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Landmark Of Desoto

3068 Nail Road West, Horn Lake, MS 38637 · For profit - Limited Liability company · 60 certified beds · (662) 280-1219 Medicare & Medicaid certified

Call the home — (662) 280-1219 Need help choosing, fast? Free, unbiased: Eldercare Locator 1-800-677-1116
Abuse-prevention, restraint, or reporting citation — no harm found (F0605) — cited Mar 20262 actual-harm citations$10,527 in federal fines
Insights

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

Worth asking about
  • it has a citation for its abuse-prevention policies, restraint use, or reporting and investigating of allegations (F0605) — cited below the harm level, meaning inspectors found the process wanting but did not find a resident harmed
  • it has 2 actual-harm citations
  • a high number of inspection citations overall (21) — worth reading through, though larger and more-often-surveyed homes tend to accrue more lower-severity tags
  • the CMS record shows $10,527 in federal fines (most recent 2024-10-30)
  • its independent health-inspection rating is low (2/5)
  • its payroll-based staffing rating is low (2/5)
  • its facility-reported quality-measure rating is low (2/5)
  • nursing-staff turnover (56%) runs well above the national median (45%)

One thing this read cannot see: what residents and families actually experience day to day. Public data misses the feel of a place — visit unannounced, ideally at a mealtime or on a weekend, talk to staff and families, and ask your tour questions.

A plain-English summary of the public record below — not a rating, ranking, or recommendation. We take no money from any facility.

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

Location & what’s nearby

Hospital
★★★ 3/5 CMS · Emergency dept. usually open 24/7 · ER 24/7
Urgent care / clinic
3040 Goodman Rd W · (662) 280-3428 · Call to confirm hours
Pharmacy
2401 Goodman Rd W · (662) 342-6229 · Call to confirm hours
Grocery
2901 Goodman Rd W · (662) 393-8885 · Call to confirm hours
Park
5633 Tulane Rd · (662) 393-5353 · Typically dawn to dusk
Place of worship
2761 Valleybrook Rd · (901) 489-5046

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

Quality measures — how residents actually fare

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

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

Trend — is this home getting better or worse?

Over 2025-02 to 2026-06, this home’s CMS overall rating held steady at 2 stars. From monthly CMS archive snapshots.

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

Overall rating2★
Inspection scorelower = better
See all quality measures vs. state & national benchmarks
MeasureThis homeState avgTypical statevs typical state
Long-stay residents whose need for help with daily activities increased20.3%20.5%15.4%worse
Long-stay residents who lose too much weight2.6%6.2%5.4%better
Long-stay residents with a catheter left in their bladder1.4%1.4%0.9%worse
Long-stay residents with a urinary tract infection3.0%2.5%2.0%worse
Long-stay residents with depressive symptoms0.7%1.6%6.5%better than state — see note marked double-dagger below the table
Long-stay residents who were physically restrained0.0%0.2%0.1%better
Long-stay residents with falls causing major injury5.8%3.1%3.3%worse
Long-stay residents whose ability to walk worsened20.2%19.6%16.1%worse
Long-stay residents on antianxiety or hypnotic medication4.5%23.8%18.9%better
Long-stay residents given the seasonal flu vaccine100.0%97.0%95.3%typical
Long-stay residents with pressure ulcers6.7%6.3%4.7%worse
Long-stay residents with worsening bladder/bowel control18.7%20.7%21.2%better
Long-stay residents who got an antipsychotic medication — see the note below the table3.6%21.7%17.1%better
Short-stay residents who newly got an antipsychotic medication7.7%2.5%1.4%worse
Short-stay residents given the seasonal flu vaccine89.9%84.6%79.4%better
Short-stay residents rehospitalized after admission34.9%27.7%22.6%worse
Short-stay residents with an outpatient ER visit12.9%15.5%12.0%typical
Long-stay hospitalizations per 1,000 resident days3.732.431.67worse
Long-stay outpatient ER visits per 1,000 resident days1.432.861.80better

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.

53.9% 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 156 Medicare stays in Oct 2022–Sep 2024, and CMS’s own comparison — not ours.

53.9%U.S. median 51.5%
Got home and stayed home
11.1%U.S. median 10.7%
Went back to hospital
55.2%U.S. median 56.6%
Met the expected recovery
0.28U.S. median 0.31
Therapy hours / resident / day
0.12hours / resident / day
Physical therapy
0.09hours / resident / day
Occupational therapy
0.06hours / resident / day
Speech therapy

Met the expected recovery: 55.2% 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 58 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 0.28 therapist hours per resident per day in 2026Q1 — more than 42% of the 13,892 homes that report any therapy hours at all.

Weekend therapy: weekend therapy hours are 14% of this home’s weekday level — it runs some therapy at the weekend, at a lower level than on weekdays. The median home that reports therapy runs 13% — weekday-focused therapy is the industry norm, not a shortfall. But recovery does not pause on a Saturday: ask what the weekend actually looks like here.

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

See every short-stay measure CMS publishes for this home
MeasureThis homeU.S. medianPeriod coveredCMS’s call
Got home and stayed homeRate of successful return to home or community from a SNF53.9%CMS range 44.2–62.051.5%Oct 2022–Sep 2024no different from U.S.
Went back to hospitalRate of potentially preventable hospital readmissions 30 days after discharge from a SNF11.1%CMS range 7.9–15.210.7%Oct 2022–Sep 2024no different from U.S.
Met the expected recoveryPercentage of residents who are at or above an expected ability to care for themselves and move around at discharge55.2%56.6%Oct 2024–Sep 2025CMS makes no comparison for this measure
Self-care at dischargePercentage of residents who are at or above an expected ability to care for themselves at discharge53.5%52.8%Oct 2024–Sep 2025CMS makes no comparison for this measure
Moving around at dischargePercentage of residents who are at or above an expected ability to move around at discharge56.9%50.0%Oct 2024–Sep 2025CMS makes no comparison for this measure
Medication problems followed upPercentage of residents whose medications were reviewed and who received follow-up care when medication issues were identified86.1%98.7%Oct 2024–Sep 2025CMS makes no comparison for this measure
Medication list to the next providerPercentage of residents where the SNF provided a current medication list to the next health care setting98.6%100.0%Oct 2024–Sep 2025CMS 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 discharge96.7%98.7%Oct 2024–Sep 2025CMS 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 stay2.8%0.0%Oct 2024–Sep 2025CMS makes no comparison for this measure
New or worsened pressure ulcersPercentage of residents with pressure ulcers/pressure injuries that are new or worsened2.8%1.9%Oct 2024–Sep 2025CMS makes no comparison for this measure
Infections that led to hospitalPercentage of infections residents got during their SNF stay that resulted in hospitalization7.0%CMS range 3.9–10.77.1%Oct 2023–Sep 2024no different from U.S.
Medicare spending per stayMedicare Spending Per Beneficiary (MSPB) for residents in SNFs1.081.02Oct 2022–Sep 2024CMS makes no comparison for this measure

From the CMS Skilled Nursing Facility Quality Reporting Program — Medicare short-stay outcomes, which is a different dataset from the long-stay quality measures above and describes a different set of residents. Where CMS risk-adjusts a measure we show its adjusted rate, and the CMS range beside it is the confidence interval CMS publishes: a home whose range is wide is a home with few stays, where one patient moves the number several points. Read the period column. These measures do not share a window — the claims-based ones (getting home, readmission, spending) lag by a year or more, because a stay has to finish and its claims settle before it can be counted. CMS’s call is CMS’s, not ours: it is the only place anyone tests whether this home differs from the national rate at all, and most homes on most measures do not. Two caveats on it. CMS tests only three of these measures — getting home, readmission, and infections that led to hospital; on the other nine it publishes a rate and no comparison, and rather than compute a verdict CMS declined to make, we say so in the column. And on readmission almost every home in the country lands on “no different”, so that row separates homes far less than getting-home does — which is why met the expected recovery, a measure CMS does not test but which spreads across the whole range, is called out above the table rather than left in this list. The U.S. median column is our own, taken across every home CMS publishes that measure for in this same file; it is not a CMS-published benchmark. Homes CMS gives no rate for are left out of it rather than counted as zero. Medicare spending per stay is a ratio, not a percentage — 1.00 means this home’s Medicare spending for a stay matched the national figure CMS compares it against, and it measures cost to Medicare, not quality of care.

Staffing

0.51
RN hours/ resident / day
0.76
LPN hours/ resident / day
1.50
Aide hours/ resident / day
2.78
Total nurse hours/ resident / day
0.45
RN hoursweekends
56.5%
Total nursing turnover
42.9%
RN turnover

How full it usually is: this home is certified for 60 beds and averages 53.6 residents a day — about 89% occupied, or roughly 6 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 2.78 hrs/resident/day is below the 3.48-hour benchmark and RN staffing of 0.51 is below the 0.55-hour RN benchmark and nurse-aide staffing of 1.50 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 2.44 hrs/resident/day on weekends vs 2.91 on weekdays — 16% thinner on weekends. RN hours go from 0.53 to 0.45 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)

This home’s total nursing-staff turnover of 56% 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

10
deficiencies at the latest standard inspection (2026-03-19)
8
at the previous standard inspection (2024-10-30)

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.

ABCDEFGHIJKL

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

21 citations, most serious first. The 12 most serious are shown; the remaining 9 are one tap away and print in full.

  • Actual harm · Gcited before2024-10-30 · tag F0656 — failed to write and follow a full care plan — isolated
    Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, staff interviews, record review, and facility policy review, the facility failed to develop a comprehensive care plan for a resident with pressure ulcers for two (2) of 20 sampled residents. Resident # 28 and Resident # 209 Findings Include: Review of the facility policy titled Care Plan Process with a revision date of 8/17 revealed, .The Care Plan must include measurable objectives and time frames and must describe the services that are to be furnished to attain or maintain the resident's highest practicable physical, mental, and psychosocial well-being . Resident #28 A review of the Skin & Wound Evaluation dated 9/19/24 revealed that Resident #28 acquired an unstageable pressure ulcer on the right fourth (4th) ring finger on 9/19/24. The quarterly Minimum Data Set (MDS) Assessment with an Assessment Reference Date (ARD) of 9/16/24 indicated that Resident #28 had a functional limitation in the range of motion (ROM) in the upper extremity on one side. A review of the comprehensive care plan for Resident #28 showed that no pressure reduction interventions 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.

    Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
  • Actual harm · G2024-10-30 · 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, record review, resident and staff interview the facility failed to provide treatment and services to prevent pressure ulcers for two (2) of five (5) residents observed with pressure ulcers. Resident #28 and Resident # 209 Findings Included: Record review of facility policy Pressure Ulcer Prevention and Treatment Intervention Guidelines, revised 10/22, revealed C. Protection from Fiction or Shear .4. Provide padding for casts, braces, splints, oxygen tubing, shoes etc. as needed to prevent friction. 5. Remove orthotics on a regular basis for skin inspection .Therapy Department Interventions .3. Explore possible therapy interventions for .c. Splinting/orthotic modifications . 1. Provide pressure ulcer topical treatments as ordered Resident #28 A review of the Skin & Wound Evaluation dated 9/19/24, revealed that Resident #28 acquired an unstageable pressure ulcer on the right fourth (4th) ring finger on 9/19/24. Record review revealed measurements of 1.4 centimeters (cm) area, 1.4 cm length, 1.3 cm width and depth not applicable (n/a). The quarterly Minimum Data…

    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 · F2026-03-19 · tag F0552 — widespread
    Ensure that residents are fully informed and understand their health status, care and treatments.
    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 staff interview, record review and facility policy review the facility failed to ensure informed consent was obtained prior to the initiation of psychotropic medications for 5 (five) of 5 residents reviewed for unnecessary medications. Resident #1, Resident #3, Resident #6, Resident #12, and Resident #38. Findings Include: Facility policy titled Psychotropic Medications, dated 02/25, stated, Consent for Anti-psychotic Medication Treatment shall be completed for new order of or increasing the dose of an anti-psychotic, psychoactive, or neuroleptic medication. The prescribing physician, or facility medical director shall complete Section I providing indications for use, diagnosis, risks, benefits, alternatives and course of therapy. Section II shall be completed by resident or resident representative. Resident #1 Record review of Resident #1's Order Summary Report revealed an order dated 2/13/26, Klonopin (anti-anxiety) 0.5 MG (milligram) oral tablet (Clonazepam) give 1 (one) tablet via PEG (percutaneous…

    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 · E2026-03-19 · tag F0605 — failed to not use drugs as a restraint — pattern
    Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
    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, staff interview, and facility policy review, the facility failed to ensure that the physician reviewed and responded to pharmacy recommendations for gradual dose reduction (GDR) and failed to ensure as-needed (PRN) psychotropic medication orders included a stop date for four (4) of five (5) residents. (Residents #1, #6, #12, and #38) Findings Include: Review of the facility policy Gradual Dose Reduction (GDR) for Psychotropic Medications with revision date of 11/17 revealed A Gradual Dose Reduction (GDR) is a stepwise tapering of a dose to determine if symptoms, conditions, or risks can be managed by a lower dose or if the dose or medication can be discontinued. Within 1st (first) year after admission on psychotropic or after initiation: GDR in 2 (two) separate quarters, with at least one month between attempts. After 1st (first) year GDR annually Review of facility policy titled Psychotropic Medications with review date 2/2025, revealed, .as needed (PRN) orders for psychotropic…

    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 · E2026-03-19 · tag F0759 — failed to keep medication error rate low — pattern
    Ensure 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, staff interview, record review and facility policy review, the facility failed to ensure the medication error rate was five (5) percent (%) or less for six (6) of thirty-three medication opportunities. Medication error rate of 18.18%.Findings Include: Review of the facility policy titled Administration of Medications revised 3/25 revealed under, Procedure . 3. Drugs and biologics are administered no more than one hour before or no more than one hour after the dosage time on the order. Also revealed under, Oral Medication Administration Procedure: . 3. Verify the physicians order, comparing the medication label to the MAR (Medication Administration Record) to verify the following:a. Right medicationb. Right dosagec. Right routed. Right timee. Right resident. Record review of Resident #17's Medication Administration Record (MAR) revealed the following medications were scheduled for administration at 9:00 AM: Lisinopril 10 milligrams (hypertension), Multivitamin liquid (supplement), Hydroxyzine 10 milligrams (anxiety), Metformin 500 milligrams (diabetes), 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.

    Pharmacy Service Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2026-03-19 · tag F0558 — failed to accommodate residents' needs and preferences — isolated
    Reasonably accommodate the needs and preferences of each resident.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, interview, record review, and facility policy review, the facility failed to have the call light accessible for Resident #30, this was for one (1) of 24 residents reviewed. Findings Include:Review of facility policy titled, Resident Call Light System, dated 07/25, revealed, A call light system is in place and operative in facility. This system allows individual residents to access a system that notifies nursing that the resident has a need . An observation and interview on 03/17/2026 at 10:50 AM observed Resident #30 lying in her bed and alert to name being called. A fall mat was on the floor next to the bed with bed in the lowest position. Observed a sign above the bed reminding resident to call for assistance, Please call, don't fall. Use the call button for assistance. Observed that call light was not within reach. Interview with the resident at that same time, asked if she knew what to do if she needed help and resident stated, I push the red button. Interview and observation on 03/17/26 at 10:56 AM with Licensed Practical Nurse (LPN) #2 stated resident 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.

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2026-03-19 · tag F0641 — isolated
    Ensure each resident receives an accurate assessment.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, staff interview, record review, and facility policy review, the facility failed to ensure the accuracy of resident assessments by inaccurately completing section H (bowel and bladder) of the Minimum Data Set (MDS) for one (1) of 18 sampled residents. Resident #11.Findings Include: Review of the facility policy titled Resident Assessment, revised 9/19, revealed, An assessment will be completed on each resident utilizing the MDS (Minimum Data Set). The reason for the assessment, schedule, and timeframes will be according to the guidance of the Resident Assessment Instrument (RAI) Manual. An observation conducted on 3/17/26 at 11:29 AM revealed Resident #11 lying in bed with a urinary catheter drainage bag attached to the lower portion of the bed frame. Record review of Resident #11's Quarterly MDS with an Assessment Reference Date (ARD) of 12/19/25 revealed under Section H (Bladder and Bowel), item H0100 an indwelling catheter was not indicated. Record review of Resident #11's December Treatment Administration Record (TAR) revealed an order dated 7/7/25, Change…

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

    Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2026-03-19 · 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

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review, staff interview, and facility policy review, the facility failed to ensure the interdisciplinary team (IDT) reviewed and revised the resident's comprehensive care plan to reflect changes in the resident's condition for one (1) of eighteen (18) residents reviewed. (Resident #18)Findings include:Review of facility policy titled Care Plan Process with review date 3/26, revealed, Regulations require facilities to complete, at a minimum and at regular intervals, a comprehensive, standardized assessment of each resident's functional capacity and needs, in relation to several specified areas.The comprehensive care plan is an interdisciplinary communication tool. The IDT will minimally include the attending physician, Registered Nurse (RN) with responsibility for the care of the resident, a nurse aide with responsibility for the resident, a member of food and nutrition services staff, the resident and the resident's representative (s) to the extent practicable, and any other disciplines as…

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

    Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2026-03-19 · 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

    Based on observation, interview, record review, and facility policy review the facility failed to provide services to maintain or improve range of motion by not ensuring a physician ordered splint was applied daily for 1 (one) of 2 (two) residents reviewed. Resident #17. Findings Included:Record review of the facility policy Range of Motion with revision date of 01/24, revealed that the purpose was To improve or maintain joint mobility and muscle strength and To prevent contractures Observations on 03/17/25 at 10:55 AM and on 03/18/26 at 8:15 AM revealed Resident #17 lying in bed, he was non-verbal with his eyes open. His right hand was contracted and there was no wrist splint device in place. It was observed that there was a hand splint on the seat of the wheelchair that was against the wall. An interview and observation on 03/18/26 at 1:50 PM with Registered Nurse (RN) #1, revealed that they only had one resident requiring hand splints in the facility. She revealed that Resident #17 had received therapy services in the past and they had put a hand splint on him but since he had…

    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 before2026-03-19 · tag F0690 — failed to manage incontinence, catheters, and urinary infections — isolated
    Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, staff interview, record review, and facility policy review, the facility failed to ensure proper positioning and management of an indwelling urinary catheter drainage system for one (1) of one (1) resident reviewed for urinary catheter. Resident #11 Findings Include: Review of the facility policy titled Perineal Care, revised 1/24, revealed under Resident with Catheter: . 7. Ensure tubing is not positioned above the level of the bladder.An observation conducted on 3/17/26 at 11:29 AM revealed Resident #11 lying in bed with a urinary catheter drainage bag attached to the lower portion of the bed frame.Record review of Resident #11's Order Summary Report revealed an order dated 7/3/25, Foley catheter care Q (every) shift and PRN (as needed).During an observation of catheter care provided to Resident #11 by Certified Nurse Aide (CNA) #1 and Registered Nurse (RN) #1 on 3/18/26 at 11:00 AM, the urinary drainage bag was removed from the lower bed frame and placed in the bed with the resident during catheter care. This positioning resulted in urinary backflow from 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.

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2026-03-19 · 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, staff interview, record review, and facility policy review, the facility failed to ensure insulins were properly stored in accordance with manufacturer's guidelines to maintain safety and effectiveness for one (1) of two (2) medication carts observed. 300 hall Findings Include:Review of the facility policy titled Medication Storage, revised 11/17, revealed, Storage, supplies and equipment necessary for appropriate temperatures and conditions per the manufacturer's specifications.An observation of the 300 hall medication cart on 3/18/26 at 9:45 AM, with Licensed Practical Nurse (LPN) #1, revealed the following insulins were in use and either exceeded the manufacturer's 28-day room temperature storage limit or were not dated when opened:Resident #2 - Open vial of Novolog that was undated.Resident #3 - Open vial of Humalog dated 12/23/25.Resident #17 - Open vial of Insulin Aspart that was undated.Resident #51 - Humalog KwikPen that was undated. Record review of the manufacturer's storage instructions for Humalog and Novolog (Insulin Aspart) revealed that once…

    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 before2026-03-19 · tag F0880 — failed to prevent and control infections — isolated
    Provide and implement an infection prevention and control program.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, staff interview, record review and facility policy review the facility failed to properly disinfect a glucometer after use, in accordance with infection control standards during one (1) of 6 (six) medication administration passes observed and failed to ensure contact precautions were in place for one (1) of five (5) residents reviewed for infection control. Resident #30.Findings Included: Review of the facility policy Infection Control Policy for General Cleaning and Maintenance of Equipment with revision date of 02/26 revealed that .Critical and invasive resident care devices (e.g. (exempli gratia), glucometers) shall be cleaned and disinfected per manufacturers' recommendations Record Review of Policy for Control of Multidrug-Resistant Organism (MDRO) Infection,latest review date 08/21 revealed, It is the policy of this facility to place residents in contact and/or droplet precautions if they are displaying symptoms of active multidrug-resistant organism (MDRO) infection An infection 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.

    Infection Control Deficiencies · Deficient, Provider has date of correction
Show the remaining 9 citations
  • Potential for harm · F2024-10-30 · 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 staff interviews and record reviews, the facility failed to submit accurate direct care staffing information to the Centers for Medicare and Medicaid Services (CMS) as required for the third quarter (Q3) of fiscal year (FY) 2024 (April 1-June 30). Findings include: Record review of a letter, on facility letter head, signed by the Administrator, revealed that the facility does not have a policy related to Payroll Based Journal (PBJ) submission. A record review of the facility's PBJ Staffing Data Report for Q3 FY 2024 revealed that the facility triggered for excessively low weekend staffing. In an interview on 10/29/24 at 12:45 PM, the Administrator stated that the facility had not submitted accurate PBJ staffing data to CMS for the third quarter of FY 2024. She explained that the corporate office was responsible for submitting PBJ staffing data for the facility; she provided the agency/contract staffing hours, while the corporate office pulls hours for facility staff from payroll records. She noted that administrative staff were sometimes reassigned to provide direct…

    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 · D2024-10-30 · 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

    Based on observation, staff interview, and facility policy review, the facility failed to provide privacy for one (1) of 20 residents reviewed as evidenced by a resident who was left uncovered and visible from the hallway. Resident # 17 Findings Include: A review of the facility's Dignity and Respect policy, revised on 7/22, stated: A facility must treat each resident with dignity and care for each resident in a manner and in an environment that promotes maintenance or enhancement of their quality of life, recognizing each resident's individuality. The facility shall protect and promote the rights of the resident . Residents will be examined and treated in a manner that maintains bodily privacy . An observation from the hallway on 10/28/24 at 9:30 AM, revealed Resident #17's door was open and was lying in bed uncovered, with an adult incontinence brief on the resident, stomach exposed, with the Percutaneous Endoscopic Gastrostomy (PEG) tube visible. In a follow-up observation from the hallway on 10/28/24 at 9:55 AM, Resident #17 was still lying uncovered in bed, with an adult brief,…

    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 · D2024-10-30 · 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 resident and staff interview, record review, and facility policy review, the facility failed to honor a resident's right to make health care decisions related to cardiopulmonary resuscitation (CPR) for one (1) of 20 sampled residents. Resident #58 Findings Include: Review of the facility policy titled Advance Directives with a revision date of 7/15 revealed under, Policy: The facility recognizes that all adults have a fundamental right to make decisions relating to their own medical treatment, including the right to accept or refuse medical care. Also revealed under, Procedure: . The resident will be encouraged to participate in all aspects of decision-making regarding care and treatment. Statements by a competent resident regarding his/her desire to accept or refuse treatment will be documented in the resident's clinical record. Record review of the Advanced Directive Consent for Resident #58 revealed, the consent was initialed and signed by a family member dated [DATE] and that Resident #58 did not…

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

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2024-10-30 · tag F0690 — failed to manage incontinence, catheters, and urinary infections — isolated
    Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
    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, staff interview, record review, and facility policy review, the facility failed to provide appropriate care services for (1) one of (5) resident care observations. (Resident # 57) Findings include: A review of the facility policy titled, Perineal Care, latest revision date 01/24 revealed. .Resident with Catheter: 4.) Using a clean washcloth or wash wipe, start at the meatus and wash the tubing in a circular motion away from the body . Rinse using the same method . An observation of catheter care with Certified Nurse Assistants (CNA) #1 and CNA #2 for Resident #57 on 10/29/24 at 11:34 AM, revealed CNA #1 cleaned one side of the urinary catheter from the urinary meatus downward with a clean soapy wet washcloth, and then cleaned the other side with a clean area section of the washcloth. CNA #1 then placed the dirty washcloth into the clean water in the wash basin, rinsed it out and used the same dirty washcloth to rinse the urinary catheter tubing/urinary meatus all in the same swipe wearing…

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

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2024-10-30 · tag F0755 — failed to provide safe pharmacy services — isolated
    Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, staff interview, record review, and facility policy review, the facility failed to maintain a system of medication records that enables periodic accurate reconciliation and accounting for all controlled medications for (1) one of (3) three narcotic storage areas reviewed. Findings include: A review of the facility policy titled, Drug-Controlled Substances, latest revision 11/17 revealed, Regulations require that the facility have a system in place to account for the receipt, usage, disposition, and reconciliation of all controlled medications . A controlled drug count is to be done at the beginning of each shift by the outgoing and on-coming nurses . An observation of the narcotic box in the medication room refrigerator with Licensed Practical Nurse (LPN) # 1 on 10/29/24 at 8:30 AM, revealed four (4) vials of Emergency Drug Kit (EDK) Lorazepam two (2) mg/ml (milligram/milliliter). LPN #1 revealed she and the other medication nurse on duty have access to the narcotic box in the refrigerator. She then confirmed the Lorazepam was not counted every shift with 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.

    Pharmacy Service Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2024-10-30 · 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, resident and staff interview, and facility policy review, the facility failed to ensure a resident's environment was free from accident hazards, as evidenced by, medications left at bedside for one (1) of twenty sampled residents. Resident #58 Findings Include: Review of the facility policy titled Medication Storage with a revision date of 11/17 revealed under, There shall be storage areas provided that assure adequate space, equipment and security for medications within the facility . An observation and interview on 10/28/24 at 9:50 AM, revealed Resident #58 lying in bed and on the bedside table was a six (6) ounce bottle of red spray liquid with a label that read, Sore Throat Spray and a one (1) fluid ounce white bottle that read, Lubricating Eye Drops. The resident revealed that she used the eye drops about six times a day for dry eyes and administered it herself. She revealed that she used the sore throat spray as needed for a sore throat. She explained the staff knew she had it because it had been on the table since she was admitted to the facility. An…

    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 before2023-08-17 · tag F0656 — failed to write and follow a full care plan — isolated
    Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on staff interviews, record review and facility policy review, the facility failed to a implement a comprehensive care plan for a resident requiring oral care and a resident requiring nail care and for two (2) of 18 residents care plans reviewed. Resident #23 and #39 Findings include: A review of the facility policy titled, Care Plan Process with a revision date of 08/17 revealed, Regulations required facilities to complete, at a minimum and at regular intervals, a comprehensive, standardized assessment of each resident's functional capacity and needs, in relation to a number of specified areas (e.g., customary routine, vision, and continence). The results of the assessment, which must accurately reflect the resident's status and needs, are to be used to develop, review, and revise each resident's comprehensive person-centered plan of care . Resident #23 Record review of Resident # 23's Care Plan with a problem on set date of 9/14/2016 revealed RESIDENT IS DEPENDENT WITH ADLS (Activities of Daily Living) Approaches . PROVIDE AM/PM CARES . Record review of Resident #23's 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.

    Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2023-08-17 · tag F0677 — failed to help fully-dependent residents with daily care — isolated
    Provide care and assistance to perform activities of daily living for any resident who is unable.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, staff interviews, record review, and facility policy review, the facility failed to provide personal hygiene to residents as evidenced by chapped peeling lips, long nails with a brown substance underneath, and yellow substance on teeth for two (2) of 18 residents sampled for activities of daily living (ADL'S). Resident #23, and #39. Findings include: Record review of the facility policy titled, Activities for Daily Living with a revision date of 12/20 revealed .Procedure: 1. ADLs to be resident-specific and reflect current resident status . Resident #23 An observation on 8/14/23 at 3:43 PM, of Resident #23 revealed, him lying in bed, non-verbal, with long fingernails on both hands that measured three-eights (3/8) inch with a brown substance underneath. The resident was observed with a thick layer of yellow substance on upper and lower teeth. An observation and interview on 8/15/23 at 10:05 AM, with Certified Nurse Aide (CNA) #4 confirmed that Resident #23 had long nails with a brown…

    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 before2023-08-17 · tag F0880 — failed to prevent and control infections — isolated
    Provide and implement an infection prevention and control program.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, staff interviews, and facility policy review, the facility failed to prevent the likelihood of the spread of infection as evidenced by staff not cleaning vital sign equipment between residents for one (1) of four (4) survey days. Findings include: Record review of facility policy titled, Infection Control Policy for General Cleaning and Maintenance of Equipment dated 8/21, revealed, It is the policy of this facility that all resident care equipment will be cleaned and decontaminated after use and will be prepared for reuse by the same or another resident. During a medication administration pass on 8/16/23 at 7:50 AM, an observation revealed Licensed Practical Nurse (LPN) #1, entered resident room [ROOM NUMBER] and vital signs were checked with the multi-resident use equipment. LPN #1 then went into resident room [ROOM NUMBER], checked the resident's vital signs using the same multi-resident use equipment. LPN#1 did not clean the multi-resident use equipment prior to use, between use, or…

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

    Infection Control Deficiencies · Deficient, Provider has date of correction

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

Worried about a resident here? There are three different people you can turn to, and they do different jobs:
  • Long-Term Care Ombudsman — a free, confidential advocate for the resident. They act only with the resident’s consent and work to resolve the problem. Find yours at theconsumervoice.org/get_help.
  • Adult Protective Services — the state agency that investigates suspected abuse, neglect, or exploitation of a vulnerable adult. Not sure of your state’s APS number? The federal Eldercare Locator will route you: 1-800-677-1116 or eldercare.acl.gov.
  • State survey agency — the regulator that licenses and inspects the home. Every state has an official nursing-home complaint line and most take complaints online; the Ombudsman or Eldercare Locator can connect you.
Not sure where to start, or need other help? Dial 2-1-1 for local resources — and if a call is hard or impossible for you, many local 211s also take a text (send your ZIP code to 898-211) or a web chat at 211.org; both vary by area, and 211.org will show what yours offers. Deaf or hard of hearing: dial 711 for the telecommunications relay service, then any number above. In an emergency, call 911.
It is illegal for a facility to retaliate against a resident or family for reporting a concern: federal law gives a resident the right to voice grievances — to the home or to any outside agency — without discrimination or reprisal (42 CFR §483.10(j)(1)). You may report anonymously.

Fines & penalties

$10,527 in federal fines across 2 penalties.

  • $5,263 — penalty dated 2024-10-30
  • $5,264 — penalty dated 2024-10-30

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 THE BEEBE FAMILY — 48 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 →

RatingThis homeChain avg
Overall 2 of 52.8-0.8 vs chain
Health inspection 2 of 53.0-1.0 vs chain
Staffing 2 of 53.3-1.3 vs chain
Quality measures 2 of 52.0≈ chain avg
The other 47 homes this chain runs (chain average 2.8★, per CMS)
1 of 5Gulfport Care CenterGulfport, MS 1 of 5Heritage Manor Of Baton Rouge IIBaton Rouge, LA 1 of 5Heritage Manor Of OpelousasOpelousas, LA 1 of 5Humphreys Co Nursing CenterBelzoni, MS 1 of 5Lawrence Co Nursing CenterMonticello, MS 1 of 5Lexington HouseAlexandria, LA 1 of 5Riverview Care CenterBossier City, LA 1 of 5Southern Hills Healthcare And RehabilitationShreveport, LA 1 of 5The SummitAlexandria, LA 1 of 5Tishomingo ManorIuka, MS 2 of 5Attala County Nursing CenterKosciusko, MS 2 of 5Heritage Manor WestShreveport, LA 2 of 5Highland HomeRidgeland, MS 2 of 5Landmark Nursing Center HammondHammond, LA 2 of 5Matthews Memorial Health Care CenterAlexandria, LA 2 of 5Myrtles Nursing Center, LLCColumbia, MS 2 of 5Perry County Nursing CenterRichton, MS 2 of 5Sardis Community NhSardis, MS 2 of 5Tunica County Health & Rehab, LLCTunica, MS 3 of 5Clarksdale Nursing CenterClarksdale, MS 3 of 5Copiah Living CenterCrystal Springs, MS 3 of 5Heritage Manor Of Ville PlatteVille Platte, LA 3 of 5Heritage Manor of HoumaHouma, LA 3 of 5J G Alexander Nursing CenterUnion, MS 3 of 5Landmark Of RayneRayne, LA 3 of 5Landmark of Baton RougeBaton Rouge, LA 3 of 5Landmark of Lake CharlesLake Charles, LA 3 of 5Senior Village Nursing & Rehabilitation CenterOpelousas, LA 3 of 5Washington Care CenterGreenville, MS 4 of 5Audubon Health and RehabThibodaux, LA 4 of 5Brandon CourtBrandon, MS 4 of 5Camellia EstatesMcComb, MS 4 of 5Forest Manor Nursing and Rehabilitation CenterCovington, LA 4 of 5Heritage House Nursing CenterVicksburg, MS 4 of 5Heritage Manor Of SlidellSlidell, LA 4 of 5Heritage Manor Of Stratmore Nursing & Rehab CtrShreveport, LA 4 of 5Heritage Manor SouthShreveport, LA 4 of 5Hillcrest Nursing CenterMagee, MS 4 of 5Landmark Of AcadianaSaint Martinville, LA 4 of 5Landmark Of CollinsCollins, MS

Showing 40 of 47; 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 / managerTypeRoleShareSince
ELTON G BEEBE SR IRRV GRNDCHILDRENS TROrganization5% OR GREATER DIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDEDsince 01/01/2010
HEALTH CARE SERVICES, INC.Organization5% OR GREATER DIRECT OWNERSHIP INTEREST; OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFNO PERCENTAGE PROVIDEDsince 01/01/2010
PATHWAY MANAGEMENT INCOrganization5% OR GREATER DIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDEDsince 01/01/2014
BEEBE, BOBBYIndividual5% OR GREATER DIRECT OWNERSHIP INTEREST; OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFNO PERCENTAGE PROVIDEDsince 01/01/2010
BEEBE, ELTONIndividual5% OR GREATER DIRECT OWNERSHIP INTEREST; CORPORATE DIRECTORNO PERCENTAGE PROVIDEDsince 01/01/1993
SADLER, ALISONIndividual5% OR GREATER DIRECT OWNERSHIP INTEREST; CORPORATE DIRECTORNO PERCENTAGE PROVIDEDsince 01/01/2005
STALLARD, FELICIAIndividual5% OR GREATER DIRECT OWNERSHIP INTEREST; CORPORATE DIRECTORNO PERCENTAGE PROVIDEDsince 01/01/2005
ELTON G. BEEBE SR IRRV CHILDRENS TROrganization5% OR GREATER INDIRECT OWNERSHIP INTEREST; ADP OF THE SNF85%since 01/01/2025
STALLARD, DAVIDIndividualCORPORATE DIRECTOR; CORPORATE OFFICER; OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 01/01/1997
KEEN, RACHELIndividualCORPORATE OFFICERsince 01/01/2013
PARKINSON, TONIIndividualCORPORATE OFFICER; OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 01/01/2010
ACCOUNT MANAGEMENT SERVICES INCOrganizationOPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 01/01/2010
ADMINISTRATIVE SYSTEMS INCOrganizationOPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 01/01/2010
PROVIDENCE CARE LLCOrganizationOPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 01/01/2010
PROVIDER PROFESSIONAL SERVICES INCOrganizationOPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 01/01/2010
REGIONAL CARE LLCOrganizationOPERATIONAL/MANAGERIAL CONTROLsince 01/01/2014
REGIONAL SERVICES, INCOrganizationOPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 01/01/2023
TRISTAR REHAB INCOrganizationOPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 01/01/2024
LOGGINS, ROBERTAIndividualOPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 02/28/2022
MALHOTRA, SUNILIndividualOPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 07/22/2017
WHITE, RUBYIndividualOPERATIONAL/MANAGERIAL CONTROLsince 01/04/2022
LINDA MAYNOROrganizationADP OF THE SNFsince 01/01/2011
MISSISSIPPI EXTENDED CARE CENTERSOrganizationADP OF THE SNFsince 01/01/2025
NUTRITION SYSTEMS CONSULTING INCOrganizationADP OF THE SNFsince 01/31/2008

CMS files one row per role, so the 45 rows in the source record cover these 24 parties — each is shown once here with every role it holds. Nothing is omitted.

14 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.

$7.0M
Net patient revenuemost recent cost report
+4.7%
Operating marginrevenue minus expenses
$576K
Related-party expense9% of expenses
Who pays — share of resident-days
Medicaid 79%Medicare 21%Other / private 0%

About 79% of this home’s resident-days are paid by Medicaid, which reimburses well below the cost of care in most states. Heavily Medicaid-dependent homes run on thinner budgets — a context worth holding next to the staffing and inspection record, not a fault in itself. This home reported $576K paid to related parties (affiliated landlords or management companies) in its most recent cost report.

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

Cost & finances

$402per resident / day
operating cost
$12,207per month
≈ monthly operating cost
$421per day
avg. revenue, all payers

Straight from this home’s Medicare cost report (CMS, FY2023). These are its operating economics — what it costs to run per resident-day and what it collects on average across Medicare, Medicaid, and private pay — not a private-pay quote. Your out-of-pocket cost depends on payer and room type, so ask the facility directly; a higher operating cost can reflect richer staffing or a sicker population. The cost-of-care planner shows regional benchmarks by care type.

What families pay in MS

Paying with Medicaid

This is a Medicare- and Medicaid-certified nursing home, so it can accept Medicaid for long-term care — like nearly all U.S. nursing homes. The private-pay figures below are what families without Medicaid pay; once a resident qualifies for Medicaid, out-of-pocket cost for covered nursing-home care is typically close to $0 (almost all of their income goes to the home as their share of the cost; they keep a small personal needs allowance — for clothing, haircuts, a phone — and Medicaid pays the rest). The amount of that allowance is set by each state. Confirm Medicaid-bed availability with the home, and see the Mississippi Medicaid page.

Typical monthly cost in Mississippi
$9,581/mo
Nursing home (semi-private)
$9,885/mo
Nursing home (private)
$4,369/mo
Assisted living

Median private-pay cost, CareScout (Genworth) 2025 Cost of Care Survey — a regional midpoint, not any single community’s rate. Private rooms and higher care levels cost more; ask for a current quote. Project your own in the cost-of-care planner.

Every figure above is reproduced from the CMS Provider Data Catalog (a public record), from the CMS extract processed 2026-08-01 — CMS provider number 255281. CMS refreshes its data monthly, and the star rating rests on the last standard inspection — dated 2026-03-19, which can lag current conditions. Staffing hours are CMS PBJ CY2026Q1 (Jan–Mar 2026). Check this record against the government’s own page for it: this home on Medicare Care Compare ↗ — the authoritative source, and the place to confirm anything here before you act on it. How we present it →

Not a government site. Eldercare Lens is not affiliated with, endorsed by, or authorized by the Centers for Medicare & Medicaid Services (CMS), Medicare, or any government agency. The star ratings, citations, and inspection wording on this page are reproduced from the public CMS record; the plain-English summaries, tiers, and comparisons around them are ours. We do not speak for CMS, and CMS has not reviewed this page. For the official record, go to Medicare Care Compare. How we’re funded →

Are you this operator? If the record here is out of date, or misses what you have since fixed, tell us and we will look: hello@eldercarelens.com. We reproduce the public CMS record and cannot change what it says — corrections to the underlying data go through CMS and your state survey agency — but we will correct anything we have got wrong about it, and we will say so on the page.

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