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Courtyard Manor Nurse Care Center & Assisted Liv

306 Sydney Martin Road, Lafayette, LA 70507 · For profit - Limited Liability company · 92 certified beds · (337) 237-3940 Medicare & Medicaid certified

Call the home — (337) 237-3940 Need help choosing, fast? Free, unbiased: Eldercare Locator 1-800-677-1116
Resident-funds citation (F0568)$22,388 in federal fines
Insights

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

In its favor
  • a strong health-inspection score (4/5) — the hardest rating to game (though it’s ranked within its own state, not nationally)
  • fewer deficiencies at its most recent standard inspection than at the one before — a sign of improvement
Worth asking about
  • it has a citation for mishandling residents’ money or property (F0568)
  • a high number of inspection citations overall (21) — worth reading through, though larger and more-often-surveyed homes tend to accrue more lower-severity tags
  • the CMS record shows $22,388 in federal fines (most recent 2023-12-26)
  • its payroll-based staffing rating is low (2/5)
  • its facility-reported quality-measure rating is low (2/5)
  • nursing-staff turnover (64%) runs well above the national median (45%)

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.

4/5
CMS overall
4 of 5
Health inspectionSurveyor-assigned, ranked within your stateInspector-verified 4 of 5
StaffingFrom payroll records (PBJ) 2 of 5
Quality measuresSelf-reported by the facility 2 of 5

Location & what’s nearby

Urgent care / clinic
409 W Pont Des Mouton Rd Ste C · (337) 886-6455 · Call to confirm hours
Pharmacy
Walgreens1.0 mi
3747 Moss St · (337) 291-1808 · Call to confirm hours
Grocery
Jockey lot flea market · (337) 889-8359 · Call to confirm hours
Park
250 Couret Dr · (337) 291-8370 · Typically dawn to dusk
Place of worship
200 E Butcher Switch Rd · (337) 237-4462

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 2 of 5
Long-stay residentspeople who live here 2 of 5
Short-stay residentsrehab / post-hospital 1 of 5

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

Trend — is this home getting better or worse?

Over 2025-02 to 2026-06, this home’s CMS overall rating improved from 1 to 4 stars. From monthly CMS archive snapshots.

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

Overall rating4★
Inspection scorelower = better
See all quality measures vs. state & national benchmarks
MeasureThis homeState avgTypical statevs typical state
Long-stay residents whose need for help with daily activities increased8.0%17.8%15.4%better
Long-stay residents who lose too much weight4.5%5.2%5.4%better
Long-stay residents with a catheter left in their bladder0.7%1.2%0.9%better
Long-stay residents with a urinary tract infection2.7%2.1%2.0%worse
Long-stay residents with depressive symptoms0.0%2.3%6.5%check this — see note marked star below the table
Long-stay residents who were physically restrained0.0%0.2%0.1%better than state — see note marked double-dagger below the table
Long-stay residents with falls causing major injury6.6%3.5%3.3%worse
Long-stay residents whose ability to walk worsened13.6%17.9%16.1%better
Long-stay residents on antianxiety or hypnotic medication20.2%23.2%18.9%typical
Long-stay residents given the seasonal flu vaccine96.2%94.9%95.3%typical
Long-stay residents with pressure ulcers3.3%5.6%4.7%better
Long-stay residents with worsening bladder/bowel control8.6%15.8%21.2%better
Long-stay residents who got an antipsychotic medication — see the note below the table34.4%22.7%17.1%worse
Short-stay residents who newly got an antipsychotic medication0.0%3.1%1.4%better than state — see note marked double-dagger below the table
Short-stay residents given the seasonal flu vaccine69.6%76.3%79.4%worse
Short-stay residents rehospitalized after admission23.0%28.0%22.6%typical
Short-stay residents with an outpatient ER visit17.5%14.8%12.0%worse
Long-stay hospitalizations per 1,000 resident days3.542.561.67worse
Long-stay outpatient ER visits per 1,000 resident days4.032.741.80worse

* This home reported 0% on a measure where lower is better. That can mean genuinely excellent care — but because the number is self-reported, a zero can also mean the problem was not recorded. Weigh it against the inspection record above.

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.

35.8% of the Medicare patients who left this home got back to the community and stayed there for at least 31 days — CMS rates that worse than the national rate. This is CMS’s risk-adjusted rate over 54 Medicare stays in Oct 2022–Sep 2024, and CMS’s own comparison — not ours.

35.8%U.S. median 51.5%
Got home and stayed home
11.5%U.S. median 10.7%
Went back to hospital
23.1%U.S. median 56.6%
Met the expected recovery
0.24U.S. median 0.31
Therapy hours / resident / day
0.09hours / resident / day
Physical therapy
0.09hours / resident / day
Occupational therapy
0.06hours / resident / day
Speech therapy

Met the expected recovery: 23.1% 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 52 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 0.24 therapist hours per resident per day in 2026Q1 — more than 32% of the 13,892 homes that report any therapy hours at all.

Weekend therapy: weekend therapy hours are 12% 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 SNF35.8%CMS range 27.4–49.651.5%Oct 2022–Sep 2024worse than U.S.
Went back to hospitalRate of potentially preventable hospital readmissions 30 days after discharge from a SNF11.5%CMS range 8.0–15.810.7%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 discharge23.1%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 discharge13.5%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 discharge25.0%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 identified100.0%98.7%Oct 2024–Sep 2025CMS makes no comparison for this measure
Medication list to the next providerPercentage of residents where the SNF provided a current medication list to the next health care settingnot reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality 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 dischargenot reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
Falls with major injuryPercentage of SNF residents who experience one or more falls with major injury during their SNF stay1.7%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 worsened0.0%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 hospitalization6.7%CMS range 3.6–12.67.1%Oct 2023–Sep 2024no different from U.S.
Medicare spending per stayMedicare Spending Per Beneficiary (MSPB) for residents in SNFs0.991.02Oct 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

0.20
RN hours/ resident / day
1.16
LPN hours/ resident / day
2.73
Aide hours/ resident / day
4.09
Total nurse hours/ resident / day
0.11
RN hoursweekends
63.8%
Total nursing turnover
RN turnover

How full it usually is: this home is certified for 92 beds and averages 82.2 residents a day — about 89% occupied, or roughly 10 beds typically open. It runs fairly full. This is a CMS average, not live availability — no public source publishes real-time vacancies, and a home can be full the day you call. Confirm with the home, and if you need a Medicaid bed specifically, ask about that separately: a home with open beds may still not have an open Medicaid bed.

Against a benchmark — not a legal minimum. In May 2024 CMS finalized the first federal staffing floor for nursing homes: 3.48 total nurse hours per resident per day, including 0.55 RN hours and 2.45 nurse-aide hours. Its hour requirements never took effect and are no longer on the books. Homes had until 2026 (2027 if rural) to comply, and that deadline never arrived: a federal court vacated the hour requirements in April 2025 (CMS has appealed), Congress then barred enforcement until 2034, and CMS formally repealed them by rule effective February 2026. This home is not required to meet these numbers, and is not violating anything by missing them. We still show the comparison because the figures are CMS’s own published estimate of adequate staffing, which makes them a useful yardstick — but they are our benchmark, not federal law: this home’s total nurse staffing of 4.09 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 0.20 is below the 0.55-hour RN benchmark and nurse-aide staffing of 2.73 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 3.58 hrs/resident/day on weekends vs 4.29 on weekdays — 17% thinner on weekends. RN hours go from 0.24 to 0.11 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)

This home’s total nursing-staff turnover of 64% 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

5
deficiencies at the latest standard inspection (2026-01-07)
8
at the previous standard inspection (2024-10-30)

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.

21 citations, most serious first. The 10 most serious are shown; the remaining 11 are one tap away and print in full.

  • Potential for harm · Fcited before2026-01-07 · tag F0812 — failed to store, cook, and serve food safely — widespread
    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observations, and interview, the facility failed to store food in accordance with professional standards for food service, and ensure sanitary conditions were maintained in the kitchen as evidenced by: multiple spots of build up debris and a red sticky substance on the covering of the ice machine;uncovered and expired food items stored in the refrigerator; andexposed hair and facial hair.This deficient practice had the potential to affect the 75 residents who consumed food from the kitchen.Findings:On 01/05/2026, a review of the facility's policy titled, Food Receiving and Storage, with a last reviewed date of 07/29/2025, revealed in part. Refrigerated/Frozen Storage 1. All food stored in the refrigerator or freezer are covered, labeled and dated ( use by date).On 01/05/2026, a review of the facility's policy titled, Refrigerator and Freezer, with a last reviewed date of 07/29/2025, revealed in part.Food Preparation Area.5.Hair nets and beard restraints are to be worn while in food preparation areas. On 01/05/2026 at 8:31 a.m., a tour of the facility's kitchen was conducted…

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

    Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2026-01-07 · tag F0580 — failed to tell family and doctor about changes — isolated
    Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observations, record review, and interviews, the facility failed to ensure that a resident's physician was immediately notified of a change in the resident's skin condition for 1 (#17) resident out 2 (#17, #77) residents investigated for pressure ulcers. Findings:Review of the facility's policy titled Change in a Resident's Condition or Status with a review date of 07/29/2025, read as follows: 1. The nurse will notify the resident's attending physician or physician on call when there has been a: i. specific instruction to notify the physician of changes in the resident's condition. Review of Resident #17's medical record revealed an admission date of 10/08/2024 with diagnoses that included cerebral infarction, prediabetes, and vascular dementia. On 01/05/2026 at 9:59 a.m., an observation was made of Resident #17 with an uncovered, open abrasion on her left facial cheek. On 01/06/2026 at 3:20 p.m., a second observation was made of Resident #17 who remained to have the uncovered, open abrasion on her left facial cheek. Review of Resident #17's medical record revealed there…

    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 before2026-01-07 · 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 record review and interview, the facility failed to refer a resident with a newly diagnosed mental disorder to the appropriate state-designated authority for Level II PASARR (Pre-admission Screening and Resident Review) evaluation and determination for 1 (#33) of 3 residents investigated for PASARR. A review of Resident #33's record revealed an admission date of 08/15/2024 with diagnoses that included in part, dementia in other diseases classified elsewhere, unspecified severity, with agitation and unspecified psychosis not due to a substance or known physiological condition. Further review revealed she was diagnosed with major depressive disorder on 10/07/2024. A review of Resident #33's Level I Pre-admission Screening and Resident Review dated 07/11/2024 was conducted. Review of Section III, 1. revealed in part, an empty box next to the diagnosis of major depressive disorder. A review of the Resident #33's document Medicaid Program, Notice of Medical Certification dated 07/30/2024 revealed that a Level II decision was not required. On 01/07/2026 at 2:36 p.m., an interview…

    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 · D2026-01-07 · tag F0645 — isolated
    PASARR screening for Mental disorders or Intellectual Disabilities
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review and interview, the facility failed to ensure a resident identified with a mental disorder had an accurately completed PASARR (Pre-admission Screening and Resident Review) on admission for 1 (Resident #57) of 3 residents investigated for PASARR.Resident #57 was admitted to the facility on [DATE] with diagnoses that included in part, unspecified dementia, unspecified psychosis not due to a substance or known physiological condition, depression, and generalized anxiety disorder. A review of Resident #57's PASARR dated 02/24/2025 was conducted. Review of Section III, 1., revealed in part, an empty box next to Other Psychotic Disorder. A review of Resident #57's document Medicaid Program, Notice of Medical Certification dated 02/28/2025 revealed in part that a Level II decision was not required. On 01/07/2026 at 2:30 p.m., an interview and review of Resident #57's record was conducted with S3ADM (Administrator). S3ADM stated that the PASARR dated on 02/24/25 was completed by another facility…

    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 before2026-01-07 · 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

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, record review, and interview, the facility failed to implement the comprehensive person-centered care plan and a physician order for a concave mattress for 1 (Resident #76) of 27 sampled residents.Review of Resident #76's record revealed the resident was admitted to the facility on [DATE] with diagnoses that include in part, anxiety disorder, unspecified dementia, psychotic disorder with delusions, Alzheimer's Disease, and bipolar disorder. A review of Resident #76's Order Summary Report revealed a physician order dated 10/14/2024 for Concave mattress every shift. A review of Resident #76''s Care Plan Report revealed in part: Focus: I am at risk for falls related to impaired mobility, generalized weakness and multiple medication use. Interventions: Maintain concave mattress to my bed.On 01/06/2026 at 2:12 p.m., an observation was made of Resident #76's empty bed. The mattress looked flat and not concave.On 01/07/2026 at 8:40 a.m., an observation was made of Resident #76's empty bed. The…

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

    Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · E2024-10-30 · tag F0726 — failed to have competent, trained nursing staff — pattern
    Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, interviews and record reviews, the facility failed to ensure that nursing staff possessed competencies and skill sets necessary to provide nursing services to meet the residents' needs safely, and attain or maintain the highest practicable physical well-being for 1(#12) of 00 sampled residents as evidenced by nursing staff failing to properly maintain and record output from a Jackson Pratt (JP) drain for Resident #12. Findings: On 10/30/2024, a review of the facility's assessment with no revision date, read in part Before any new diagnoses is accepted into the facility the facility ensures the staff is competent of taking care of the resident. If a new diagnosis occurs then the facility would seek education and resources to ensure that the facility is able to care for the resident and new diagnoses, through this process. Further review revealed a review of clinical competencies within the clinical department is done on hire, annually and as needed based on need to ensure new protocols 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.

    Nursing and Physician Services Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2024-10-30 · tag F0558 — failed to accommodate residents' needs and preferences — isolated
    Reasonably accommodate the needs and preferences of each resident.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record reviews, observations and interviews, the facility failed to ensure reasonable accommodation of resident's needs for 1 (#12) out of 29 sampled residents as evidenced by Resident #12's easy touch call light device outside of her reach. Findings: On 10/30/2024, a review of the facility's policy titled Call System, Residents with no revision date, read in part residents are provided with a means to call staff for assistance through a communication system that directly calls a staff member or a centralized work station. Review of Resident #12's clinical record revealed he was admitted to the facility on [DATE] with diagnoses which included, but were not limited to, Hemiplegia and Hemiparesis, Non-traumatic Intracranial Hemorrhage Affecting Left Non-dominant Side, Contracture Left and Right hand, and Right Mastectomy. Review of Resident #12's October 2024 physician's orders revealed an order dated 11/15/2023 which read in part .ensure flat soft touch call bell is within reach at all times, every…

    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 before2024-10-30 · tag F0580 — failed to tell family and doctor about changes — isolated
    Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review and interviews, the facility failed to notify a resident's representative when a resident had a significant change in condition for 1 (#18) resident out of 29 sampled residents. Findings: A review of the facility's policy titled, Change in a Resident's Condition or Status with a last reviewed date of 03/15/2024, read in part, . Our facility promptly notifies the resident, his or her attending physician, and the resident representative of changes in the resident's medical/mental condition and/or status; 4. Unless otherwise instructed by the resident, a nurse will notify the resident's representative when: b. there is a significant change in the resident's physical, mental, or psychosocial status. Review of Resident #18's record revealed he was admitted to the facility on [DATE] with diagnoses that included in part, Cerebral Infarction, Aphasia, and Alzheimer's disease. Review of Resident #18's progress notes revealed a note dated 10/11/2024 by S15LPN (Licensed Practical Nurse) that read in…

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

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2024-10-30 · 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

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, record reviews and interviews, the facility failed to ensure that services were provided as outlined in the comprehensive plan of care for 1 (#12) of 29 sampled residents as evidenced by staff failing to turn Resident #12 every two hours. Findings: Review of the resident's electronic health record revealed she was admitted to the facility on [DATE] with diagnoses including Malignant Neoplasm of Unspecified Site of Female Breast, Aphasia, Contracture of Muscle, Hemiplegia and Hemiparesis Following Cerebral Infarction Affecting Right Dominant Side, Contracture Left and Right Hand, and Alzheimer's Disease. Review of the resident's current physician's orders revealed an order dated 04/29/2023 which read, Turn every two hours every shift. Review of the resident's MAR (Medication Administration Record) for October 2024 read in part .turn every two hours every shift. Review of the resident's care plan dated 03/07/2024 read in part .at risk for impaired skin integrity related to incontinence, 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 · D2024-10-30 · tag F0677 — failed to help fully-dependent residents with daily care — isolated
    Provide care and assistance to perform activities of daily living for any resident who is unable.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review, observation, and interview, the facility failed to ensure a resident who was unable to carry out Activities of Daily Living (ADLs) received the necessary services to maintain good grooming and personal hygiene for 1 (#57) of 3 (#12, #47 and #57) residents reviewed for ADLs. Findings: Review of Resident #57's clinical record revealed he was admitted to the facility on [DATE] with the following diagnoses, in part, Hemiplegia and Hemiparesis following other non traumatic intracranial hemorrhage affecting left non-dominant side, Contracture to left and right hand, and Contracture to left and right leg. Review of the Minimum Data Set (MDS) dated [DATE] read in part .Brief Interview for Mental Status (BIMS) score was 9, which indicated he had moderate cognitive impairment. Review of the resident's care plan dated 08/27/2024 read in part At risk for bowel and bladder incontinence related to immobility, Benign Prostatic Hyperplasia (BPH), Overactive bladder. I am incontinent of bowel and bladder,…

    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
Show the remaining 11 citations
  • Potential for harm · Dcited before2024-10-30 · 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 observations, interviews, and record reviews, the facility failed to provide respiratory care consistent with professional standards of practice for 1 of 1 residents (#46) investigated for respiratory care out of a finalized sample of 29 residents by failing to label and properly store Resident #46's CPAP (continuous positive airway pressure) mask. Findings: Resident #46 was admitted to the facility on [DATE] with diagnoses which included, but were not limited to Cerebral Infarction, Congestive Heart Failure, Acute and Chronic Respiratory Failure with Hypercapnia, Sleep Apnea and Morbid (Severe) Obesity. Review of Resident #46's physician orders revealed an order initiated on 01/26/2024 that read Change CPAP humidifier chamber and full mask with head gear every 6 months and prn (as needed.) Review of Resident #46's care plan revealed in part . I am at risk for respiratory complications r/t (related to) chronic respiratory failure, sleep apnea and obesity. I require O2 (oxygen) therapy and I use a CPAP…

    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 · D2024-10-30 · tag F0732 — isolated
    Post nurse staffing information every day.
    What the surveyor found here — the official record, unedited, may be distressing

    Based on observations and interview, the facility failed to ensure staffing information posted daily was accurate and current. The facility's census was 83. Findings: On 10/29/2024 at 10:15 a.m., an observation of the daily posted staffing information revealed a date of 10/28/2024. On 10/29/2024 at 10:16 a.m., an observation of the daily posted staffing information and an interview was conducted with S14WC (Ward Clerk). She stated that she was responsible for posting the staffing information on a daily basis. S14WC confirmed the date of 10/28/2024 on the posting and stated that they have always posted the staffing information for the previous day. On 10/29/2024 at 10:50 a.m., an interview was conducted with S1ADM (Administrator). She confirmed that the staffing information posted was from the previous day (10/28/2024). She stated the information had always been posted with the prior, and not the current date.

    Nursing and Physician Services Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2024-10-30 · tag F0806 — failed to honor food preferences — isolated
    Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, interviews, and record review, the facility failed to honor and accommodate food preferences for 2 (#17 and #23) out of 6 (#17, #23, #26, #49, #72, and #379) residents reviewed for dining. This deficient practice had the potential to affect 78 residents who consumed meals from the kitchen. Resident #17 Review of Resident #17's medical record revealed he was admitted to the facility on [DATE] with diagnoses which included, but were not limited to Type 2 Diabetes Mellitus and Muscle Wasting and Atrophy. Review of Resident #17's most recent Annual Minimum Data Set (MDS) assessment dated [DATE], revealed the resident's Brief Interview for Mental Status (BIMS) score was 8, indicating his cognition was moderately impaired. Review of Resident #17's meal ticket, read in part, . meal note: No [NAME] Leafy foods. On 10/29/2024 at 12:40 p.m. and observation and interview was conducted with Resident #17. Resident #17 was observed to have iceberg lettuce on his meal tray. Resident #17 stated that he…

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

    Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · E2023-09-27 · tag F0568 — pattern
    Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.
    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 maintain a system of accounting of each resident's personal funds entrusted to the facility on the resident's behalf by failing to provide quarterly statements for 1 (# 49) of 1 resident investigated for personal funds out of a finalized sample of 41 residents. Findings: A review of the facility's policy titled Resident Trust Fund, read in part .Policy Interpretation and Implementation. Should a resident decide to deposit into a resident trust fund it should consist of the items below .4. Quarterly statements reflecting the interest earned and balance of the account are to be mailed to all residents and or responsible party. Resident #49 was admitted to the facility on [DATE]. The resident had a BIMS (Brief Interview of Mental Status) score of 14, indicating that her cognition was intact. On 09/26/2023 at 8:00 a.m., an interview was conducted with Resident #49. The resident stated that she should have $38.00 left over after her bills were paid each…

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

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Ecited before2023-09-27 · tag F0644 — pattern
    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 record review and interview, the facility failed to refer a resident with a newly diagnosed mental disorder to the appropriate state-designated authority for Level II PASARR (Preadmission Screening and Resident Review) evaluation and determination for 2 (#1, #18) of 4 (#1, #18, #53, #62) residents investigated for PASARR in a final sample of 41 residents. Resident #1 A review of Resident #1's record revealed an admission date of 04/24/2012. Further review revealed he was diagnosed with Schizophrenia on 06/04/2015. A review of the Resident #1's current physician's orders September 2023 revealed he had been prescribed the antipsychotic medication Seroquel 25mg (milligrams) related to the diagnosis of Schizophrenia. Further review of Resident #1's record revealed a Level 1 PASARR (Preadmission Screening and Resident Review) dated 06/22/2010. No PASARR Level II was noted in Resident #1's record. On 09/27/2023 at 10:50 a.m., an interview conducted with S5SSD (Social Service Director), who stated that when a resident is diagnosed with a new mental disorder, the facility sends a…

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

    Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Ecited before2023-09-27 · tag F0656 — failed to write and follow a full care plan — pattern
    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

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, record review and interview, the facility failed to ensure the resident's comprehensive plan of care was implemented for 2 (#6 and #49) residents out of 41 sampled residents as evidenced by: 1. Failing to follow the physician's standing orders to address a blood sugar reading of 44 for Resident #6 and 2. Failing to ensure Resident #49 received a renal diet. Findings: Resident #6 Review of the resident's electronic clinical record revealed the resident was admitted to the facility on [DATE]. The resident's diagnoses included Parkinson's Disease, Peripheral Vascular Disease, Chronic Kidney Disease, Atherosclerotic Heart Disease, Diabetes, and Hypertension. Review of the resident's care plan revealed the resident was at risk for unstable blood glucose related to Diabetes. The care plan included an intervention for diabetic medication as ordered by physician. Review of the resident's physician's standing orders revealed in part: For CBG (Capillary Blood Glucose) results in the range of 0-64…

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

    Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Ecited before2023-09-27 · tag F0812 — failed to store, cook, and serve food safely — pattern
    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation and interview, the facility failed to serve food in accordance with professional standards for food service safety as evidenced by failing to ensure that dietary staff utilize the appropriate hair covering when not covering a beard with a beard restraint to prevent hair from contacting food. This deficiency had the potential to affect the entire census of 79 residents, who consumed food that was prepared in the kitchen. Findings: A review of the facility's Policy and Procedure titled Preventing Foodborne Illness-Employee Hygiene and Sanitary Practices was conducted. The policy included, in part: Policy Statement: Food and nutrition services employees follow appropriate hygiene and sanitary procedures to prevent spread of foodborne illnesses. Hair Nets: 15 Hair nets or caps and/or beard restraints are worn when cooking, preparing or assembling food to keep hair from contacting exposed food, clean equipment, utensils and linens. On 09/25/2023 at 09:43 a.m., an observation was conducted of S10DA (Dietary Aide) working in the kitchen as food was being prepared for…

    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 · D2023-09-27 · 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

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on policy review, record review, and interview, the facility failed to ensure each resident's plan of care and clinical record accurately reflected their advanced directives for 1 (#65) out of 41 sampled residents. This deficient practice had the potential to affect the entire census of 79 residents. Findings: A review of the facility's policy titled Advance Directives read, in part .If the resident has an Advance directive .4. The plan of care for each resident is consistent with his or her documented treatment preferences and/or advance directive . Resident #65 was admitted to the facility on [DATE] with diagnoses including: Acute Respiratory Failure with Hypoxia, Benign Prostatic Hyperplasia, and Acute Lymphoblastic Leukemia. A review of Resident #65's care plan revealed he had an Advanced Directive with a DNR (Do Not Resuscitate) status. A review of Resident # 65's record revealed an Advanced Directive with no circled beside DNR and no also circled beside CPR (Cardio Pulmonary Resuscitation). On [DATE]…

    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 before2023-09-27 · tag F0580 — failed to tell family and doctor about changes — isolated
    Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review and interview, the facility failed to ensure the nurse informed each resident's RP (Responsible Party) of a significant change in condition as evidenced by: 1. Failing to notify Resident #6's RP when the resident was transferred to the hospital and; 2. Failing to notify Resident #69's RP when the resident had an unwitnessed fall for 2 (#6, #69) out of 41 sampled residents. Findings: 1. Resident #6. Review of the resident's electronic clinical record revealed the resident was admitted to the facility on [DATE]. The resident's diagnoses included Parkinson's Disease, Peripheral Vascular Disease, Chronic Kidney Disease, Atherosclerotic Heart Disease, Diabetes, and Hypertension. Review of the resident's Nurses Note dated 04/11/2023 at 19:23 (7:23 p.m.) revealed: Alerted by CNA (Certified Nursing Assistant) that resident was lethargic. Upon entering the patient room noticed that the resident was not being herself and she had a wet cough. Checked blood sugar, CBG (Capillary Blood Glucose) was 44.…

    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 before2023-09-27 · 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 observations, interview, and record review the facility failed to provide respiratory care consistent with professional standards for 2 (#39, and #65) of 2 (#39 and #65) residents reviewed for respiratory care in a final sample of 41 residents. The facility failed to ensure: 1. Respiratory equipment was properly stored when not in use 2. Resident #65 received oxygen as ordered by the physician. Findings: Review of the facility's policy titled, Oxygen Administration read in part .Purpose: The purpose of this procedure is to provide guidelines for safe oxygen administration. Caring for equipment 1. Oxygen tubing must be changed weekly for residents utilizing oxygen. 2. Humidifier bottles must be changed weekly for residents utilizing oxygen. 3. Oxygen tubing must be kept in a bag while not in use. 1. Resident # 39 Review of Resident #39's record revealed she was admitted to the facility on [DATE] with diagnoses including Shortness of Breath, Acute Respiratory Failure, and Unspecified with Hypoxia or…

    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 · D2023-09-27 · tag F0880 — failed to prevent and control infections — isolated
    Provide and implement an infection prevention and control program.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, record review and interview, the nurse failed to perform hand hygiene after removing gloves during wound care 1 (#7) out of 1 residents investigated for pressure ulcers in a final sample of 41 residents. Findings: Review of the facility's policy titled, Hand Washing and Hand Hygiene Policy read in part .7. Use an alcohol-based hand rub containing at least 62% alcohol or, alternatively, soap (antimicrobial or non-antimicrobial) and water for the following situations b. before and after direct contact with residents, i. after contact with a resident's intact skin, k. after handling used dressings, l. after contact with objects in the immediate vicinity of the resident, m. after removing gloves. Review of Resident #7's electronic medical record revealed he was admitted to the facility on [DATE]. Resident #7's pertinent medical conditions, included in part: Fracture of unspecified part of neck of right femur, Acute Cholecystitis, Dysphagia, and Heart Failure. Review of Resident #7's September…

    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

“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

$22,388 in federal fines across 2 penalties.

  • $3,252 — penalty dated 2023-12-26
  • $19,136 — penalty dated 2023-09-27

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.

Who owns this facility

Owner / managerTypeRoleSince
SARVER FAMILY LLCOrganizationDIRECT OWNERSHIP INTERESTsince 06/11/2006
BEGLIS, AMYIndividualINDIRECT OWNERSHIP INTERESTsince 12/17/2018
BERTRAND, ALANIndividualINDIRECT OWNERSHIP INTEREST; ADP OF THE SNFsince 01/02/2017
BERTRAND, DAVIDIndividualINDIRECT OWNERSHIP INTEREST; ADP OF THE SNFsince 01/02/2017
BILLEAUD, DANIELIndividualINDIRECT OWNERSHIP INTERESTsince 03/25/2019
BILLEAUD, JOSHUAIndividualINDIRECT OWNERSHIP INTERESTsince 03/25/2019
COLLINS, DARLAIndividualINDIRECT OWNERSHIP INTERESTsince 01/01/2020
FOREMAN, LINDAIndividualINDIRECT OWNERSHIP INTEREST; ADP OF THE SNFsince 08/22/2005
LANE, ALLISONIndividualINDIRECT OWNERSHIP INTERESTsince 01/01/2020
LOUVIERE, TRACIEIndividualINDIRECT OWNERSHIP INTERESTsince 01/01/2020
MELANCON, KARLAIndividualINDIRECT OWNERSHIP INTERESTsince 01/01/2020
MENARD, AMBERIndividualINDIRECT OWNERSHIP INTERESTsince 03/25/2019
MILLER, CASSIEIndividualINDIRECT OWNERSHIP INTERESTsince 12/17/2018
PETRY, GWENIndividualINDIRECT OWNERSHIP INTEREST; ADP OF THE SNFsince 08/22/2005
SARVER, AUSTINIndividualINDIRECT OWNERSHIP INTERESTsince 12/17/2018
SARVER, BRONSONIndividualINDIRECT OWNERSHIP INTERESTsince 01/01/2018
SARVER, DANNYIndividualINDIRECT OWNERSHIP INTEREST; ADP OF THE SNFsince 08/22/2005
SARVER, LANAIndividualINDIRECT OWNERSHIP INTERESTsince 12/01/2021
SARVER, LOGANIndividualINDIRECT OWNERSHIP INTERESTsince 12/17/2018
SARVER, MARLONIndividualINDIRECT OWNERSHIP INTEREST; ADP OF THE SNFsince 03/17/2025
SARVER, NANCYIndividualINDIRECT OWNERSHIP INTERESTsince 12/01/2021
SARVER, NICHOLASIndividualINDIRECT OWNERSHIP INTERESTsince 01/01/2018
SARVER, WILLIE BELLEIndividualINDIRECT OWNERSHIP INTEREST; ADP OF THE SNFsince 08/22/2005
SARVER, ZACHARYIndividualINDIRECT OWNERSHIP INTERESTsince 01/01/2018
VIATOR, CHELSIIndividualINDIRECT OWNERSHIP INTERESTsince 01/01/2018
VIATOR, LACIEIndividualINDIRECT OWNERSHIP INTERESTsince 01/01/2018
DUGAL, JOHNIndividualOPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 04/04/2019
LAUGHLIN, DONNAIndividualOPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 11/21/2016
MILLER, DAWNIndividualOPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 09/01/2016

CMS files one row per role, so the 39 rows in the source record cover these 29 parties — each is shown once here with every role it holds. Nothing is omitted. The source lists no ownership percentage for any of them — PECOS records a share only for equity interests, not for board or management roles.

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

Follow the money — this home’s finances

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

$7.2M
Net patient revenuemost recent cost report
+16.7%
Operating marginrevenue minus expenses
$7K
Related-party expense0% of expenses
Who pays — share of resident-days
Medicaid 60%Medicare 8%Other / private 32%

This home reported $7K paid to related parties (affiliated landlords or management companies) in its most recent cost report.

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

Cost & finances

$220per resident / day
operating cost
$6,700per month
≈ monthly operating cost
$264per 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 LA

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 Louisiana Medicaid page.

Typical monthly cost in Louisiana
$7,604/mo
Nursing home (semi-private)
$8,076/mo
Nursing home (private)
$5,163/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 195606. CMS refreshes its data monthly, and the star rating rests on the last standard inspection — dated 2026-01-07, 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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