Hoyt Nursing & Rehab Centre

Location & what’s nearby

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Nearest of each type, straight-line distance. Hospitals come from the CMS Hospital General Information registry; everything else from Overture Maps (public data). Hospital and park hours are typical — call ahead to confirm.

Quality measures — how residents actually fare

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

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

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

47.1% 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 120 Medicare stays in Oct 2022–Sep 2024, and CMS’s own comparison — not ours.

Met the expected recovery: 61.4% 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 70 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 0.39 therapist hours per resident per day in 2026Q1 — more than 66% of the 13,892 homes that report any therapy hours at all.

Weekend therapy: weekend therapy hours are 7% of this home’s weekday level — it runs some therapy at the weekend, at a lower level than on weekdays. The median home that reports therapy runs 13% — weekday-focused therapy is the industry norm, not a shortfall. But recovery does not pause on a Saturday: ask what the weekend actually looks like here.

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

Staffing

How full it usually is: this home is certified for 128 beds and averages 89.3 residents a day — about 70% occupied, or roughly 39 beds typically open. It often has substantial empty capacity — worth asking why, since low census can reflect either a new or shrinking home or one families are avoiding. This is a CMS average, not live availability — no public source publishes real-time vacancies, and a home can be full the day you call. Confirm with the home, and if you need a Medicaid bed specifically, ask about that separately: a home with open beds may still not have an open Medicaid bed.

Against a benchmark — not a legal minimum. In May 2024 CMS finalized the first federal staffing floor for nursing homes: 3.48 total nurse hours per resident per day, including 0.55 RN hours and 2.45 nurse-aide hours. Its hour requirements never took effect and are no longer on the books. Homes had until 2026 (2027 if rural) to comply, and that deadline never arrived: a federal court vacated the hour requirements in April 2025 (CMS has appealed), Congress then barred enforcement until 2034, and CMS formally repealed them by rule effective February 2026. This home is not required to meet these numbers, and is not violating anything by missing them. We still show the comparison because the figures are CMS’s own published estimate of adequate staffing, which makes them a useful yardstick — but they are our benchmark, not federal law: this home’s total nurse staffing of 3.88 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 0.40 is below the 0.55-hour RN benchmark and nurse-aide staffing of 2.44 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 3.62 hrs/resident/day on weekends vs 3.98 on weekdays — 9% thinner on weekends. RN hours go from 0.47 to 0.22 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)

This home’s total nursing-staff turnover of 43% is about the same as 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 more than at the previous inspection — worsening. Fewer citations over time suggests a home is fixing problems; a rising count is a warning sign — though two surveys are a short record, and survey teams differ. These counts are from the standard annual health survey only; the full citation list below may also include findings from complaint investigations, so the two won’t always add up.

Inspection deficiencies

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

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

33 citations, most serious first. The 13 most serious are shown; the remaining 20 are one tap away and print in full.

• Actual harm · Gcited before2025-05-22 · tag F0686 — failed to prevent and treat pressure sores (bedsores) — isolated
  Provide appropriate pressure ulcer care and prevent new ulcers from developing.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observation, interview and record review, the facility failed to prevent the development of a facility-acquired, Stage IV pressure ulcer for one resident (Resident #58) of two residents reviewed, resulting in the development of a new left heel pressure injury, while residing in the facility with the potential for pain /discomfort, prolonged illness, and infections. Findings include: Resident #58: In an interview on 05/20/25 at 08:56 AM Resident #58 stated that she has a new sore to the bottom of her foot that she did not have when she came. Resident #58 was noted to be seated in a reclining position in the bed watching (Detroit) Tiger baseball on TV. Observation of APM air mattress to bed was in place set to 27-minute cycle with #5 comfort level settings. There were no soft boots noted on the resident at that time. Record review of Resident #58's 'Skin & Wound' tab in the electronic medical record revealed that on 1/9/2025 a wound photo noted left heel eschar, a new pressure injury. Measurements of the left heel pressure injury were documented as: new exact date 1/9/2025…

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

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Actual harm · G2025-04-11 · tag F0600 — failed to protect residents from abuse and neglect — isolated
  Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY This Citation pertains to Intake Numbers MI00151907 and MI00152097. Based on observation, interview and record review, the facility failed to prevent resident-to-resident abuse/assault of one resident (Resident #101), resulting in Resident #101, who was totally dependent for all care and had bilateral lower limb amputations and upper extremities contractures, receiving a black eye with facial contusions while residing in the facility. Findings include. Record review of the Health Care Association of Michigan (HCAM) 'Rights or Residents in Michigan Nursing Facilities' 2022 booklet revealed 'You have the right to designate a representative, in accordance with state law and any legal surrogate so designated may exercise the resident's rights to the extent provided by state law . Respect & Dignity: The right to receive written notice, including the reason for the change, before your room or roommate in the facility is changed. Safe environment: You have the right to a safe, clean, comfortable and homelike…

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

  Freedom from Abuse, Neglect, and Exploitation Deficiencies · Deficient, Provider has date of correction
• Actual harm · Gcited before2025-04-11 · tag F0684 — failed to provide proper treatment and quality of care — isolated
  Provide appropriate treatment and care according to orders, resident’s preferences and goals.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY This Citation pertains to Intake Number MI00151904. Based on interview and record review, the facility failed to 1) Ensure that a timely, complete and accurate resident assessment was done for a change of condition and 2) Transfer a resident to the hospital in a timely manner for 1 resident (Resident #101) of 5 residents reviewed for quality of resident care, resulting in a failure to transfer to the hospital during an acute change of condition, decreased blood pressure, increased pulse rate, increased temperature, and, subsequently, death. Findings Include: Resident #101: Review of the Face Sheet, Minimum Data Set (MDS, resident assessment toll), dated [DATE], nursing and physician progress notes dated [DATE] through [DATE], and care plans dated 3/25, revealed Resident #101 was 59 years-old, alert, admitted to the facility on [DATE] from the hospital with a diagnosis of sepsis, and dependent on staff for Activities of Daily Living. The resident's diagnoses included, pneumonic, acute on chronic respiratory…

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

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2026-05-11 · tag F0553 — failed to let residents help plan their care — isolated
  Allow resident to participate in the development and implementation of his or her person-centered plan of 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 This Citation pertains to Intake Number 2995609.Based on interview and record review, the facility failed to ensure that quarterly care planning meetings were accomplished and that the resident and resident's representative were included in the care planning allowing them to make informed decisions regarding healthcare and treatment options for one resident (Resident #1) of one resident reviewed for care planning. Findings include:Resident #1 (R1):A review of R1's medical record revealed an admission into the facility on 5/9/24 and a readmission on [DATE] with diagnoses that included fracture of right femur, history of falling, unsteadiness on feet, abnormalities of gait and mobility. A review of the Minimum Data Set assessment, dated 3/4/26, for R1 revealed a Brief Interview of Mental Status score of 14/15 that indicated intact cognition and the Resident needed substantial/maximal assistance to roll left and right and was dependent on helper for transfers. On 5/7/26 at 10:44 AM, an interview was conducted 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.

  Resident Rights Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2025-05-22 · tag F0578 — failed to honor advance directives / code status — isolated
  Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review the facility to timely update and formulate advance directives for two residents (#37 and #239) of two residents reviewed for advance directives (legal documents that allow a person to identify decisions about end-of-life care ahead of time). Findings Include: Resident #37: On [DATE] at 3:20 PM, a review was conducted of Resident #37's medical record and it indicated she admitted to the facility on [DATE] with diagnoses that included Atherosclerotic Heart Disease, Diabetes, Hypertension, Dementia, Orthopedic aftercare, Anxiety and Depression. Further review of Resident #37's chart showed there had been no discussion with the resident or her daughter regarding formulating advance directives. Social Services Assessment [DATE]: -No mention of advance directives nor is there is section within this assessment to address it. Progress Notes: [DATE] at 02:27: Resident arrived via (ambulance) 2 pa (person assist) resident here for after care of electrical cervical laminectomy,…

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

  Resident Rights Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2025-05-22 · tag F0657 — failed to keep the care plan current — isolated
  Develop 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 observation, interview and record review, the facility failed to update care plans for one resident (#69) of two residents reviewed, resulting in a failure to add interventions for timely reweighs of Resident #69 to prevent weight loss. Findings include. Resident #69: Observation on 05/20/25 at 02:25 PM of Resident #69 was lying in bed with the head of the bed elevated. Resident #69 was noted to have loose skin to neck and upper arm areas. The surveyor questioned possible weight loss. Record review of resident medical record weights log on 04/07/2025, the resident weighed 131.4 lbs. On 05/07/2025, the resident weighed 121.2 pounds which is a -7.76 % Loss in 30 days. Record review of Resident #69's 'Nutritional' care plan date initiated 8/1/2024 and revision date of 2/27/2025 revealed that there were no added interventions to address the new weight loss of 10.2 pounds in 30 days. There were interventions to re-weigh the resident in a timely manner, or when to re-weigh on a regular basis. In an Interview on 05/21/25 at 02:45 PM with the Registered Dietitian (RD) M stated that…

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

  Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Dcited before2025-05-22 · tag F0684 — failed to provide proper treatment and quality of care — isolated
  Provide appropriate treatment and care according to orders, resident’s preferences and goals.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview and record review, the facility failed to document and notify the physician of a popped/ruptured boil/skin condition for one resident (Resident #36), resulting in Resident #36 having a right anterior neck boil that was 'popped by a staff member with no physician's order, no documentation of the wound site and drainage, with the potential for infection. Findings include: In an interview on 05/21/25 at 02:19 PM with the Director of Nursing and Clinical Consultant A notified the state surveyor that there were no nursing policies for: Pressure ulcer staging policy for skin, Nursing documentation policy, physician order policy, and/or standards of care policy. The Clinical Consultant stated, we have standards used by goggle, nurses use their phones. Resident #36: Record review of Resident #36's 'Skin assessment' form dated 5/9/2025 noted a boil to right side back of neck, there were no measurements of size of diameter and/or height, color or edema of the boil noted. The nurse…

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

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Dcited before2025-05-22 · tag F0688 — failed to keep residents mobile / prevent decline — isolated
  Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview and record review the facility failed to implement continuation of preventative mobility services for one resident (#37) of one resident reviewed for restorative therapy services. Findings Include: Resident #37: On 5/20/2025 at 2:55 PM, Resident #37 was observed sitting in her wheelchair in her room. She stated she was waiting on a ramp and bathroom handrails to be installed at her daughter's home and then she would be discharged home. Resident #37 expressed concern that since being cut from therapy on 5/13/25, she is scared she will lose the advances she made, which will make the transition back home more difficult. Resident #37 was asked if she is in a restorative program, and she stated she is not. She reported facility staff only get her out of bed, assist with care and help her in /out of the wheelchair. On 5/20/2025 at 3:20 PM, a review was conducted of Resident #37's medical record and it indicated she admitted to the facility on [DATE] with diagnoses that included…

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

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2025-05-22 · tag F0691 — failed to provide colostomy / ostomy care — isolated
  Provide appropriate colostomy, urostomy, or ileostomy care/services for a resident who requires such services.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview and record review, the facility failed to ensure the prevention of cross contamination during colostomy care for 2 resident's (Resident's #40 and #69) of 2 resident's reviewed for ostomy care, resulting in the high potential for cross contamination, resident and staff illness with possible hospitalization. Findings Include: Resident #40: Review of the Face Sheet, care plans dated 6/24, and diagnosis list, revealed Resident #40 was [AGE] years old, admitted to the facility on [DATE], had a Guardian in place for medical and finical decisions, and was dependent on staff for all Activities of Daily Living/ADL's. The residents' diagnosis included, Acute kidney failure, carrier or suspected carrier of Methicillin Susceptible Staphylococcus Aures (antibiotic resistant organism), ulcerative pancolitis, chronic kidney disease, anemia, high blood pressure, diabetes, anxiety disorder, ileostomy status (artificial opening in large intestines), Bipolar disorder, Crohn's disease, cognitive…

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

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2025-05-22 · tag F0693 — failed to provide proper feeding-tube care — isolated
  Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview and record review, the facility failed to ensure supervision, follow care-planned interventions and physician's orders for one resident (Resident #81) of one resident reviewed for NPO status (nothing by mouth), resulting in access to water at bedside, resident's admitted consumption of the water with the likelihood of asymptomatic aspiration going unnoticed/unassessed. Findings include. Resident #81: On 5/20/25, at 8:59 AM, Resident #81 resting in bed awake. There is an enteral feed pump on a pole without feed solution. There was a clear plastic lidded cup with an open straw on their over bed table with approximately ¾'s full of water. There is an additional clear plastic cup 1/3 full of water with a white plastic spoon. On 5/20/25, at 9:03 AM, CNA P entered Resident #81's room and was overheard speaking to the resident I have to throw it away because the ice chips melted. On 5/20/25, at 11:19 AM, a record review of Resident #81's electronic medical record revealed an admission on…

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

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2025-05-22 · tag F0726 — failed to have competent, trained nursing staff — isolated
  Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview and record the review the facility failed to prevent medication errors and missed admission medication doses for one resident (Resident #240) of one resident reviewed for new resident admission. Findings include: Resident #240: On 5/20/2025 at 9:37 AM, Resident #240 was observed laying in bed and it appeared she was holding something in her mouth. Her daughter had called via Facetime (while this writer was in the room) and explained if her pills are administered whole, at time she will not swallow them. Two nurses entered the room and readjusted Resident #240 in the room and Nurse F stated she administered her medications this morning and they were crushed, in applesauce. The resident eventually opened her mouth and there was nothing found. Quick review was completed of Resident #240 physician orders and there was no, order located for crushing of medications. On 5/20/2025 at approximately 1:00 PM, a review was conducted of Resident #240's medical record and it indicated she…

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

  Nursing and Physician Services Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2025-05-22 · tag F0757 — failed to avoid unnecessary drugs — isolated
  Ensure each resident’s drug regimen must be free from unnecessary drugs.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview and record review, the facility failed to attempt a Gradual Dose Reduction (GDR) for one resident (Resident #49) of one resident reviewed for mood, resulting in a lack of an attempt at a GDR for psychotropic medications, Cymbalta and Trazadone. Findings include. Resident #49: On 5/20/25, at 8:37 AM, Resident #49 was resting in their bed with their eyes open and did not respond to good morning. On 5/20/25, at 8:40 AM, CNA P offered Resident #49 doesn't always respond depending on their morning mood. On 5/20/25, at 3:03 PM, Resident #49 was in their room in their wheelchair eating a snack. On 5/21/25, at 1:14 PM, a record review of Resident #49's electronic medical record revealed an admission on [DATE] with diagnoses that included Stroke, Depression and Dementia. Resident #49 had severely impaired cognition and required assistance with all Activities of Daily Living. A review of the Physician orders revealed: Cymbalta Oral Capsule Delayed Release Particles 20 MG (Duloxetine HCl)…

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

  Pharmacy Service Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Dcited before2025-05-22 · tag F0761 — failed to label and store drugs safely — isolated
  Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observation, interview and record review, the facility failed to store and discard medications for 4 of 5 medication carts reviewed, resulting in a lack of dating of multi-dose medications (insulins/Inhalers/eye drops), accu-check solution and sticks opened and undated. Findings include: Observation and interview on 05/20/25 at 08:45 AM with licensed Practical Nurse (LPN) D of the 400-unit medication cart revealed: In the top drawer of the cart there to be a clear plastic medication 30ml cup with 4 white capsules noted already set-up in the drawer. LPN D stated that she did not put those in the cart and that they were already in the cart when she came on duty at 6:30AM and they were already in the cart. LPN D stated that she believed the capsules were Acidophiles capsules. Observation of the left-hand small drawer revealed there to be blood sugar monitoring supplies. Observation of the Accu-check solutions were not dated when opened and blood sugar sticks note to be undated also. Observation, interview and records review on 05/20/25 at 09:28 AM with Licensed Practical Nurse…

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

  Pharmacy Service Deficiencies · Deficient, Provider has date of correction

“Cited before” means this same F-tag appears on at least one other survey date in the record we hold — counting complaint investigations as well as standard surveys, with no time limit. It is our own read of the data, not CMS’s: CMS uses repeat deficiency as a formal term tied to consecutive standard surveys, and that is a narrower test than this one. A tag marked here may or may not meet it.

Fines & penalties

$30,740 in federal fines across 1 penalty.

• $30,740 — penalty dated 2025-05-22

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 NEXCARE HEALTH SYSTEMS — 20 facilities. Here is how its ratings compare with the chain’s average across all its homes: See the whole chain — ratings, flags, fines and finances →

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

Who owns this facility

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 $1.5M paid to related parties — landlords or management companies under common ownership — equal to about 13% 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. 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.

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