Neville Center At Fresh Pond For Nursing & Rehab
640 Concord Avenue, Cambridge, MA 02138 · For profit - Corporation · 112 certified beds · (617) 497-0600 Medicare & Medicaid certified
On the public record, this home looks stronger than most — but visit before you decide.
- a strong health-inspection score (4/5) — the hardest rating to game (though it’s ranked within its own state, not nationally)
- no federal fines or payment denials on record
- a high payroll-based staffing rating (4/5)
- lower-than-typical staff turnover (33% vs 45% nationally) — better care continuity
- a high number of inspection citations overall (19) — worth reading through, though larger and more-often-surveyed homes tend to accrue more lower-severity tags
One thing this read cannot see: what residents and families actually experience day to day. Public data misses the feel of a place — visit unannounced, ideally at a mealtime or on a weekend, talk to staff and families, and ask your tour questions.
A plain-English summary of the public record below — not a rating, ranking, or recommendation. We take no money from any facility.
| Health inspectionSurveyor-assigned, ranked within your stateInspector-verified | 4 of 5 |
| StaffingFrom payroll records (PBJ) | 4 of 5 |
| Quality measuresSelf-reported by the facility | 4 of 5 |
Location & what’s nearby
Open in Google Maps ↗ · Directions ↗ · Larger map ↗
Nearest of each type, straight-line distance. Hospitals come from the CMS Hospital General Information registry; everything else from Overture Maps (public data). Hospital and park hours are typical — call ahead to confirm.
Quality measures — how residents actually fare
| Overall quality measures | 4 of 5 |
| Long-stay residentspeople who live here | 4 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 4 stars. From monthly CMS archive snapshots.
Horizontal axis runs 2025-02 to 2026-06. That is where CMS’s monthly archive ends, so the right-hand edge of each line is that month — not today.
See all quality measures vs. state & national benchmarks
| Measure | This home | State avg | Typical state | vs typical state |
|---|---|---|---|---|
| Long-stay residents whose need for help with daily activities increased | 8.1% | 16.4% | 15.4% | better |
| Long-stay residents who lose too much weight | 5.0% | 5.1% | 5.4% | typical |
| Long-stay residents with a catheter left in their bladder | 0.0% | 0.8% | 0.9% | better |
| Long-stay residents with a urinary tract infection | 2.7% | 1.8% | 2.0% | worse |
| Long-stay residents with depressive symptoms | 6.3% | 15.5% | 6.5% | typical |
| Long-stay residents who were physically restrained | 0.0% | 0.1% | 0.1% | better |
| Long-stay residents with falls causing major injury | 4.9% | 3.4% | 3.3% | worse |
| Long-stay residents whose ability to walk worsened | 7.1% | 15.4% | 16.1% | better |
| Long-stay residents on antianxiety or hypnotic medication | 12.2% | 19.5% | 18.9% | better |
| Long-stay residents given the seasonal flu vaccine | 100.0% | 94.8% | 95.3% | typical |
| Long-stay residents with pressure ulcers | 4.4% | 4.2% | 4.7% | typical |
| Long-stay residents with worsening bladder/bowel control | 11.2% | 21.2% | 21.2% | better |
| Long-stay residents who got an antipsychotic medication§ — see the note below the table | 17.1% | 21.4% | 17.1% | typical |
| Short-stay residents who newly got an antipsychotic medication | 0.1% | 1.4% | 1.4% | better |
| Short-stay residents given the seasonal flu vaccine | 93.3% | 77.7% | 79.4% | better |
| Short-stay residents rehospitalized after admission | 28.5% | 25.7% | 22.6% | worse |
| Short-stay residents with an outpatient ER visit | 9.4% | 11.9% | 12.0% | better |
| Long-stay hospitalizations per 1,000 resident days | 2.02 | 1.88 | 1.67 | worse |
| Long-stay outpatient ER visits per 1,000 resident days | 1.50 | 1.50 | 1.80 | better |
§ 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.
61.8% of the Medicare patients who left this home got back to the community and stayed there for at least 31 days — CMS rates that better than the national rate. This is CMS’s risk-adjusted rate over 554 Medicare stays in Oct 2022–Sep 2024, and CMS’s own comparison — not ours.
Met the expected recovery: 42.5% 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 301 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 0.74 therapist hours per resident per day in 2026Q1 — more than 93% of the 13,892 homes that report any therapy hours at all.
Weekend therapy: weekend therapy hours are 23% 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
| Measure | This home | U.S. median | Period covered | CMS’s call |
|---|---|---|---|---|
| Got home and stayed homeRate of successful return to home or community from a SNF | 61.8%CMS range 57.6–65.4 | 51.5% | Oct 2022–Sep 2024 | better than U.S. |
| Went back to hospitalRate of potentially preventable hospital readmissions 30 days after discharge from a SNF | 9.5%CMS range 7.6–11.4 | 10.7% | Oct 2022–Sep 2024 | no different from U.S. |
| Met the expected recoveryPercentage of residents who are at or above an expected ability to care for themselves and move around at discharge | 42.5% | 56.6% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Self-care at dischargePercentage of residents who are at or above an expected ability to care for themselves at discharge | 40.2% | 52.8% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Moving around at dischargePercentage of residents who are at or above an expected ability to move around at discharge | 46.5% | 50.0% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Medication problems followed upPercentage of residents whose medications were reviewed and who received follow-up care when medication issues were identified | 100.0% | 98.7% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Medication list to the next providerPercentage of residents where the SNF provided a current medication list to the next health care setting | 100.0% | 100.0% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Medication list to the familyPercentage of residents where the SNF provided a current medication list to the resident, family, and/or caregiver at final discharge | 96.3% | 98.7% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Falls with major injuryPercentage of SNF residents who experience one or more falls with major injury during their SNF stay | 0.5% | 0.0% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| New or worsened pressure ulcersPercentage of residents with pressure ulcers/pressure injuries that are new or worsened | 1.3% | 1.9% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Infections that led to hospitalPercentage of infections residents got during their SNF stay that resulted in hospitalization | 5.7%CMS range 3.9–8.2 | 7.1% | Oct 2023–Sep 2024 | no different from U.S. |
| Medicare spending per stayMedicare Spending Per Beneficiary (MSPB) for residents in SNFs | 0.86 | 1.02 | Oct 2022–Sep 2024 | CMS makes no comparison for this measure |
From the CMS Skilled Nursing Facility Quality Reporting Program — Medicare short-stay outcomes, which is a different dataset from the long-stay quality measures above and describes a different set of residents. Where CMS risk-adjusts a measure we show its adjusted rate, and the CMS range beside it is the confidence interval CMS publishes: a home whose range is wide is a home with few stays, where one patient moves the number several points. Read the period column. These measures do not share a window — the claims-based ones (getting home, readmission, spending) lag by a year or more, because a stay has to finish and its claims settle before it can be counted. CMS’s call is CMS’s, not ours: it is the only place anyone tests whether this home differs from the national rate at all, and most homes on most measures do not. Two caveats on it. CMS tests only three of these measures — getting home, readmission, and infections that led to hospital; on the other nine it publishes a rate and no comparison, and rather than compute a verdict CMS declined to make, we say so in the column. And on readmission almost every home in the country lands on “no different”, so that row separates homes far less than getting-home does — which is why met the expected recovery, a measure CMS does not test but which spreads across the whole range, is called out above the table rather than left in this list. The U.S. median column is our own, taken across every home CMS publishes that measure for in this same file; it is not a CMS-published benchmark. Homes CMS gives no rate for are left out of it rather than counted as zero. Medicare spending per stay is a ratio, not a percentage — 1.00 means this home’s Medicare spending for a stay matched the national figure CMS compares it against, and it measures cost to Medicare, not quality of care.
Staffing
How full it usually is: this home is certified for 112 beds and averages 99.5 residents a day — about 89% occupied, or roughly 12 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 4.16 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 0.88 is at or above the 0.55-hour RN benchmark and nurse-aide staffing of 2.22 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 3.54 hrs/resident/day on weekends vs 4.41 on weekdays — 20% thinner on weekends — a notable drop. RN hours go from 1.09 to 0.37 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)
This home’s total nursing-staff turnover of 33% is below the national median of 45%. 1 administrator has left in the past year.
Payroll-based (PBJ) staffing hours, as reported for Jan–Mar 2026 (CMS PBJ CY2026Q1) — the most recent quarter CMS has published, so they can lag a change of operator or staffing agency. Higher is generally better. Registered-nurse coverage and weekend staffing are the numbers families most often overlook — an RN on site matters most when something goes wrong, and coverage usually thins on weekends. High turnover means residents rarely see the same caregiver twice. One caveat: these are hours as reported, not adjusted for how sick or heavy-care this home’s residents are. CMS separately publishes a case-mix-adjusted view; we show the reported hours. A home caring for higher-acuity residents needs more hours to deliver the same care, so compare these figures against homes doing similar work, and read them next to the inspection record rather than alone.
Inspection trend
Deficiencies are fewer than at the previous inspection — improving. Fewer citations over time suggests a home is fixing problems; a rising count is a warning sign — though two surveys are a short record, and survey teams differ. These counts are from the standard annual health survey only; the full citation list below may also include findings from complaint investigations, so the two won’t always add up.
Inspection deficiencies
State health-inspection citations, most serious first. Each carries an F-code (the federal rule it cites, e.g. F-684 = quality of care) and a letter A–L marking how serious and how widespread the problem was — we translate that grid into the plain tiers shown here. Wording is the official federal description.
Each letter is a CMS scope-severity level; highlighted ones are where this home has citations. A–C = no harm found; D–F = potential for harm; G–I = actual harm; J–L = immediate jeopardy. Within each band the later letter is the more widespread finding (an isolated G is one resident; a widespread I is a pattern), so rightward and downward is worse.
19 citations, most serious first. The 10 most serious are shown; the remaining 9 are one tap away and print in full.
- Potential for harm · E2026-05-13 · tag F0812 — failed to store, cook, and serve food safely — patternProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observation and interview, the facility failed to store and handle food in accordance with professional standards for food service safety, potentially putting the residents at risk for foodborne illness. Specifically, 1. The facility failed to ensure that food was stored, labeled, and dated properly, and that food/beverages were not expired and personal drinks were not stored in the kitchen refrigerator.2. The facility failed to ensure staff wore beard coverings and staff did not handle ready-to-eat food with contaminated gloves.3. The facility failed to consistently monitor the effective use of a low temperature manual chemical sanitization station and failed to document the parts per million (PPM) of the sanitizing solution, to ensure effective sanitization. Findings include:Review of the facility policy titled Food Storage Guideline, dated 1/3/22, indicated but was not limited to the following: Food will be stored in an area that is clean, dry and free from contaminants. Food will be stored at appropriate temperatures and by methods designed to prevent contamination 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.
- Potential for harm · D2026-05-13 · tag F0687 — failed to care for feet properly — isolatedProvide appropriate foot care.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, record reviews and interviews, the facility failed to ensure that one Resident (#74) was provided with treatment and care to maintain good foot health, out of a total sample of 21 residents. Specifically for Resident #74 who was last seen by the podiatrist on 2/12/26, and the podiatrist recommended that Resident #74 be seen as medically necessary but no sooner than 60 days, the facility failed to ensure the Resident was seen on 5/4/26, when his/her nails needed services. Finding include:Review of the facility policy titled Consultant Services (Audiology, Podiatry, Dental, Optometry) Guideline, dated 9/20/20, indicated but was not limited to the following: Each resident (responsible person) shall be offered the services of (Consultant Services) for audiology, podiatry, dental and optometry while residing in the center. 1. During the admission process, the licensed nurse shall review with each resident or responsible person that professional services covering audiology, dental, podiatry, and…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · Dcited before2026-05-13 · tag F0761 — failed to label and store drugs safely — isolatedEnsure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, record review and interview, the facility failed to ensure medications were stored as required for one Resident (#78), out of a total sample of 21 residents. Specifically, the facility failed to ensure that medications were not left at the bedside for Resident #78 while unsupervised by staff. Findings include:Review of the facility policy titled General Dose Preparation and Medication Administration, dated as revised 11/15/24, indicated but was not limited to the following: 2. Dose Preparation: Facility should take all measures required by facility policy and applicable law, including, but not limited to the following:-2.8 Facility staff should not leave medications or chemicals unattended. 5. During medication administration, facility staff should take all measures required by facility policy and applicable law, including, but not limited to:5.4 Administer the medications within timeframes specified by facility policy or manufacturers information. 5.9 Observe the resident's consumption of…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2026-05-13 · tag F0806 — failed to honor food preferences — isolatedEnsure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observations, record reviews and interviews, the facility failed to consistently accommodate resident food allergies, intolerances, and preferences for two Resident (#42 and #104) out of a total sample of 21 residents. Specifically,1. For Resident #42, who had allergies listed as wheat and lactose, the facility served the Resident French toast, bacon (a dislike), a cookie containing wheat and milk, and scrambled eggs with cheese.2. For Resident #104, who required a vegan (diet that avoids all animal derived products such as meat and dairy) diet and had dairy listed as a dislike, the facility served Resident #104 half and half creamers containing dairy on three occasions. Findings include:Review of the facility policy, Resident's Choice Meals, dated September 2025, indicated in post-acute care settings, residents may have input into menu planning and may select the menu for meals on a regular basis once a month or more often if deemed appropriate. 1. The director of food and nutrition services will meet with residents via resident council meetings to get input on the menu…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2026-05-13 · tag F0908 — failed to keep essential equipment working — isolatedKeep all essential equipment working safely.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, record review and interviews, the facility failed to ensure all equipment is maintained in safe operating condition. Specifically, 1. The facility failed to ensure the grease trap was maintained according to manufacturer's recommendations.2. The facility failed to ensure the two bays of the three-bay sink were in safe operating condition. Findings include:1. On 5/11/26 at 7:10 A.M., the surveyor observed in the main kitchen area, the floor under and around the three-bay sink, there was a pipe covered in a buildup of thick, dark brown, black, yellow, tan, gray shiny substance that extended to the pipes, onto the floor, was coming out of the grease trap container and had an odor. A kitchen staff member was observed washing dishes and said the grease trap and under sink area has looked like that for a while. During an interview on 5/12/26 at 12:27 P.M., the Food Service Director (FSD) said the grease trap is cleaned monthly and is handled by the Maintenance Director. The FSD said she keeps 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.
- Potential for harm · D2025-05-28 · tag F0686 — failed to prevent and treat pressure sores (bedsores) — isolatedProvide appropriate pressure ulcer care and prevent new ulcers from developing.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observations, interviews, and record review, the facility failed to provide necessary treatment, services, interventions to promote healing and prevent new pressure ulcers from developing for two Residents (#3 and #60) out of 19 total sampled residents. Specifically, 1.) For Resident #3, who had a left heel pressure ulcer, the facility failed to implement booties (heel offloading devices which are designed to prevent and treat pressure ulcers) as ordered by the physician. 2.) For Resident #60, who had a history of a heel pressure ulcer, the facility failed to implement booties as ordered by the physician. Findings include: Review of the facility policy titled 'Skin Management Guideline', revised 8/10/17, indicated: - The purpose of this guideline is to provide information regarding the management of skin conditions and identification of pressure ulcer/injury risk factors and interventions for specific risk factors. - Risk Assessment: Reposition the resident as indicated in the care plan. - Mobility/Repositioning: Provide support devices and assistance as needed. -…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2025-05-28 · tag F0692 — failed to prevent malnutrition and dehydration — isolatedProvide enough food/fluids to maintain a resident's health.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, record reviews and interviews, the facility failed to adequately maintain the nutrition and hydration status of two Residents (#8 and #28) out of a total sample of 19 residents.Specifically, 1. For Resident #8,the facility failed to follow up on a significant weight change. 2.For Resident #28,the facility failed to follow a physician's order for a fluid restriction. Findings include: Review of the facility policy titled 'Weight Management' dated 6/2024, indicated the following but not limited to: -A discrepancy of plus or minus three (3) pounds weekly for a weekly weight will require that the resident be re-weighed to validate weight discrepancy by a licensed nurse. A discrepancy of plus or minus five (5) pounds for a monthly weight will require that the resident be re-weighed to validate the weight discrepancy by a licensed nurse. -The Registered Dietician (RD) shall be notified of the validated weight gain or loss at this time. Resident #8 was admitted to the facility in April 2024 with…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2025-05-28 · tag F0694 — isolatedProvide for the safe, appropriate administration of IV fluids for a resident when needed.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observations, interviews, and record review, the facility failed to provide care and maintenance of a peripherally inserted central catheter (PICC), consistent with professional standards of practice for one Resident (#60), out of a total sample of 19 residents. Specifically, for Resident #60, the facility failed to implement a physician's order for weekly routine PICC dressing changes, as required. Findings include: Review of the facility policy titled 'Central Vascular Access Device (CVAD) Dressing Change', revised 1/25/04, indicated: - Verify prescriber order. - Perform sterile dressing changes using Standard - Aseptic Non Touch Technique: at least weekly. Resident #60 was admitted to the facility in December 2022 with diagnoses including sepsis and urinary tract infection. Review of the most recent Minimum Data Set (MDS) assessment, dated 4/25/25, indicated Resident #60 was cognitively intact as evidenced by a Brief Interview for Mental Status (BIMS) score of 15 out of 15. This MDS also indicated Resident #60 received intravenous medications. Review of Resident #60's…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2025-05-28 · tag F0755 — failed to provide safe pharmacy services — isolatedProvide 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 policy review, observation and staff interview, the facility failed to ensure pharmaceutical services met the needs of each resident. Specifically, the facility failed to ensure insulin and intravenous emergency kits were replaced by the pharmacy after being opened on two out of three units. Findings include: Review of the facility policy titled 'Emergency Medication Supplies (Emergency kits), dated 11/15/24, indicated the following: -The facility may request an on-demand exchange of the emergency kit as needed by calling the pharmacy and arranging the exchange. -To indicate the emergency kit was opened by the facility staff and replacement of the box or replenishment of removed doses is needed, the tamper -evident lock or seals provided by the pharmacy may be a different color than the original one placed by the pharmacy. On 5/28/25 at 10:03 A.M., during the inspection of the medication room on the second floor. The surveyor observed an insulin kit in the refrigerator; the kit was opened and some of the contents had been removed from the kit. There was no documentation…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · Dcited before2025-05-28 · tag F0761 — failed to label and store drugs safely — isolatedEnsure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observations and interviews the facility failed to ensure drugs and biologicals were stored in accordance with acceptable professional standards of practice. Specifically, nursing failed to ensure medications were dated once opened, and stored according to manufacturer's guidelines, in one of three medication carts observed. Findings include: Review of the facility policy titled 'Storage and Expiration Dating of Medications and Biologicals', dated 8/1/24, indicated the following: -Once any medication or biological is opened, facility should follow manufacture/supplier guidelines with respect to expiration dates for opened medications. Facility staff should record the date opened on the primary medication container (example, vial, bottled, inhaler) when the medication has a shortened expiration date once opened. On 5/28/25 at 9:56 A.M., the surveyor and Nurse #1 observed the second floor medication cart: -Two bottles of Lumigan eye drops, opened and undated. -One bottle of pilocarpine eye drops, opened and undated. -One bottle of latanoprost eye drops, opened and undated.…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
Show the remaining 9 citations
- Potential for harm · Dcited before2025-05-28 · tag F0842 — failed to keep accurate, complete medical records — isolatedSafeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observations, interviews, and record reviews, the facility failed to accurately document in the medical record for two Residents (#60 and #3) out of 19 total sampled residents. Specifically, 1.) For Resident #60, the nurses inaccurately documented: a.) a peripherally inserted central catheter (PICC) dressing change as being completed when it was not; b.) heel booties (heel offloading devices which are designed to prevent and treat pressure ulcers) as being implemented when they were not; and c.) side rails were padded when they were not. 2.) For Resident #3, the nurses inaccurately documented heel booties being implemented and heels being offloaded when they were not. Findings include: Review of the facility policy titled 'Charting and Documentation', revised 2/4/17, indicated: - Documentation in the medical record will be objective (not opinionated or speculative), complete, and accurate. 1.) Resident #60 was admitted to the facility in December 2022 with diagnoses including sepsis, urinary tract infection, and diabetes. Review of the most recent Minimum Data Set (MDS)…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2024-12-03 · tag F0887 — isolatedEducate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on records reviewed and interviews, for one of three sampled residents (Resident #1), who had an activated Health Care Proxy, and upon admission had given signed consent for him/her to be administered the COVID-19 Vaccination, the Facility failed to ensure he/she was given the vaccine, increasing Resident #1 risk for acquiring the infection. Findings include: Review of the Facility's Policy, titled Coronavirus/COVID-19 Disease: Vaccination-Resident and Staff, dated 04/01/24, indicated the Facility will offer an updated 2023-2024 COVID-19 vaccine to residents and staff who have not received a monovalent vaccine, and who wish to be considered Up to Date with COVID-19 vaccine administration. Resident #1 was admitted to the Facility in September 2024, diagnoses included moderate dementia with mood disturbance, cognitive communication deficit, syncope and collapse, repeated falls, hypertension heart disease, delusional disorder, weakness, major depression disorder, anxiety, and difficulty with walking. Review of Resident #1's Medical Record indicated Resident #1's Health Care Agent…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2024-07-23 · tag F0550 — failed to protect resident dignity and rights — isolatedHonor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
What the surveyor found here — the official record, unedited, may be distressing
Based on observation and interview, the facility failed to provide residents with a dignified dinning experience on one of three units. Findings include: On 7/22/24 at 8:41 A.M., the surveyors observed residents on the 3rd floor unit being served on institutional trays in the dining room during the breakfast meal. On 7/23/24 at 8:32 A.M., the surveyors observed residents on the 3rd floor unit being served on institutional trays in the dining room during the breakfast meal. On 7/23/24 at 12:34 A.M., the surveyors observed residents on the 3rd floor unit being served on institutional trays in the dining room during the lunch meal. During an interview on 7/23/24 at 12:41 P.M., Unit Manager #1 said that all the meals are served on trays in the dining rooms.
- Potential for harm · D2024-07-23 · tag F0655 — isolatedCreate and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
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 for one Resident (#81) of 25 sampled residents, to develop a baseline care plan to address his/her risk for falls. Findings include: The facility policy Accident and Incidents Guideline dated 2/8/2018, indicated: - The interdisciplinary team (IDT), based upon the identified potential risk factors develops and implements an individualized plan of care. Resident #81 was admitted to the facility in July 2024, and had diagnoses which included difficulty in walking, ataxia (loss of coordination of voluntary muscle movements), repeated falls, Parkinson's disease, syncope (fainting) and collapse, and orthostatic hypotension (low blood pressure that happens when standing after sitting or lying down and can cause dizziness or lightheadedness and possibly fainting). Review of Resident #81's Fall Risk assessment dated [DATE], indicated he/she was at a moderate risk for falls. The assessment indicated a falls care plan was to be developed and it included specific…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2024-07-23 · tag F0656 — failed to write and follow a full care plan — isolatedDevelop 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 develop a dental care plan for one Resident (#87) out of 25 sampled residents. Findings include: Resident #87 was admitted to the facility in February 2024 with diagnoses including malnutrition, kidney disease and depression. On 7/22/24, at 8:50 A.M. the surveyor observed Resident #87 to have only two top teeth, both of which were carious. During an interview on 7/22/24 at 8:50 A.M. Resident #87 said that he/she wants to see a dentist. Resident #87 then said that he/she thinks that his/her partial plates were lost in the move to the facility. Review of the Minimum Data Set (MDS) dated [DATE], indicated that Resident #87 scored a 15 out of 15 on the Brief Interview for Mental Status exam, indicating intact cognition. Review of the facility document titled NUT-Nutrition/Hydration Assessment V3-V4 dated 5/8/24, section V. Oral Status/Swallowing indicated that Resident #87 had missing or broken teeth and had a partial lower denture as well as…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2024-07-23 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolatedEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, interviews and record review, the facility failed to ensure the environment was free from hazards that could cause accidents for one Resident (#79) out of a sample of 25 Residents. Specifically, the facility failed to pad the Resident's side rails as ordered. Findings include: A review of the facility's policy titled 'Accident & Incidents Guideline' with a revision date of February 2018 indicated the following: -It is the center's policy to provide an environment that is free from hazards over which the center has control. The intent of this policy is that the center identifies each resident at risk for accidents, and adequately plans care and implements procedures to prevent accidents. Resident #79 was admitted to the facility in December 2022 with diagnoses including localization related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, not intractable, without status epilepticus. A review of the most recent Minimum Data Set (MDS) dated [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.
- Potential for harm · Dcited before2024-07-23 · tag F0761 — failed to label and store drugs safely — isolatedEnsure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interviews, policy review and observations, the facility failed to secure medication on one of three units (second floor). Findings include: Review of the facility policy Storage of Medications dated [DATE], indicated: - Drugs and biologicals used in the facility are stored in locked compartments under proper temperature, light and humidity control. On [DATE] at 8:42 A.M., on the second floor unit, the surveyor observed Nurse #1 remove an expired bottle of liquid Trazodone, 5 milligrams per milliliter, from the refrigerator located in the unit's locked medication room. Nurse #1 gave the medication to Unit Manager #2, who then placed it on the nursing station desk, which was located approximately two feet from the common area hallway. Trazodone is a prescription medication used for the treatment of depression. On [DATE] at 9:33 A.M., the surveyor returned to the second floor unit and observed the same bottle of liquid Trazodone on the nursing station desk. No staff were at the desk or the nursing…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2024-07-23 · tag F0790 — failed to provide dental care — isolatedProvide routine and 24-hour emergency dental care for 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 records reviewed and interviews for two Residents (#87 and #89) out of a total sample of 25, the facility failed to provide dental care. Specifically: 1. For Resident #87, who had broken/carious teeth and lost his/her lower dentures, the facility failed to ensure he/she had a timely dental consultation. 2. For Resident #89, the facility failed to follow up on the recommendation for the fabrication of the upper dentures, three months after originally recommended. Findings Include: Review of the facility policy titled Dental Care guideline dated 5/23/18, indicated the following: The facility will if necessary or requested, assist the resident with making appointments or arrange dental services. A dentist will be made available for each resident through a contractual agreement by an approved dental provider that services the center or from the community. 1. Resident #87 was admitted to the facility in February 2024 with diagnoses including malnutrition, kidney disease and depression. On 7/22/24 at 8:50…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · Dcited before2024-07-23 · tag F0842 — failed to keep accurate, complete medical records — isolatedSafeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, record review and interview, the facility failed to maintain accurate medical records in accordance with professional standards and practices for two Residents (#87 and #79) out of a total sample of 25 residents. Specifically: 1. For Resident #87, the facility failed to accurately document the dental status on the nursing admission assessment, 2. For Resident #79, the facility failed to accurately document the presence of side rail pads after Resident #79's room change. Findings include: Review of the facility policy titled Nursing admission guideline dated as revised on 12/20/22, indicated that the purpose of this guideline is to gather information about the resident's physical, emotional, cognitive, and psychosocial condition upon admission for the purposes of managing the resident, initiating the care plan, and completing required assessment instruments, including the MDS (minimum data set). Further review indicated that the nurse conducts an admission assessment including a review 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.
“Cited before” means this same F-tag appears on at least one other survey date in the record we hold — counting complaint investigations as well as standard surveys, with no time limit. It is our own read of the data, not CMS’s: CMS uses repeat deficiency as a formal term tied to consecutive standard surveys, and that is a narrower test than this one. A tag marked here may or may not meet it.
- Long-Term Care Ombudsman — a free, confidential advocate for the resident. They act only with the resident’s consent and work to resolve the problem. Find yours at theconsumervoice.org/get_help.
- Adult Protective Services — the state agency that investigates suspected abuse, neglect, or exploitation of a vulnerable adult. Not sure of your state’s APS number? The federal Eldercare Locator will route you: 1-800-677-1116 or eldercare.acl.gov.
- State survey agency — the regulator that licenses and inspects the home. Every state has an official nursing-home complaint line and most take complaints online; the Ombudsman or Eldercare Locator can connect you.
Fines & penalties
No federal fines in the current CMS record.
Who owns this facility
| Owner / manager | Type | Role | Share | Since |
|---|---|---|---|---|
| NEVILLE COMMUNITIES HOME INC | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | since 10/22/1999 |
| ROCKLAND TRUST COMPANY | Organization | 5% OR GREATER MORTGAGE INTEREST | — | since 07/30/2013 |
| MCPHERSON, STEPHANIE | Individual | W-2 MANAGING EMPLOYEE | — | since 03/22/2019 |
| RASO, STEVEN | Individual | CORPORATE DIRECTOR; OPERATIONAL/MANAGERIAL CONTROL | — | since 05/01/2010 |
| BARANELLO, ROBERT | Individual | CORPORATE OFFICER | — | since 11/01/2006 |
| LEIPZIG, GLORIA | Individual | CORPORATE OFFICER | — | since 10/01/2012 |
| STOCKARD, JIM | Individual | CORPORATE OFFICER | — | since 10/01/2012 |
| LANDMARK MANAGEMENT SOLUTIONS, LLC | Organization | OPERATIONAL/MANAGERIAL CONTROL | — | since 05/01/2010 |
CMS files one row per role, so the 9 rows in the source record cover these 8 parties — each is shown once here with every role it holds. Nothing is omitted.
3 organizational owners listed — a facility can be part of a larger chain. CMS ownership data is known to under-report private-equity and REIT ties; treat as a starting point.
Follow the money — this home’s finances
Where a nursing home’s revenue comes from and where it goes — including money paid to companies under the same ownership. Most consumer sites never show this; we reproduce it straight from the Medicare cost report.
This home reported $186K paid to related parties (affiliated landlords or management companies) in its most recent cost report. A reported operating loss is common in this industry and is not by itself a sign of trouble — but paired with large related-party payments it can mean profit is being taken elsewhere in the ownership structure.
Source: CMS Healthcare Provider Cost Reporting Information System (HCRIS), Medicare cost report Form CMS-2540 · fiscal year 2023. Facilities self-file these reports; figures are unaudited and a year or two behind. A home with no Medicare cost report on file shows no figures here.
Cost & finances
Straight from this home’s Medicare cost report (CMS, FY2023). These are its operating economics — what it costs to run per resident-day and what it collects on average across Medicare, Medicaid, and private pay — not a private-pay quote. Your out-of-pocket cost depends on payer and room type, so ask the facility directly; a higher operating cost can reflect richer staffing or a sicker population. The cost-of-care planner shows regional benchmarks by care type.
What families pay in MA
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 Massachusetts Medicaid page.
Median private-pay cost, CareScout (Genworth) 2025 Cost of Care Survey — a regional midpoint, not any single community’s rate. Private rooms and higher care levels cost more; ask for a current quote. Project your own in the cost-of-care planner.
Every figure above is reproduced from the CMS Provider Data Catalog (a public record), from the CMS extract processed 2026-08-01 — CMS provider number 225378. CMS refreshes its data monthly, and the star rating rests on the last standard inspection — dated 2026-05-13, 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.