Olivia Restorative Care Center

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.

Therapy staffing: this home’s payroll records show 0.13 therapist hours per resident per day in 2026Q1 — more than 9% of the 13,892 homes that report any therapy hours at all.

Weekend therapy: weekend therapy hours are 3% of this home’s weekday level — it runs therapy on weekdays, with essentially none at the weekend. 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 60 beds and averages 44.5 residents a day — about 74% occupied, or roughly 16 beds typically open. It usually has some room. This is a CMS average, not live availability — no public source publishes real-time vacancies, and a home can be full the day you call. Confirm with the home, and if you need a Medicaid bed specifically, ask about that separately: a home with open beds may still not have an open Medicaid bed.

Against a benchmark — not a legal minimum. In May 2024 CMS finalized the first federal staffing floor for nursing homes: 3.48 total nurse hours per resident per day, including 0.55 RN hours and 2.45 nurse-aide hours. Its hour requirements never took effect and are no longer on the books. Homes had until 2026 (2027 if rural) to comply, and that deadline never arrived: a federal court vacated the hour requirements in April 2025 (CMS has appealed), Congress then barred enforcement until 2034, and CMS formally repealed them by rule effective February 2026. This home is not required to meet these numbers, and is not violating anything by missing them. We still show the comparison because the figures are CMS’s own published estimate of adequate staffing, which makes them a useful yardstick — but they are our benchmark, not federal law: this home’s total nurse staffing of 3.62 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 0.73 is at or above the 0.55-hour RN benchmark and nurse-aide staffing of 2.49 is at or above the 2.45-hour aide benchmark. What federal law does require today is unchanged: “sufficient” nursing staff for residents’ needs and an RN on duty at least 8 consecutive hours a day, 7 days a week (42 CFR 483.35). Those are judged by inspectors on site, not by these averages, so read this comparison alongside the inspection record rather than as a pass/fail.

Weekend coverage: total nurse staffing is 3.20 hrs/resident/day on weekends vs 3.79 on weekdays — 16% thinner on weekends. RN hours go from 0.80 to 0.55 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%. 1 administrator has left in the past year.

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

Inspection trend

Deficiencies are unchanged from the previous inspection. 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.

40 citations, most serious first. The 16 most serious are shown; the remaining 24 are one tap away and print in full.

• Immediate jeopardy · Jcited before2025-05-30 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolated
  Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and document review, the facility failed to provide assessed supervision needs for 2 of 3 residents (R1, R4) who were at risk for elopement. R1 was able to leave the facility undetected for one hour despite having a wander guard on, which resulted in an immediate jeopardy (IJ). The IJ began on 5/21/25, when R1, while wearing a wander guard bracelet, successfully eloped from the building without the alarm sounding. R1 was allowed out of the locked front entrance by an unknown responsible party (had the pin code to the locked door), crossed a highway, and was found by community members approximately one mile from the facility an hour later, winded but unharmed. The administrator, director of nursing (DON), and nurse consultant were notified of the immediate jeopardy on 5/29/25 at 9:30 a.m. The immediate jeopardy was removed on 5/29/25, but noncompliance remained at the lower score and severity of D, which indicated no actual harm with potential for more than minimal harm which is…

  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 plan of correction
• Immediate jeopardy · Jcited before2025-05-12 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolated
  Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and document review, the facility failed to comprehensively assess supervision needs, develop individualized person-centered interventions to mitigate risks and hazards for 1 of 3 residents (R1) reviewed for elopement risk. This resulted in an immediate jeopardy (IJ) when R1 left the facilty without staff knowledge and was found 12 blocks away, unharmed by a community member. The immediate jeopardy began on 5/5/25 when R1 left the facility and was found by a community member several blocks away confused, and returned to the facility by local police. The IJ was identified on 5/8/25. The administrator, director of nursing (DON), director of operations, and director of clinical operations were notified of the immediate jeopardy on 5/8/25 at 5:10 p.m. The immediate jeopardy was removed on 5/12/25, but noncompliance remained at the lower scope and severity level of D, which indicated no actual harm with potential for more than minimal harm that is not immediate jeopardy. Findings…

  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
• Immediate jeopardy · Lcited before2025-04-09 · tag F0880 — failed to prevent and control infections — widespread
  Provide and implement an infection prevention and control program.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and document review the facility failed to implement infection control strategies for respiratory protection to mitigate the risk and spread of Respiratory Syncytial Virus (RSV- an infection of the respiratory tract). As a result, the facility developed an outbreak where 8 residents (R10, R13, R14, R11, R12, R17, R6, and R16) tested positive for RSV and 3 residents were suspected to have RSV (R15, R7, R18); 2 residents (R10 and R12) were seen in the emergency department (ED) and 3 residents (R11, R13, and R14) were hospitalized at a higher level of care. This resulted in a system wide failure in infection control procedures to prevent the spread of illness within the facility resulting in an immediate jeopardy (IJ) which placed all residents at a high likelihood of serious illness and/or death by contracting a communicable respiratory disease. The Immediate Jeopardy (IJ) began on 3/23/25 when R10 tested positive for RSV and the facility failed to implement infection control…

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

  Infection Control Deficiencies · Deficient, Provider has date of correction
• Immediate jeopardy · Jcited before2025-04-09 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolated
  Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and document review the facility failed to comprehensively assess falls for root cause, revise the care plan and implement appropriate interventions to prevent and/or reduce the risk of falls with major injury for 2 of 3 residents (R20, R22) who had falls. This resulted in an immediate jeopardy for R20 who had a history of traumatic brain injuries and sustained a fall that resulted in a subdural hematoma and was hospitalized . The IJ began on 3/28/25 after R20 had a fall, the facility failed to assess and implement appropriate interventions to prevent/mitigate risk for falls which resulted in R20's fall on 4/4/25 in which R20 suffered an intercranial brain injury and hospitalization. The Administrator, director of nursing (DON) were notified of the IJ on 4/8/25 at 6:32p.m. The immediate jeopardy was removed on 4/9/25 at 4:40 p.m., but non-compliance remained at the lower scope and severity level D, which indicated no actual harm with the potential for more that minimal harm 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.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Actual harm · G2025-08-20 · tag F0760 — failed to prevent significant medication errors — isolated
  Ensure that residents are free from significant medication errors.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview, and document review, the facility failed to correctly transcribe medication orders according to physician instructions, for 2 of 4 (R10 and R11) residents reviewed for transcription of orders. This error resulted in R10 missing four doses of her long- acting insulin that led to her re hospitalization to intensive care units (ICU) due to diabetic ketoacidosis (DKA), a serious complication of diabetes. Findings include:R10's face sheet, undated, identified she was admitted to the facility on [DATE] with diagnoses of type one diabetes (dependent on insulin to control blood sugars).R10's hospital Discharge summary dated [DATE], indicated R10 was admitted to ICU on 8/11/25, for DKA and septic shock from a urinary tract infection (UTI). R10's insulin regime was readjusted at discharge.R10's hospital discharge orders dated 8/14/25, indicated to inject subcutaneously (SQ) 25 units of insulin glargine (Lantus)100 units/milliliter, every evening.R10's electronic medical record (eMAR), dated for August…

  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
• Actual harm · Gcited before2025-02-14 · 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 interview and document review, the facility failed to complete an assessment including, vital signs and general condition, when a change in condition was reported to a nurse for 1 of 3 (R1) residents reviewed for quality of care. This resulted in harm for R1 who continued to decline and later that day required emergency medical care and passed away. Findings include: R1's admission Minimum Data Set (MDS), dated [DATE], indicated R1 had diagnoses of multiple sclerosis, sepsis (a serious infection), and acute ischemia of the intestine (when the blood flow to the intestine is suddenly cut off). R1's MDS indicated she required substantial assistance with all activities of daily living (ADLs) and was cognitively intact. R1's care plan, dated [DATE], indicated R1 was dependent on staff assistance for bed mobility, dressing and personal hygiene. R1's care plan indicated she was dependent on the assistance of staff to pivot transfer to/from the bed to the wheelchair or commode. A Physicians Order for Life…

  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 before2025-12-03 · tag F0609 — failed to report abuse allegations — isolated
  Timely 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

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and document review the facility failed to report an allegation of abuse timely to law enforcement and the State Agency for 1 of 1 resident (R1) reviewed for allegations of abuse.Findings include: A Vulnerable Adult Maltreatment Report submitted to the State Agency on 11/23/25, alleged staff to resident sexual abuse when on 11/21/25, R1 reported that on 11/4/25, during his bath, nursing assistant (NA)-A put her fingers in his rectum, washed his genitals too long, and gave him an erection. R1 reported this embarrassed him. This incident was reported to the director of nursing (DON), and assistant director of nursing (ADON) on 11/21/25. The DON verbalized awareness of the alleged abuse and had done an investigation. The report noted the alleged sexual abuse had not been previously reported to law enforcement. R1's quarterly minimum data set (MDS) dated [DATE], identified R1 had intact cognition, required staff assist with transferring, toileting, dressing, and showering. R1 diagnoses 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.

  Freedom from Abuse, Neglect, and Exploitation Deficiencies · Deficient, Provider has date of correction
• Potential for harm · F2025-07-10 · tag F0725 — failed to have enough nursing staff — widespread
  Provide 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 interview and document review, the facility failed to have licensed nursing coverage on staff for 24 hours a day, based on payroll and other verifiable, auditable data during 1 of 1 quarter reviewed - Quarter 2, 2025, (January 1 to March 31st), to the Centers for Medicare and Medicaid Services (CMS), according to specifications established by CMS. This had the potential to affect all 39 residents living in the facility.Findings include: Review of the 2/09/25, Daily Assignment Sheet identified 1 charge nurse was assigned for the day and 1 charge nurse for the evening shift (minimum 12 hr. shifts). Licensed practical nurse (LPN)-E was listed as having worked the day shift. Registered nurse (RN)-C was listed as having worked the night shift. Review of 2/09/25, Individual Daily Staffing [NAME] Report 1702D identified the facility data submitted for Provider Based Journal (PBJ) noted of the floor staff working that day, there was noted to be 1 registered nurse (RN-C), and 1 contract LPN (LPN-E) captured for hours worked. Review of 2/09/25, staff timesheet punches provided 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.

  Nursing and Physician Services Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Fcited before2025-07-10 · tag F0727 — failed to provide required RN coverage — widespread
  Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on interview and record review, the facility failed to ensure a registered nurse (RN) was on duty a minimum of 8 consecutive hours per day, 7 days per week, for 6 of 90 days reviewed. This had the potential to affect all 39 residents living in the facility.Findings include: Review of the facility schedule and timesheets for January 2025, February 2025, and March 2025 identified on:1) January, there was no RN coverage for 2 of 31 days: 1/24/25 and 1/31/25.2) February, there was no RN coverage for 3 of 28 days: 2/09/25, 2/14/25, 2/15/25.3) March, there was no RN coverage for 1 of 31 days: 3/02/25. Interview on 7/10/25 at 9:53 a.m., with director of nursing (DON) identified the facility had revised staffing hours according to resident care needs. Nursing staff hours was reviewed and discussed every day at their interdisciplinary team (IDT) meetings and communicated with the administrator. DON would expect nursing schedules to be reviewed daily, identify gaps of nursing coverage, and communicate those concerns effectively to reduce inadequate staffing on the units. Interview 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.

  Nursing and Physician Services Deficiencies · Deficient, Provider has date of correction
• Potential for harm · F2025-07-10 · tag F0812 — failed to store, cook, and serve food safely — widespread
  Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observation, interview, and document review, the facility failed to ensure infection control practices were maintained to ensure dietary staff were wearing a hair net and/or beard nets while in 1 of 1 kitchen and during meal services. The facility also failed to ensure 1 of 2 dining room refrigerators remained clean, and food was dated within the refrigerator to ensure it was not used beyond expiration. Additionally, the facility failed to ensure all Chlorine test strips for monitoring the dishwasher chemical level were not expired. Findings include:Observation and interview on 7/7/25 at 11:32 a.m., identified upon entrance to the kitchen for initial tour, dietary aide (DA)-A was preparing drinks for transportation to the dining rooms for the noon meal. DA-A had no hair net on. DA-A reported she was supposed to be wearing a hair net and there was no reason she did not have it on. Observation and interview on 7/7/25 at 11:40 a.m., cook (C)-A was standing behind the steam table outside of the north dining room and dishing up food for residents' noon meal. C-A had a hair net…

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

  Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
• Potential for harm · F2025-07-10 · tag F0838 — failed to assess facility resources and resident needs — widespread
  Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on interview and document review, the facility failed to implement 1 of 1 facility assessment and ensure the required nursing staff were scheduled and working to provide care and services to residents. Findings include: Review of the 2/09/25, Daily Assignment Sheet identified 1 charge nurse was assigned for the day and 1 charge nurse for the evening shift (minimum 12 hr. shifts). Licensed practical nurse (LPN)-E was listed as having worked the day shift. Registered nurse (RN)-C was listed as having worked the night shift. Review of 2/09/25, Individual Daily Staffing [NAME] Report 1702D identified the facility data submitted for Provider Based Journal (PBJ) noted of the floor staff working that day, there was noted to be 1 registered nurse (RN-C), and 1 contract LPN (LPN-E) captured for hours worked. Review of 2/09/25, staff timesheet punches provided by the facility identified only RN-C was clocked in as having worked. There was no way to verify LPN-E had worked the hours documented on the assignment sheet and as captured in the PBJ. Review of the facility schedule and…

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

  Administration Deficiencies · Deficient, Provider has date of correction
• Potential for harm · F2025-07-10 · tag F0851 — widespread
  Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on interview and document review, the facility failed to submit accurate staffing data based on payroll and other verifiable, auditable data during 1 of 1 quarter reviewed - Quarter 2, 2025, (January 1 to March 31st), to the Centers for Medicare and Medicaid Services (CMS), according to specifications established by CMS. This had the potential to affect all 39 residents living in the facility.Findings include: JANUARYReview of the 1/24/25, Daily Assignment Sheet identified 1 charge nurse as noted to be on the day shift, 1 charge nurse on the evening shift, and 1 nurse for RN coverage. Review of 1/24/25, staff timesheets identified:1) Licensed practical nurse (LPN)-B had worked 06:59 a.m. to 11:36 a.m. and 11:59 a.m. to 9:06 p.m., for a total of 13.62 hours.2) LPN-C had worked 06:00 a.m. to 7:40 p.m., for a total of 12.67 hours.3) RN-C had worked 06:03 p.m. to 06:30 a.m., the next day for a total of 11.45 hours. Review of the 1/24/25, Individual Daily Staffing- 1702D [NAME] Report identified 1 LPN with 13.62 captured hours, and 1RN with 13.0 captured hours. FEBRUARYReview 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.

  Administration Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Fcited before2025-07-10 · tag F0880 — failed to prevent and control infections — widespread
  Provide and implement an infection prevention and control program.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observation and interview the facility failed to disinfect 1of 2 glucometers (capillary blood glucose sampling device) after use to prevent transmission of blood borne diseases. Additionally, the facility failed to complete accurate staff illness surveillance for 2 of 2 staff. Findings include: Observation on 7/9/25 at 7:43 a.m., with registered nurse (RN)-A identified RN-A gathered the glucometer from the treatment cart to check R15’s blood sugar. RN-A used a lancet to prick R15’s finger to obtain a blood sample to test R15’s blood sugar with the glucometer. RN-A exited R15’s room and walked back to the treatment cart where she placed the used lancet in the sharp’s container and the glucometer back in the drawer next to another resident’s glucometer without first disinfecting it. She walked back to the nurse’s station to chart the blood sugar and check to see if R15 required any sliding scale insulin. Interview on 7/9/25 at 7:55 a.m., RN-A stated she had meant to disinfect the glucometer, but she had gotten “nervous and forgot”. RN-A then opened the treatment cart and…

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

  Infection Control Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2025-07-10 · tag F0678 — failed to provide CPR when needed — isolated
  Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.
  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 document review, the facility failed to update code status for 1 of 16 resident (R40) who requested to have his code status changed.Findings include:Document review on [DATE] at 4:51 p.m., R40 was identified to be a full code (Cardiopulmonary Resuscitation (CPR)) noted on his electronic medical record dashboard. Review of R40's Provider Orders for Life-Sustaining Treatment (POLST) signed by the resident and the physician identified he had changed his code status on [DATE] from CPR to Do not resuscitate (DNR).Interview on [DATE], at 2:00 p.m., with licensed practical nurse (LPN)-A identified if a resident's heart stops, they look at the dashboard to check code status, she explained the dashboard is at the top of a resident's main page in Point Click Care (PCC). PCC is the electronic system the facility uses for resident medical records. LPN-A opened R40's PCC main page and identified his code status is CPR. She identified when a resident is admitted they complete a Provider…

  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 before2025-05-30 · tag F0550 — failed to protect resident dignity and rights — isolated
  Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
  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 document review, the facility failed to have a system to ensure residents who were cognitively intact, and not an elopement risk could freely enter and exit the facility for 1 of 1 residents (R5) reviewed for resident rights. Findings include: R5' Face sheet dated 5/27/25, indicated R5 was admitted to the facility on [DATE] and his diagnoses included osteonecrosis (death of bone tissue due to a lack of blood supply) and alcohol dependence. R5's Elopement Risk Evaluation dated 5/23/25, indicated R1 was not at risk for elopement and current interventions included a check in and out log. R5's care plan dated 5/23/25, indicated resident was a low elopement risk and was a smoker. Further, R5's care plan indicated he was independent with locomotion in his wheelchair. On 5/27/25 at 11:50 a.m., upon entering the facility, the entrance door was observed to be locked and there was a doorbell to ring. Staff appeared and typed in a code to unlock the door. On 5/29/25 at 9:49 a.m., R5 was…

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

  Resident Rights Deficiencies · Deficient, Provider has plan of correction
• Potential for harm · D2025-05-30 · 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

  Based on interview and document review, the facility failed to ensure contracted resident care staff were competently trained on facility resident procedures, as well as provided access to electronic medical records (EMR) to implement person-centered resident care needs, interventions related to resident care to ensure safety and reduce the risk of complication (i.e. elopement). This had the potential to affect all 46 residents currently residing in the facility. Findings include: On 5/28/25 at 9:17 a.m., nursing assistant (NA)-D stated her first shift working at the facility was on 5/21/25. NA-D stated she received no training for the facility prior to the start of her shift and did not have access to any of the resident's care plans until management arrived at the facility at approximately 9:00 a.m. On 5/28/25 at 3:40 p.m. director of nursing (DON) stated contracted agency staff were expected to complete the packet that was printed and placed at the front desk before they would start working on the floor. Further, DON stated they would be assigned a staff member to assist them…

  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

“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

No federal fines in the current CMS record.

Who owns this facility

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.

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 MN