River Ridge Center
3 Brazier Lane, Kennebunk, ME 04043 · For profit - Corporation · 62 certified beds · (207) 985-3030 Medicare & Medicaid certified
This home has serious findings on its record. Read them closely before you consider it.
- fewer deficiencies at its most recent standard inspection than at the one before — a sign of improvement
- CMS lists it as a Special Focus candidate — not on the watch list itself, but among the homes CMS is watching because of its recent inspection history
- it has a citation for its abuse-prevention policies, restraint use, or reporting and investigating of allegations (F0609) — cited below the harm level, meaning inspectors found the process wanting but did not find a resident harmed
- it has a citation for mishandling residents’ money or property (F0565)
- inspectors cited 1 immediate-jeopardy problem — the most serious level
- a high number of inspection citations overall (27) — worth reading through, though larger and more-often-surveyed homes tend to accrue more lower-severity tags
- the CMS record shows $15,334 in federal fines (most recent 2025-07-28)
- its payroll- and facility-reported staffing and quality-measure scores sit well above its independent inspection score
- its independent health-inspection rating is low (1/5)
- nursing-staff turnover (59%) runs well above the national median (45%)
- about 18% of its spending goes to commonly-owned related companies
One thing this read cannot see: what residents and families actually experience day to day. Public data misses the feel of a place — visit unannounced, ideally at a mealtime or on a weekend, talk to staff and families, and ask your tour questions.
A plain-English summary of the public record below — not a rating, ranking, or recommendation. We take no money from any facility.
| Health inspectionSurveyor-assigned, ranked within your stateInspector-verified | 1 of 5 |
| StaffingFrom payroll records (PBJ) | 3 of 5 |
| Quality measuresSelf-reported by the facility | 3 of 5 |
Worth a closer look. This home's staffing and quality-measure ratings run 2 stars above its independent health-inspection score. The inspection is done by state surveyors; the quality-measure score leans on data the facility reports about itself, and staffing on its payroll (PBJ) submissions — so a gap this large is worth reading the inspection record for.
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 | 3 of 5 |
| Long-stay residentspeople who live here | 3 of 5 |
| Short-stay residentsrehab / post-hospital | 3 of 5 |
Quality-measure stars summarize outcomes CMS tracks from the assessments each home submits — avoidable hospitalizations and ER visits, falls with injury, pressure ulcers, unplanned weight loss, and long-term antipsychotic use. Because the underlying data is self-reported, weigh a high score against the independent inspection record. Long-stay = permanent residents; short-stay = rehab and post-hospital stays.
Trend — is this home getting better or worse?
Over 2025-02 to 2026-06, this home’s CMS overall rating fell from 3 to 1 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 | 16.9% | 24.4% | 15.4% | typical |
| Long-stay residents who lose too much weight | 3.6% | 5.2% | 5.4% | better |
| Long-stay residents with a catheter left in their bladder | 0.0% | 1.1% | 0.9% | better |
| Long-stay residents with a urinary tract infection | 1.8% | 2.2% | 2.0% | typical |
| Long-stay residents with depressive symptoms | 59.3% | 11.6% | 6.5% | check this† — see note marked dagger below the table |
| Long-stay residents who were physically restrained | 0.0% | 0.0% | 0.1% | better than state‡ — see note marked double-dagger below the table |
| Long-stay residents with falls causing major injury | 4.8% | 4.1% | 3.3% | worse |
| Long-stay residents whose ability to walk worsened | 33.3% | 25.6% | 16.1% | worse |
| Long-stay residents on antianxiety or hypnotic medication | 15.9% | 17.4% | 18.9% | better |
| Long-stay residents given the seasonal flu vaccine | 100.0% | 95.5% | 95.3% | typical |
| Long-stay residents with pressure ulcers | 4.2% | 4.3% | 4.7% | typical |
| Long-stay residents with worsening bladder/bowel control | 25.6% | 29.2% | 21.2% | worse |
| Long-stay residents who got an antipsychotic medication§ — see the note below the table | 29.4% | 20.2% | 17.1% | worse |
| Short-stay residents who newly got an antipsychotic medication | 0.8% | 1.2% | 1.4% | better |
| Short-stay residents given the seasonal flu vaccine | 80.3% | 74.5% | 79.4% | typical |
| Short-stay residents rehospitalized after admission | 20.0% | 20.8% | 22.6% | better |
| Short-stay residents with an outpatient ER visit | 10.2% | 16.1% | 12.0% | better |
| Long-stay hospitalizations per 1,000 resident days | 0.76 | 1.45 | 1.67 | better |
| Long-stay outpatient ER visits per 1,000 resident days | 0.93 | 2.01 | 1.80 | better |
† This value is several times the typical-state benchmark. It can be real, or it can be a coding artifact in what the facility submitted. 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.
50.2% of the Medicare patients who left this home got back to the community and stayed there for at least 31 days — which CMS reads as no different from the national rate. This is CMS’s risk-adjusted rate over 74 Medicare stays in Oct 2022–Sep 2024, and CMS’s own comparison — not ours.
Met the expected recovery: 57.9% 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 76 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 0.81 therapist hours per resident per day in 2026Q1 — more than 95% of the 13,892 homes that report any therapy hours at all.
Weekend therapy: weekend therapy hours are 11% 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 | 50.2%CMS range 38.2–62.5 | 51.5% | Oct 2022–Sep 2024 | no different from U.S. |
| Went back to hospitalRate of potentially preventable hospital readmissions 30 days after discharge from a SNF | 11.1%CMS range 7.6–15.9 | 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 | 57.9% | 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 | 46.0% | 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 | 51.3% | 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 | 96.9% | 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 | 90.9% | 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 | 95.1% | 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 | 1.0% | 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 | 8.2% | 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 | 8.3%CMS range 5.2–13.4 | 7.1% | Oct 2023–Sep 2024 | no different from U.S. |
| Medicare spending per stayMedicare Spending Per Beneficiary (MSPB) for residents in SNFs | 1.07 | 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 62 beds and averages 56.7 residents a day — about 91% occupied, or roughly 5 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 4.05 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 1.57 is at or above the 0.55-hour RN benchmark and nurse-aide staffing of 1.96 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 3.60 hrs/resident/day on weekends vs 4.24 on weekdays — 15% thinner on weekends. RN hours go from 1.71 to 1.25 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)
This home’s total nursing-staff turnover of 59% 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
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.
27 citations, most serious first. The 11 most serious are shown; the remaining 16 are one tap away and print in full.
- Immediate jeopardy · Kcited before2025-07-28 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — patternEnsure 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 water temperature observations, water temperature log reviews, interviews, and review of facility's Water Temps [temperatures] policy the facility failed to act on identified hazards in a resident's environment and implement interventions to prevent potential accidents/injuries by ensuring that hot water temperatures, accessible to residents did not exceed 120 degrees Fahrenheit for 7 of 9 months reviewed (January 2025 through July 2025) on 3 of 3 units ([NAME] River, Kennebec River and Mousam River). The failure of the facility to ensure that hot water temperatures accessible to residents did not exceed 120 degrees Fahrenheit created the potential for residents to be scalded/burned by the domestic hot water. This created an Immediate Jeopardy (IJ) situation for residents.1. On 7/24/25 at 3:19 p.m., a surveyor identified that hot water in the public bathroom across from the rehabilitation department was extremely hot to the touch. The surveyor immediately obtained a water temperature of 132.6 degrees…
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 · F2025-07-28 · tag F0835 — failed to run the facility competently — widespreadAdminister the facility in a manner that enables it to use its resources effectively and efficiently.
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 ensure the facility was Administered in a manner that ensured the resident environment remained as free from accident hazards, as evidenced by Federal findings under 42 CFR S483.25(d), F689- Free of Accident Hazards/Supervision/Devices, on 3 of 3 resident units. This failure to ensure a process was in place to monitor and correct hot water temperatures in excess of 120 degrees Fahrenheit (F) has the potential to affect all 57 residents.During a review of the facility's Hot Water Temperature Logs, from 10/31/24 through 7/18/24, the first recorded excessively high hot water temperature was on 12/2/24 at 121 degrees F. On 12/9/24, the service hall bathroom temperature was recorded at 130 degrees F. During the next 6 months, temperature logs revealed consistently high hot water temperatures. On 1/3/25, a comment was written on the log which stated all hot. On 1/10/25, a comment stated running hot due to system. On 1/13/25, a comment stated hot, faulty hot water system. On 1/21/25, a comment stated all running…
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 · Ecited before2025-07-28 · tag F0584 — failed to keep a safe, clean, comfortable home — patternHonor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations and interviews, the facility failed to adequately provide housekeeping and maintenance services necessary to maintain the building in a sanitary, orderly, and comfortable environment on 3 of 3 wings (Mousam River, Kennebec River and [NAME] River) for 2 of 2 facility tours.1. On 7/22/25 at 8:24 a.m., during an interview with the Administrator, the surveyor discussed the thick bubbled and peeling/flaking red paint on multiple doors on Mousam River unit. The Administrator explained the door repairs were part of the Plan of Correction (POC) for a citation back on 5/28/25. The facility had ordered 30 new doors that are due to come in November 2025. However, in the interim, Maintenance is removing the Acrovyn layer, sanding the door down and applying paint, stating that the red painted doors have been completed. At this time, both the surveyor and the Administrator observed the following Mousam River unit doors with bubbled/peeling/flaking red paint: the double doors into Sebago Hall, 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.
- Potential for harm · E2025-07-28 · tag F0725 — failed to have enough nursing staff — patternProvide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on Payroll Based Journal staffing (PBJ) report, weekend staffing schedules and interview, the facility failed to ensure sufficient direct care staff were scheduled and on duty to meet the needs of residents that reside in the facility for weekends of the first quarter 2025 (October 1 - December 31, 2024) and second quarter 2025 (January 1 - March 31, 2025).The Center for Medicare & Medicaid (CMS) PBJ Report revealed the facility triggered for low weekend staffing during the first quarter of 2024 and second quarter of 2025.Review of the first quarter of 2024 weekend staffing schedules indicated 8 weekend days where there was an insufficient number of direct care staff.Review of the second of 2025 weekend staffing schedules indicated 2 weekend days where there was an insufficient number of direct care staff.On 7/28/25 at 11:18 a.m., during an interview and review of the weekend staffing for the first and second quarter, the Market Clinical Advisor confirmed that the facility triggered for low weekend staffing per the PBJ reports and the facility did not ensure enough staff were…
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 · Ecited before2025-07-28 · tag F0761 — failed to label and store drugs safely — patternEnsure 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 expired medications were removed from the supply available for use in 2 of 3 medication storage rooms reviewed (Kennebunk River and Mousam River Units). 1. On 7/24/25 at approximately 10:00 a.m., a surveyor observed the medication storage room on the Kennebunk River Unit with the unit nurse manager. The emergency intravenous medication and supply stock, stored in a large plastic tote, was noted to contain 2 prepackaged syringes of Heparin lock flush 500 units/5 ml (milliliter), with expiration dates of 4/30/25. In addition, observation of the medication storage refrigerator noted 1 vial of Insulin Lispro 100 units/ml prescribed to a resident who had been discharged on 4/16/25. The unit manager confirmed the findings at the time of the observations.2. On 7/24/25 at 10:30 a.m., a surveyor observed the medication storage room on the Mousam River Unit with the Market Clinical Advisor. One (1) vial of PPD (purified protein derivative) labeled with an opened date of 6/1/25, remained available for resident use past the 30…
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 · E2025-07-28 · tag F0806 — failed to honor food preferences — patternEnsure 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, interviews, record reviews, and facility policy, the facility failed to ensure that a resident's choices for food preferences were followed for 3 of 4 residents (Resident #22, #43, and #75) 1. On 7/22/25 at 12:53 p.m. the surveyor observed Resident #22 being served a ham sandwich. Resident #22 stated he/she does not like or want pork and has met with the dietician to discuss his/her preferences but, “they still keep giving me pork”. Review of the dietary slip on the resident’s food tray only indicated, “NO EGG EVER” On 7/22/25 at 1:05 p.m., during an interview, Certified Nurses Aid (CNA) #6 stated, they keep sending it (pork) and “we keep telling the kitchen”. The surveyor observed the CNA calling the kitchen to request a substitution for resident #22’s ham sandwich. On 7/23/25 at 8:47 a.m., a surveyor observed Resident #22 being served bacon on his/her breakfast plate and then observed staff calling the kitchen. When resident #22’s second plate came out it also had bacon on it as observed by the surveyor. On 7/23/25 at 12:14 p.m., the Food Service Director…
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 · E2025-07-28 · tag F0865 — failed to run a quality-improvement (QAPI) program — patternHave a plan that describes the process for conducting QAPI and QAA activities.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on interviews and record reviews the facility failed to ensure that its Quality Assurance Process Improvement (QAPI) committee systematically identified and addressed a known safety concern related to elevated water temperatures in resident areas, despite prior awareness documented by the Safety Committee.Findings:On 07/24/25 at approximately 9:00 a.m., during an interview with the Administrator, she stated that the QAPI committee's current focus areas were identified as Falls with Injury, Trauma Services, and Staffing. There was no mention of water temperature concerns.On 07/24/25 at approximately 3:19 p.m., the survey team measured water temperatures exceeding 124 F in multiple resident-accessible areas, posing a potential risk of scalding. (See F689)On 07/24/25 at 3:45 p.m., the Administrator provided Safety Committee Minutes from February 2025, which listed Working on Repairs (AAA) for water temp issues under agenda item #5. However, no documentation was present under Action Required, and no evidence was provided that the issue had been escalated to or addressed by 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.
- Potential for harm · Ecited before2025-07-28 · tag F0880 — failed to prevent and control infections — patternProvide 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, interviews and record reviews, the facility failed that ensure staff were educated and knowledgeable about Enhanced Barrier Precautions (EBP) in 3 out of 3 units surveyed for Infection Control and Prevention. (Kennebunk River Unit, Mousam River Unit and [NAME] River Unit) Facility Policy Titled IC308 Enhanced Barrier Precautions states: In addition to Standard Precautions, Enhanced Barrier Precautions (EBP) will be used (when Contact Precautions do not otherwise apply) for novel or targeted multi-drug resistant organisms (MDROs). Enhanced Barrier Precautions (EBP) are an infection control intervention designed to reduce the transmission of novel or multi-drug resistant organisms. It employs targeted personal protective equipment (PPE) use during high contact patient/resident (hereinafter patient) activities.On 7/23/25 at 10:30 a.m., a surveyor observed EBP precaution signage on the doors of the following rooms in Kennebunk River Unit, Mousam River Unit and [NAME] River Unit; M1, M2, M8,…
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 before2025-07-28 · tag F0657 — failed to keep the care plan current — isolatedDevelop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on record review and interview, the facility failed to revise the care plan to reflect a resident's current status for 1 of 2 residents reviewed for insulin use (#46).On 7/21/25 at 11:32 a.m., a surveyor asked Resident #46 if he/she received insulin. Resident #46 stated he/she used to receive insulin twice daily and now receives none, and didn't know why this had changed. A review of the clinical record revealed diagnoses including Type 2 Diabetes Mellitus and long term use of insulin. The MDS (Minimum Data Set) 3.0 admission Assessment, dated 4/25/25, Section C, Cognitive Patterns, noted a BIMS (Brief Interview of Mental Status) score of 15, indicating Resident #46 is cognitively intact. Section N, Medications, noted Resident #46 received insulin injections. The current care plan, with a revision date of 5/15/25, for the focus area of: The resident has a diagnosis of diabetes: Insulin Dependent, includes an intervention: Provide diabetes education and related complications as appropriate. A review of physician orders noted Resident #46 had been admitted with on 4/19/25 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 · E2025-05-28 · tag F0842 — failed to keep accurate, complete medical records — patternSafeguard 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, record reviews and interviews, the facility failed to maintain a complete medical record for 5 of 5 Residents reviewed for unwitnessed falls. A surveyor reviewed the facility policy Titled Centers' Nursing Policies - NSG215 Falls Management last reviewed on 3/15/24 under Section 5.3 ; Any patient who sustains an injury to the head from a fall and/or has a fall unwitnessed by staff will be observed for neurological abnormalities by performing neurological check, per policy. A surveyor reviewed the facility policy Titled Centers' Nursing Policies - NSG204 Neurological Evaluation last reviewed 2/1/23 reads; Neurological evaluation will be performed as indicated or ordered. When a patient sustains injury to the head or face and/or an unwitnessed fall, neurological evaluation will be performed: Every 15 minutes x two hours, then Every 30 minutes x two hours, then, Every 60 minutes x four hours, then Every eight hours until at least 72 hours has elapsed. 1. On 5/28/25 a surveyor reviewed Resident #1's Electronic Medical Record (EMR) under Progress notes and learned…
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 F0609 — failed to report abuse allegations — isolatedTimely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on interviews and record reviews, the facility failed to report a fall with suspicion of negligence and significant injury within the required time frame for 1 out of 1 resident. (Resident #6) Findings: The Department of Licensing and Certification (DLC) received a report from the facility on 5/15/25 at 3:50 p.m. about a resident who fell on 5/13/25 at 10:50 p.m. The report was labeled as FINAL. There was no initial report received by the department. The report indicated Resident #6 had fallen from an elevated bed after being left alone. On 5/28/25 a surveyor reviewed the Genesis Health OPS-300 Policy - Abuse Prohibition that stated under Section 7 Immediately upon receiving information concerning a report of suspected or alleged abuse, mistreatment, or neglect, the Administrator or designee will perform the following. 7.3 Report all allegations to the appropriate state and local authority(s) involving neglect, exploitation or mistreatment (including injuries of unknown source), suspected criminal activity, and misappropriation of patient property not later than two (2) hours…
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 16 citations
- Potential for harm · Dcited before2025-05-28 · 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 record reviews, the facility failed to ensure that a resident received adequate supervision when resident was left unattended in a raised bed. This action resulted in resident fall d injury for 1 of 6 residents reviewed for falls (Resident #6). In addition, the facility failed to ensure that the resident environment was free of accidents and hazards. Findings: 1. On 5/15/25 at 3:50 p.m. the Department of Licensing and Certification (DLC) received a facility reported incident that on 5/13/25 at 10:50 a.m. Resident #6 had been left alone in an elevated bed resulting in a fall between the wall and the bed. Record review of Resident #6's Minimum Data Set assessment (MDS), dated [DATE] under section GG indicated that Resident #6 was dependent on staff for almost all Activities of Daily Living (ADL) needs including bed mobility. On 5/28/25 a surveyor reviewed Resident #6's care plan and found a focus stating Resident #6 is at risk for falls with interventions including Utilize low bed. On 5/28/25 a surveyor…
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 · E2024-09-19 · 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 observations, interviews, record reviews and the facility's Food Storage: Cold Foods, Food Storage: Dry Goods and the Food Preparation policy and Procedures, all revised on 2/2023, the facility failed to ensure that foods in the dry storage room, the walk-in refrigerator and freezer were labeled and/or dated, stored appropriately and not expired. In addition, the facility failed to ensure all foods were held at appropriate temperatures for 1 of 1 day of survey. Findings: Food Storage: Cold Foods revised 2/2023 states, all foods will be stored wrapped or in covered containers, labeled and dated, and arranged in a manner to prevent cross contamination. Food Storage: Dry Goods revised 2/2023 states, All packaged and canned food items will be kept clean, dry, and properly sealed Food Preparation policy and Procedure, revised on 2/2023 states, All Time/Temperature Control for Safety (TCS) foods frozen and refrigerated will be appropriately stores in accordance with guidelines ., Dining Services staff will be responsible for food preparation procedures that avoid contamination by…
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 · Fcited before2022-08-17 · tag F0880 — failed to prevent and control infections — widespreadProvide and implement an infection prevention and control program.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observations, record review, and interviews, the facility failed to follow the facility's Infection Control Policies and Procedures to prevent the introduction and spread of Coronavirus Infectious Disease 2019 (COVID-19) into the facility. This has the potential to affect all residents at the facility (52 residents). Findings: The facilities, Infection Control Policies and Procedures last reviewed on 6/7/2021 states, Entrance Screening. Active screening of all persons entering the Center (such as employees, visitors, medically necessary personnel, contracted staff/vendors, and volunteers) will be done upon entry into the Center. Follow the Screening of Visitors and Employees, Return to Work Guidance for Employee and Employee Workers Comp guidelines (refer to Central Coronavirus site) and section 1.2 Employees who screen positive for temperature or symptom criteria will be instructed to return home and self-isolate. On 8/16/22 at 7:00 a.m., upon entrance to the facility, there was no one at the information desk for screening and no signs on the desk with screening…
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 · E2022-08-17 · tag F0565 — failed to support the resident council — patternHonor the resident's right to organize and participate in resident/family groups in the facility.
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 review of resident council meeting minutes, interviews and facility policy, the facility failed to document results of the grievances voiced by members of the Resident Council for 6 of 8 months reviewed. In addition, the facility failed to ensure that all residents that wished to attend resident Council meetings were present (Resident's #18, #24, and #49). Findings: Review of facility policy Resident Council reviewed 3/7/18 states, .Genesis HealthCare Centers promote and support self governing and decision making Resident Councils .To provide residents, patients, and guests an opportunity to meet regularly and without interference, to participate in educational opportunities, and have input into the recreation, policies, and issues affecting their care and lives in the community . 1. Review of Resident Council meeting minutes [NAME] the following: - On 1/29/22, concerns were voiced regarding, sometimes we don't get knives with meals, and run out of mugs, and sometimes laundry takes longer, and things go…
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 · E2022-08-17 · tag F0655 — patternCreate 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 interviews, record review, and facility policy, the facility failed to ensure a baseline care plan was developed and implemented within 48 hours that included the instructions needed to provide minimum healthcare information necessary to care for 4 of 22 Residents reviewed for care plans (#22, #201, #204, and #301) Findings: Review of facility policy Person-Centered Care Plan reviewed 6/12/19 states, .The Center must develop and implement a baseline person-centered care plan within 48 hours for each patient that includes the instructions needed to provide effective and person-centered care that meet professional standards of quality care . 1. Resident #22 was admitted to the facility on [DATE] with diagnoses to include schizophrenia, bipolar disorder, and nicotine dependence. Review of the signed provider orders for July 2022 reveled orders with start date of 4/22/22 for Nicotine Patch 24-hour 21 mg/24 hr. Apply 1 patch Trans dermally one time a day for smoking cessation. Remove before applying new…
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 · Ecited before2022-08-17 · tag F0761 — failed to label and store drugs safely — patternEnsure 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 and interview, the facility failed to adequately date and properly dispose of open biologicals according to manufacturer specifications in 3 of 3 units, [NAME] River, Mousam River and Kennebunk River. Findings: 1. On 8/15/22 at 11:59 a.m., during observation of [NAME] River Unit medication storage with the Register Nurse (RN) Manager, a surveyor observed the following: - The medication storage room contained an unopened bottle of Geri Dryl with an expiration date of 5/22. The refrigerator contained 1(one) opened multi use vial of Tuberculin Purified Protein Derivative (TB) with manufacturer's directions of once entered, vial should be discarded after 30 days, further observation reveals that the TB vial did not have an opened date nor a discard date. - The [NAME] River PO medication cart contained an opened bottle of Geri Dryl with an expiration date of 5/22. At this time, the LPN, confirmed the expired medications and the TB vial should have been labeled with an open date. 2. On 8/16/22 at…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
- Potential for harm · D2022-08-17 · tag F0561 — failed to honor residents' choices — isolatedHonor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
What the surveyor found here — the official record, unedited, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review and interviews, the facility failed to ensure that a resident's choice in the area of bathing were being followed for 1 of 2 sampled residents (Resident #200). Findings: On 8/15/22 at 11:00 a.m., during an interview, Resident #200 stated that he/she has not been offered a shower or a whirlpool but prefers a shower and would like one. On 8/17/22 at 8:52 a.m., during an interview, the CNA stated Resident #200 should have 2 showers a week on Mondays and Thursday on the evening shift. Review of the Certified Nursing Assistant (CNA) documentation from admission 8/8/22 through 8/17/22 indicated he/she has not received a shower, this review did show he/she received 4 bed baths and no refusals were noted. On 8/17/22 at 9:05 a.m., both the surveyor and the [NAME] Unit Register Nurse Manager (RN) reviewed the CNA documentation for resident #200's tub/shower schedule and bathing. There was no evidence of a shower being offered/given and/or refused. The RN stated, it doesn't look like [he/she] had one.
- Potential for harm · Dcited before2022-08-17 · tag F0584 — failed to keep a safe, clean, comfortable home — isolatedHonor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation and interview, the facility failed to adequately provide housekeeping and maintenance services necessary to maintain the building in good repair and sanitary condition for 1 of 3 units for 3 of 3 survey days (Kennebunk River Unit). Finding: 1. On 8/15/22 at approximately 11:00 a.m., a surveyor observed Room K12 on the Kennebunk River Unit. One resident remained in the semi-private room. The other resident had been discharged on 8/9/22. At the bedside of the discharged resident, a full suction canister was observed, as well as bags of tube feeding and water, both dated 8/9/22, hanging from a pump. On 8/17/22 at 12:00 p.m., the surveyor observed the suction canister and tube feeding items had been removed and the room cleaned. On 8/17/22 at 12:00 p.m., the surveyor discussed with the Administrator the items that were observed in the room [ROOM NUMBER] days after the resident was discharged and available for other residents to access. 2. During observations of the Kennebunk River Unit common…
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 before2022-08-17 · tag F0657 — failed to keep the care plan current — isolatedDevelop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
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 review and revise the care plan to reflect the current needs of a resident in the area of infection control. (#46) Finding: A review of Resident #46's clinical record noted the resident was re-admitted on [DATE] from an acute care hospital. The hospital Discharge summary, dated [DATE], stated Precaution Alert: ESBL (Extended Spectrum Beta-Lactamase), MRSA (Methicillin-resistant Staphylococcus aureus), both Multidrug Resistant Organisms (MDRO). The discharge summary contained a note stating the resident had previously been treated at the hospital for an ESBL urinary tract infection and discharged on 7/14/22. The dashboard for Resident #46's electronic medical record noted MRSA G-tube site, (gastrostomy tube). A review of Resident #46's care plan, with a revision date of 8/10/22, did not include the requirement for staff to use transmission-based precautions when providing care in order to prevent disease transmission. On 8/16/22 at 2:45 p.m., in 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 · Dcited before2022-08-17 · 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 record reviews, interviews and the facility's Resident Smoking Policy, the facility failed to complete an assessment of resident capabilities and deficits to determine resident safety for 2 of 2 residents reviewed for smoking. (Resident #22, and #301). Findings: Review of provided Survey Ready Binder undated, section 4: states [RiverRidge] is a non-smoking facility for residents. If a resident chooses to smoke the process for Smoking would be followed and a smoking assessment would be completed for safety purposes. [RiverRidge] Center does not currently have any residents that choose to smoke. However, any resident [who do choose] to smoke have a designated smoking area (away from the building) which they can identify. All residents have a smoking assessment, and care plan to reflect this status. Staff store and manage the lighters and cigarettes for all residents who smoke.] Review of facility Smoking Policy reviewed 11/4/19 states, .For Centers that allow smoking, smoking (including the use 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 · D2022-08-17 · tag F0759 — failed to keep medication error rate low — isolatedEnsure medication error rates are not 5 percent or greater.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observation, interview, and record review, the facility failed to be free of medication error rate of 5% or more. There was a total of 2 medication errors out of 27 opportunities. The medication error rate was 7.41%. Findings: On 8/16/22 at approximately 7:39 a.m., a surveyor observed the Licensed Practical Nurse (LPN) prepare medications for Resident #49, which included physician orders for: Escitalopram Oxalate Tablet 5mg (milligrams), Give 2 tablet by mouth one time a day for depression and Cholecalciferol Tablet 25mcg (microgram), Give 2 tablet by mouth one time a day for supplement. The LPN dispensed one tab of the Escitalopram 5mg and one tab of the Cholecalciferol 25mcg into the medicine cup. She then locked the medication cart, grabbed the medicine cup and the water, completing the medication preparation. At this time the surveyor intervened, questioning the dosage/number of tablets dispensed of both the Escitalopram and Cholecalciferol. The LPN reviewed the medications in the medicine cup and confirmed she did not dispense the correct number of tablets for both…
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 · D2022-08-17 · tag F0908 — failed to keep essential equipment working — isolatedKeep all essential equipment working safely.
What the surveyor found here — the official record, unedited, may be distressing
Based on observations, and interviews, the facility failed to ensure that the residents' wheelchairs were maintained in good repair to provide safe and functional use for 2 of 2 residents observed (#5 and #301). 1. On 8/15/22 at 11:38 a.m., observation of Resident #5's wheelchair's foot board had pieces missing along the edge with bare foam and rubber showing, creating an uncleanable surface. The wheelchair also had a heavy amount of food waste along the side and base. At this time, the wheelchair conditions were confirmed with the Mousam River Registered Nurse Unit Manager. 2. On 8/15/22 at 2:37 p.m., 8/16/22 at 1:37 p.m., and 8/17/22 at 10:00 a.m., observations of Resident #301's wheelchair with the right-side armrest missing. On 8/17/22 at 10:02 a.m., in an interview with the Kennebec Registered Nurse Manger, she confirmed the condition of the wheelchair stating, she had attempted to secure it back on multiple times but it will not stay on and the facility does not currently have a maintenance person.
- Potential for harm · Ecited before2020-01-16 · tag F0584 — failed to keep a safe, clean, comfortable home — patternHonor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
What the surveyor found here — an excerpt from the official record, may be distressing
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations and interviews, the facility failed to ensure the resident environment was clean and homelike in 3 of 3 resident units and 5 of 8 common areas during 1 of 4 days of survey. Findings: On 1/14/20 between 11:15 a.m. and 12:15 p.m., during a tour with the Administrator, Director of Maintenance and Director of Nursing, a surveyor confirmed the following: 1. On the Moussam River Unit: -Whirlpool Room: missing floor tile piece at threshold, multiple black skid marks on floor, radiator with chipped paint, missing and stained caulking at base of toilet. -Brown substance on carpeted wall near Supplies closet, corner of cove base heavily soiled and torn; -Brown substance on carpeted wall outside of room [ROOM NUMBER]. -Cove base between rooms [ROOM NUMBERS] with chipped paint. -Missing laminate on corner of wall across from the nursing station. -Activity/Dining Room (Sebago): casing and walls with heavily chipped paint. -The two activity/dining rooms (Arrowhead): radiators with chipped paint, casings…
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 before2020-01-16 · 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 — the official record, unedited, may be distressing
Based on observations and interviews, the facility failed to ensure proper storage of medications on 1of 3 units (Kennebunk Unit) during 1 of 4 survey days. Finding: On 1/13/20 at 6:01 p.m., upon entry to the Kennebunk Unit, a surveyor observed the Registered Nurse (RN) walk away from the nurse's medication cart and enter a resident's room, leaving the medication unlocked and unattended for approximately 2 minutes. Upon returned to the medication cart the RN confirmed with the surveyor that is was unlocked and unattended. On 1/15/20 at 3:15 p.m., during an interview with the Administrator and Director of Nursing, a surveyor confirmed the unattended and unlocked medication cart allowed residents and other unauthorized persons access to medications.
- No harm found · B2022-08-17 · tag F0641 — patternEnsure each resident receives an accurate assessment.
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 that a Minimum Data Set, Version 3.0 (MDS) was accurately coded for 2 of 3 residents reviewed for infections. (#46 and #201) Findings: 1. Resident #46's clinical record stated the resident was re-admitted on [DATE] from an acute care hospital. The hospital Discharge summary, dated [DATE], stated Precaution Alert: ESBL (Extended Spectrum Beta-Lactamase), MRSA (Methicillin-resistant Staphylococcus aureus), both Multidrug Resistant Organisms (MDRO). A Significant Change Assessment, with an Assessment Reference Date (ARD) of 7/26/22, and completed on 7/26/22, and a Medicare 5-day MDS, with an ARD of 8/1/22, completed on 8/1/22, under Section Infections I1700, Multidrug-Resistant Organism (MDRO), both were checked under the NO column. On 8/16/22 at 3:20 pm, the finding was discussed with the Director of Nursing and the Senior Director of Nursing. 2. Resident #201's clinical record stated that the resident was re-admitted on [DATE] with a diagnosis 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.
- No harm found · B2020-01-16 · tag F0623 — patternProvide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on interview and record review, the facility failed to issue a written transfer/discharge notice to residents or their representative for a facility-initiated transfer/discharge for 2 of 3 sampled residents transferred/discharged to an acute care facility (Residents #33 and #57). Findings: 1. On record review, the surveyor noted Resident #33 transferred to an acute care facility on 11/4/19 for further evaluation and treatment. The surveyor could not locate evidence that a written transfer/discharge notice was provided to the resident's representative. On 1/15/20 at 1:35 p.m., the Charge Nurse informed the surveyor she could not locate any evidence that the discharge/transfer notice was provided to the resident representative. The surveyor later confirmed the finding during an interview with the Director of Nursing and Administrator on 1/15/20 at 3:15 p.m. who confirmed a clear process was not in place to consistently insure a written notice is provided to the resident representatives. 2. On record review, the surveyor noted Resident #57 had transferred to an acute care…
This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.
“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
$15,334 in federal fines across 1 penalty.
- $15,334 — penalty dated 2025-07-28
Dates are the dates CMS records the penalty, not the date of the conduct behind it. CMS publishes penalties on a rolling window, so this is what is currently on the public file — not the home’s lifetime history, and an older fine may attach to a problem that has since been corrected. The amounts are as imposed: the CMS file does not record whether a penalty was appealed, reduced, or paid, so we don’t say. Ask the home what each one was for and what changed since.
Part of a chain
This home belongs to GENESIS HEALTHCARE — 184 facilities. Here is how its ratings compare with the chain’s average across all its homes: See the whole chain — ratings, flags, fines and finances →
| Rating | This home | Chain avg | |
|---|---|---|---|
| Overall | 1 of 5 | 2.4 | -1.4 vs chain |
| Health inspection | 1 of 5 | 2.3 | -1.3 vs chain |
| Staffing | 3 of 5 | 2.5 | +0.5 vs chain |
| Quality measures | 3 of 5 | 3.5 | -0.5 vs chain |
The other 183 homes this chain runs (chain average 2.4★, per CMS)
Showing 40 of 183; lowest-rated first.
A home rated well below its chain’s average can signal local problems; a chain with a low average across the board is a bigger pattern worth researching. CMS chain data under-reports private-equity and REIT ownership, so treat this as a floor, not the full picture.
Who owns this facility
| Owner / manager | Type | Role | Share | Since |
|---|---|---|---|---|
| GENESIS HEALTHCARE OF MAINE LLC | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100% | since 04/23/2012 |
| FC-GEN OPERATIONS INVESTMENT LLC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED | since 02/02/2015 |
| GEN OPERATIONS I LLC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED | since 02/02/2015 |
| GEN OPERATIONS II LLC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED | since 02/02/2015 |
| GENESIS HEALTHCARE INC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED | since 02/02/2015 |
| GENESIS HEALTHCARE LLC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED | since 02/02/2015 |
| GENESIS HOLDINGS LLC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED | since 02/02/2015 |
| GHC HOLDINGS LLC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED | since 12/01/2012 |
| SUN HEALTHCARE GROUP INC | Organization | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED | since 02/02/2015 |
| WHITMAN, ARNOLD | Individual | 5% OR GREATER INDIRECT OWNERSHIP INTEREST | NO PERCENTAGE PROVIDED | since 03/01/2015 |
| BERG, MICHAEL | Individual | CORPORATE OFFICER | — | since 03/02/2015 |
| BRIDGEFORD, LAURA | Individual | CORPORATE OFFICER | — | since 06/01/2024 |
| MENDELSON, AVI | Individual | CORPORATE OFFICER | — | since 06/01/2024 |
| DOANE, STEPHEN | Individual | OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNF | — | since 03/01/2024 |
| MORRIS, DIANE | Individual | OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNF | — | since 12/23/2023 |
| ROLLINS, TARA | Individual | OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNF | — | since 03/01/2024 |
CMS files one row per role, so the 19 rows in the source record cover these 16 parties — each is shown once here with every role it holds. Nothing is omitted.
9 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 $1.8M paid to related parties — landlords or management companies under common ownership — equal to about 18% of its total expenses. Money routed to affiliated companies can leave a home’s own books looking lean while owners still profit; it is the mechanism regulators watch most closely in private-equity and REIT deals.
Source: CMS Healthcare Provider Cost Reporting Information System (HCRIS), Medicare cost report Form CMS-2540 · fiscal year 2023. Facilities self-file these reports; figures are unaudited and a year or two behind. A home with no Medicare cost report on file shows no figures here.
Cost & finances
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 ME
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 Maine 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 205065. CMS refreshes its data monthly, and the star rating rests on the last standard inspection — dated 2025-07-28, 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.