 was being pushed in a wheelchair by a therapist and requested pain medication from RN 8. RN 8 explained to Resident 238 she already had her Tylenol. Resident 238 explained she was in severe pain from walking with therapy. RN 8 indicated she would check into it. Resident 238 again requested pain medication as soon as possible. RN 8 did not offer any non-med interventions at the time of observation. 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.

    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.

Worried about a resident here? There are three different people you can turn to, and they do different jobs:
  • Long-Term Care Ombudsman — a free, confidential advocate for the resident. They act only with the resident’s consent and work to resolve the problem. Find yours at theconsumervoice.org/get_help.
  • Adult Protective Services — the state agency that investigates suspected abuse, neglect, or exploitation of a vulnerable adult. Not sure of your state’s APS number? The federal Eldercare Locator will route you: 1-800-677-1116 or eldercare.acl.gov.
  • State survey agency — the regulator that licenses and inspects the home. Every state has an official nursing-home complaint line and most take complaints online; the Ombudsman or Eldercare Locator can connect you.
Not sure where to start, or need other help? Dial 2-1-1 for local resources — and if a call is hard or impossible for you, many local 211s also take a text (send your ZIP code to 898-211) or a web chat at 211.org; both vary by area, and 211.org will show what yours offers. Deaf or hard of hearing: dial 711 for the telecommunications relay service, then any number above. In an emergency, call 911.
It is illegal for a facility to retaliate against a resident or family for reporting a concern: federal law gives a resident the right to voice grievances — to the home or to any outside agency — without discrimination or reprisal (42 CFR §483.10(j)(1)). You may report anonymously.

Fines & penalties

$14,015 in federal fines across 1 penalty.

  • $14,015 — penalty dated 2025-11-13

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 CARDON & ASSOCIATES — 19 facilities. Here is how its ratings compare with the chain’s average across all its homes: See the whole chain — ratings, flags, fines and finances →

RatingThis homeChain avg
Overall 2 of 53.7-1.7 vs chain
Health inspection 2 of 53.3-1.3 vs chain
Staffing 2 of 52.5-0.5 vs chain
Quality measures 3 of 54.6-1.6 vs chain
The other 18 homes this chain runs (chain average 3.7★, per CMS)

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

Who owns this facility

Owner / managerTypeRoleShareSince
RIVERVIEW HOSPITALOrganization5% OR GREATER DIRECT OWNERSHIP INTEREST100%since 01/01/2011
ORIX REAL ESTATE CAPITAL LLCOrganization5% OR GREATER SECURITY INTEREST; ADP OF THE SNFsince 06/11/2025
BALLA, MATTHEWIndividualMANAGING CONTROL - GOVERNING BODY; OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 05/23/2022
CATTELL, ZACHARYIndividualMANAGING CONTROL - GOVERNING BODY; OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 04/25/2022
FAUTH, KENDRAIndividualMANAGING CONTROL - GOVERNING BODY; OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 12/26/2021
GORMAL, GREGGIndividualMANAGING CONTROL - GOVERNING BODY; OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 10/01/2016
HAUG, AMYIndividualMANAGING CONTROL - GOVERNING BODY; OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 01/04/2022
HOLLIDAY, ALYSSAIndividualMANAGING CONTROL - GOVERNING BODY; OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 03/15/2022
HYATT, DAVIDIndividualMANAGING CONTROL - GOVERNING BODY; OPERATIONAL/MANAGERIAL CONTROLsince 03/27/2023
LOPOSSA, LYNNIndividualMANAGING CONTROL - GOVERNING BODY; OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 12/17/2023
MCCLELLAND, THOMASIndividualMANAGING CONTROL - GOVERNING BODY; OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 12/26/2021
SPENCER, LEAANNIndividualMANAGING CONTROL - GOVERNING BODY; ADP OF THE SNFsince 06/18/2018
FRIEND, JAYNAIndividualCORPORATE OFFICER; OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 06/01/2021
CARDON AND ASSOCIATES INCOrganizationOPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 06/10/2025
CARDON MANAGEMENT COMPANY LLCOrganizationOPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 06/10/2025
MOORE OPERATING GROUP INCOrganizationOPERATIONAL/MANAGERIAL CONTROLsince 05/18/2020
KARNER, JIMIndividualOPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 06/18/2012
MCINTOSH, ERICIndividualOPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 10/31/2021
MTAFU, ANKEIndividualOPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 08/07/2023
PARACHA, IBRARIndividualOPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 03/15/2021
HEADLEY, KATHYIndividualINDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNFsince 08/25/2025
MOORE, DANIELIndividualINDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNFsince 08/25/2025
MOORE, DAVIDIndividualINDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNFsince 08/25/2025
MOORE, STEPHENIndividualINDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNFsince 08/25/2025
ANKURA CONSULTING GROUP LLCOrganizationADP OF THE SNFsince 06/15/2022
BRADLEY & ASSOCIATES INCOrganizationADP OF THE SNFsince 01/01/2023
CARMEL H&L PROPERTY LLCOrganizationADP OF THE SNFsince 12/01/2011
COLE MARKETING COMMUNICATIONS INCOrganizationADP OF THE SNFsince 04/01/2015
FORVIS MAZARS LLPOrganizationADP OF THE SNFsince 01/01/2021
HEALTHDRIVE PODIATRY GROUP PAOrganizationADP OF THE SNFsince 03/07/2019
HEART OF CARDON LLCOrganizationADP OF THE SNFsince 09/06/2007
ISD RENAL INCOrganizationADP OF THE SNFsince 07/16/2021
JEFFREY L MORER OD PCOrganizationADP OF THE SNFsince 03/07/2019
LACY BEYL & COMPANY INCOrganizationADP OF THE SNFsince 07/15/2015
LIFESPAN THERAPY LLCOrganizationADP OF THE SNFsince 10/25/2007
MED-PASS INCORPORATEDOrganizationADP OF THE SNFsince 09/01/2020
MOBILE AUDIOLOGY ASSOCIATES PCOrganizationADP OF THE SNFsince 03/07/2019
MOSER CONSULTING INCORPORATEDOrganizationADP OF THE SNFsince 04/01/2020
PROACTIVE CLINICAL PARTNERSOrganizationADP OF THE SNFsince 01/01/2020
RESPIRATORY PARTNERS INCOrganizationADP OF THE SNFsince 11/01/2019
RESTUP, LLCOrganizationADP OF THE SNFsince 06/29/2022
THIRD EYE HEALTH INCOrganizationADP OF THE SNFsince 02/04/2022
VOHRA WOUND PHYSICIANS OF THE WEST PCOrganizationADP OF THE SNFsince 09/01/2021
VOX GLOBAL LLCOrganizationADP OF THE SNFsince 02/28/2019
BRACKMAN, KATHRYNIndividualADP OF THE SNFsince 08/01/2020

CMS files one row per role, so the 72 rows in the source record cover these 45 parties — each is shown once here with every role it holds. Nothing is omitted.

25 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.

$18.5M
Net patient revenuemost recent cost report
+2.3%
Operating marginrevenue minus expenses
$5.1M
Related-party expense28% of expenses
Who pays — share of resident-days
Medicaid 74%Medicare 6%Other / private 21%

About 74% of this home’s resident-days are paid by Medicaid, which reimburses well below the cost of care in most states. Heavily Medicaid-dependent homes run on thinner budgets — a context worth holding next to the staffing and inspection record, not a fault in itself. This home reported $5.1M paid to related parties — landlords or management companies under common ownership — equal to about 28% 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

$374per resident / day
operating cost
$11,375per month
≈ monthly operating cost
$383per day
avg. revenue, all payers

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

What families pay in IN

Paying with Medicaid

This is a Medicare- and Medicaid-certified nursing home, so it can accept Medicaid for long-term care — like nearly all U.S. nursing homes. The private-pay figures below are what families without Medicaid pay; once a resident qualifies for Medicaid, out-of-pocket cost for covered nursing-home care is typically close to $0 (almost all of their income goes to the home as their share of the cost; they keep a small personal needs allowance — for clothing, haircuts, a phone — and Medicaid pays the rest). The amount of that allowance is set by each state. Confirm Medicaid-bed availability with the home, and see the Indiana Medicaid page.

Typical monthly cost in Indiana
$8,943/mo
Nursing home (semi-private)
$10,326/mo
Nursing home (private)
$5,639/mo
Assisted living

Median private-pay cost, CareScout (Genworth) 2025 Cost of Care Survey — a regional midpoint, not any single community’s rate. Private rooms and higher care levels cost more; ask for a current quote. Project your own in the cost-of-care planner.

Every figure above is reproduced from the CMS Provider Data Catalog (a public record), from the CMS extract processed 2026-08-01 — CMS provider number 155181. CMS refreshes its data monthly, and the star rating rests on the last standard inspection — dated 2025-09-25, which can lag current conditions. Staffing hours are CMS PBJ CY2026Q1 (Jan–Mar 2026). Check this record against the government’s own page for it: this home on Medicare Care Compare ↗ — the authoritative source, and the place to confirm anything here before you act on it. How we present it →

Not a government site. Eldercare Lens is not affiliated with, endorsed by, or authorized by the Centers for Medicare & Medicaid Services (CMS), Medicare, or any government agency. The star ratings, citations, and inspection wording on this page are reproduced from the public CMS record; the plain-English summaries, tiers, and comparisons around them are ours. We do not speak for CMS, and CMS has not reviewed this page. For the official record, go to Medicare Care Compare. How we’re funded →

Are you this operator? If the record here is out of date, or misses what you have since fixed, tell us and we will look: hello@eldercarelens.com. We reproduce the public CMS record and cannot change what it says — corrections to the underlying data go through CMS and your state survey agency — but we will correct anything we have got wrong about it, and we will say so on the page.

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