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Arbors At Gallipolis

170 Pinecrest Drive, Gallipolis, OH 45631 · For profit - Limited Liability company · 99 certified beds · (740) 446-7112 Medicare & Medicaid certified

Need help choosing, fast? Free, unbiased: Eldercare Locator 1-800-677-1116
Flagged for abuseBehavioral-health or dementia-care citations — no harm found (F0744, F0758)1 actual-harm citation1 actual-harm citation CMS recorded as corrected before the inspection ended (past non-compliance)
Insights

This home has serious findings on its record. Read them closely before you consider it.

In its favor
  • no federal fines or payment denials on record
  • a high payroll-based staffing rating (4/5)
  • lower-than-typical staff turnover (27% vs 45% nationally) — better care continuity
Worth asking about
  • CMS has flagged it for abuse
  • it has an abuse, neglect, or exploitation citation (F0600), cited Apr 2026
  • it has 1 actual-harm citation
  • inspectors recorded 1 serious finding as past non-compliance — the problem was found, fixed, and verified before the survey closed, so it is history rather than a current condition, but it is still worth asking what changed
  • a high number of inspection citations overall (23) — worth reading through, though larger and more-often-surveyed homes tend to accrue more lower-severity tags
  • its payroll-based staffing score sits well above its independent inspection score
  • its independent health-inspection rating is low (2/5)

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) 4 of 5
Quality measuresSelf-reported by the facility 3 of 5

Worth a closer look. This home's staffing rating runs 2 stars above its independent health-inspection score. The inspection is done by state surveyors; the staffing score rests on the facility's own payroll (PBJ) submissions — so a gap this large is worth reading the inspection record for.

Location & what’s nearby

Hospital
★★★★ 4/5 CMS · Emergency dept. usually open 24/7 · ER 24/7
Urgent care / clinic
254 Pinecrest Dr · (740) 578-4824 · Call to confirm hours
Pharmacy
1168 Jackson Pike · (740) 446-6879 · Call to confirm hours
Grocery
1129 Jackson Pike · (740) 446-4008 · Call to confirm hours
Park
Typically dawn to dusk
Place of worship

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

Quality measures — how residents actually fare

Overall quality measures 3 of 5
Long-stay residentspeople who live here 4 of 5
Short-stay residentsrehab / post-hospital 2 of 5

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

Trend — is this home getting better or worse?

Over 2025-02 to 2026-06, this home’s CMS overall rating fell from 3 to 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 increased1.7%5.3%15.4%better than state — see note marked double-dagger below the table
Long-stay residents who lose too much weight5.3%6.2%5.4%typical
Long-stay residents with a catheter left in their bladder0.5%0.2%0.9%worse than state — see note marked double-dagger below the table
Long-stay residents with a urinary tract infection1.6%0.4%2.0%worse than state — see note marked double-dagger below the table
Long-stay residents with depressive symptoms0.0%30.1%6.5%check this — see note marked star below the table
Long-stay residents who were physically restrained0.0%0.1%0.1%better
Long-stay residents with falls causing major injury6.0%3.2%3.3%worse
Long-stay residents whose ability to walk worsened1.2%6.1%16.1%better than state — see note marked double-dagger below the table
Long-stay residents on antianxiety or hypnotic medication67.3%25.5%18.9%check this — see note marked dagger below the table
Long-stay residents given the seasonal flu vaccine100.0%94.5%95.3%typical
Long-stay residents with pressure ulcers3.1%3.4%4.7%better
Long-stay residents with worsening bladder/bowel control19.7%21.4%21.2%typical
Long-stay residents who got an antipsychotic medication — see the note below the table8.4%8.8%17.1%better
Short-stay residents who newly got an antipsychotic medication0.0%1.2%1.4%better
Short-stay residents given the seasonal flu vaccine85.7%75.6%79.4%typical
Short-stay residents rehospitalized after admission24.5%24.9%22.6%typical
Short-stay residents with an outpatient ER visit16.9%12.9%12.0%worse
Long-stay hospitalizations per 1,000 resident days2.131.731.67worse
Long-stay outpatient ER visits per 1,000 resident days3.351.801.80worse

* This home reported 0% on a measure where lower is better. That can mean genuinely excellent care — but because the number is self-reported, a zero can also mean the problem was not recorded. Weigh it against the inspection record above.

This value is several times the typical-state benchmark. It can be real, or it can be a coding artifact in what the facility submitted. Weigh it against the inspection record above.

On this measure the state average is at least twice (or half) the typical state — a gap that size is usually how the state codes and reports the measure, not how its homes actually perform. Against a benchmark this state does not sit on, a “vs typical state” verdict would mostly be measuring the state, so we compare this home with its own state instead and show both averages.

§ Antipsychotics carry an FDA boxed warning — they raise the risk of death in older people with dementia-related psychosis, and are not approved for that use. So this measure is partly a read on whether a home sedates residents instead of staffing for them. But read a low rate carefully in both directions: CMS excludes residents coded with schizophrenia (and Tourette's or Huntington's) from this measure, and federal auditors have found implausible increases in schizophrenia coding since the measure was published — so a very low rate can reflect recoding rather than less prescribing. Ask the home what share of its residents carry a schizophrenia diagnosis, and how it handles behavioral symptoms without medication.

CMS quality measures, as Care Compare shows them. For most rows lower is better (fewer falls, ulcers, hospitalizations); vaccination rates are the exception. Not every row is risk-adjusted. CMS adjusts some measures for resident mix, but falls with major injury, antipsychotic use, physical restraints and the vaccination rates are unadjusted rates — so a home caring for heavier or more behaviorally complex residents can look worse on them without providing worse care. The “typical state” column is the median of the 50 state averages — not a national average of all homes. We use it because a plain average across homes is pulled badly off course by a few states’ reporting habits (long-stay depressive symptoms is the clearest case: Illinois codes it several times higher than most states, which alone lifted the all-homes figure to about twice what a typical state records). The median of state averages resists that — but it does weigh every state equally, so a large state counts no more than a small one, and it is a benchmark of our construction rather than a CMS-published figure. better/worse means the home differs from that benchmark by more than 10% of it; closer than that reads typical. CMS does not publish how many residents each measure covers, and the counts are often small — a single resident can move a rate by several points — so treat small gaps as noise. These come from data the facility reports, so weigh them against the independent inspection record above.

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

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

46.9% 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 39 Medicare stays in Oct 2022–Sep 2024, and CMS’s own comparison — not ours.

46.9%U.S. median 51.5%
Got home and stayed home
10.0%U.S. median 10.7%
Went back to hospital
39.1%U.S. median 56.6%
Met the expected recovery
0.36U.S. median 0.31
Therapy hours / resident / day
0.16hours / resident / day
Physical therapy
0.17hours / resident / day
Occupational therapy
0.03hours / resident / day
Speech therapy

Met the expected recovery: 39.1% 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 23 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 0.36 therapist hours per resident per day in 2026Q1 — more than 62% of the 13,892 homes that report any therapy hours at all.

Weekend therapy: weekend therapy hours are 11% of this home’s weekday level — it runs some therapy at the weekend, at a lower level than on weekdays. The median home that reports therapy runs 13% — weekday-focused therapy is the industry norm, not a shortfall. But recovery does not pause on a Saturday: ask what the weekend actually looks like here.

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

See every short-stay measure CMS publishes for this home
MeasureThis homeU.S. medianPeriod coveredCMS’s call
Got home and stayed homeRate of successful return to home or community from a SNF46.9%CMS range 33.9–62.451.5%Oct 2022–Sep 2024no different from U.S.
Went back to hospitalRate of potentially preventable hospital readmissions 30 days after discharge from a SNF10.0%CMS range 6.8–14.810.7%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 discharge39.1%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 discharge34.8%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 discharge39.1%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 identified100.0%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 settingnot reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality 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 dischargenot reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
Falls with major injuryPercentage of SNF residents who experience one or more falls with major injury during their SNF stay5.7%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 worsened0.0%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 hospitalization6.4%CMS range 3.1–11.57.1%Oct 2023–Sep 2024no different from U.S.
Medicare spending per stayMedicare Spending Per Beneficiary (MSPB) for residents in SNFs1.211.02Oct 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

0.70
RN hours/ resident / day
0.90
LPN hours/ resident / day
2.11
Aide hours/ resident / day
3.72
Total nurse hours/ resident / day
0.40
RN hoursweekends
26.8%
Total nursing turnover
8.3%
RN turnover

How full it usually is: this home is certified for 99 beds and averages 83.6 residents a day — about 84% occupied, or roughly 15 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 3.72 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 0.70 is at or above the 0.55-hour RN benchmark and nurse-aide staffing of 2.11 is below the 2.45-hour aide benchmark. What federal law does require today is unchanged: “sufficient” nursing staff for residents’ needs and an RN on duty at least 8 consecutive hours a day, 7 days a week (42 CFR 483.35). Those are judged by inspectors on site, not by these averages, so read this comparison alongside the inspection record rather than as a pass/fail.

Weekend coverage: total nurse staffing is 3.24 hrs/resident/day on weekends vs 3.91 on weekdays — 17% thinner on weekends. RN hours go from 0.83 to 0.40 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)

This home’s total nursing-staff turnover of 27% is below the national median of 45%. 1 administrator has left in the past year.

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

Inspection trend

7
deficiencies at the latest standard inspection (2025-04-21)
8
at the previous standard inspection (2023-07-05)

Deficiencies are fewer than at the previous inspection — improving. Fewer citations over time suggests a home is fixing problems; a rising count is a warning sign — though two surveys are a short record, and survey teams differ. These counts are from the standard annual health survey only; the full citation list below may also include findings from complaint investigations, so the two won’t always add up.

Inspection deficiencies

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

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.

23 citations, most serious first. The 12 most serious are shown; the remaining 11 are one tap away and print in full.

  • Actual harm · Gcited before2026-04-29 · tag F0600 — failed to protect residents from abuse and neglect — isolated
    Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY THE FOLLOWING DEFICIENCY REPRESENTS AN INCIDENT OF PAST NON-COMPLIANCE THAT WAS SUBSEQUENTLY CORRECTED PRIOR TO THIS SURVEY.Based on record review, review of a self-reported incident (SRI), review of facility investigative documentation, review of facility video footage, personnel file review, policy review, and interview the facility failed to protect Resident #70's right to be free from abuse by Certified Nursing Assistants (CNAs) #210, #220 and #225. Actual harm occurred on 04/11/26 when Resident #2, who was cognitively impaired and diagnosed with dementia, was physically and psychosocially abused by CNAs #210, #220, and #225. The three CNAs forced the resident into a chair, held his arms down to keep him seated, and were overheard by other residents teasing and laughing at him. A reasonable person in the resident's position would have experienced fear, distress, humiliation, and a loss of dignity as a result of this treatment. Following the incident, Resident #2 was noted to have bruising and a skin tear to…

    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 · Past Non-Compliance
  • Actual harm · Gcited before2023-07-05 · 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, record review, review of online manufacturer guidance, and interview the facility failed to ensure equipment was maintained in a safe manner to prevent falls with injury for Resident #43 and Resident #50. The facility failed to provide adequate supervision and assistance to prevent Resident #48 from falls and eloping. Actual harm occurred on 02/03/23 when Resident #50 sustained a fall when the anti-rollbacks on his wheelchair were not properly functioning. The resident complained of severe pain for three days following the incident, with a decrease in functional mobility without any type of interventions. On 02/06/23 the resident was admitted to the hospital with a fractured right hip. Actual harm also occurred on 06/01/23 when Resident #43, who required staff assistance for personal care fell from a shower gurney after the rail of the gurney broke sustaining a fractured femur. Prior to the incident, there was no evidence the facility conducted any type of preventative maintenance 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.

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2026-04-29 · tag F0744 — failed to care for residents with dementia — isolated
    Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.
    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, policy review and interview the facility failed to ensure Resident #2, who had a diagnosis of dementia with behaviors received adequate, necessary and effective interventions as per his care plan to de-escalate a behavioral episode and to prevent increased agitation for the resident. This affected one resident (#2) of five residents reviewed for abuse. Findings include: Review of Resident #2's medical record revealed the resident was admitted to the facility on [DATE] with diagnoses including vascular dementia, unspecified psychosis, depression, seizure disorder, cognitive communication deficit, unsteadiness on feet, and muscle weakness. Record review revealed a plan of care dated 03/13/26 for behaviors related to dementia, psychosis, depression, and insomnia as evidenced by restlessness, anxiousness/ nervousness, physical aggression, hallucinations, delusions, exit seeking, history of verbal aggression, and wandering. Interventions included administer medications as ordered and observe…

    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 · F2025-04-21 · tag F0761 — failed to label and store drugs safely — widespread
    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 — the official record, unedited, may be distressing

    Based on observation and interviews, the facility failed to ensure opened multi-dose Tuberculin Purified Protein (TB) vials were dated when opened. This had the potential to affect all 81 residents residing in the facility. Findings Include: On 04/17/25 10:15 A.M., observation of the third floor medication room refrigerator revealed an opened vial of Tuberculin Purified Protein one milliliter (ml) was undated to when the first dose was obtained. Registered Nurse (RN) #196 verified the vial of TB solution was not dated when opened at the time of the observation. On 04/17/25 at 10:22 A.M., observation of the second floor medication room refrigerator revealed an opened vial of Tuberculin Purified Protein one milliliter (ml) was undated to when the first dose was obtained. Licensed Practical Nurse (LPN) #157 verified the TB solution was not dated when opened at the time of the observation.

    Pharmacy Service Deficiencies · Deficient, Provider has plan of correction
  • Potential for harm · D2025-04-21 · tag F0684 — failed to provide proper treatment and quality of care — isolated
    Provide appropriate treatment and care according to orders, resident’s preferences and goals.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, record review, facility policy review and interview, the facility failed to implement adequate and effective interventions to promote healing and prevent the deterioration of a left below the knee surgical site with staples for Resident #48 at the time of the resident's admission. This affected one resident (#48) reviewed for surgical wounds and for pressure wounds.Findings include:Review of the medical record for Resident #48 revealed an admission date of 3/20/25 with diagnoses including acquired absence of left leg below knee, need for assistance with personal care, weakness, cerebral infarction, atherosclerosis of native arteries of extremities with gangrene, left leg, hemiplegia, affecting left non-dominant side, dementia, and chronic obstructive pulmonary disease. Review of Resident #48's admission skin assessment dated [DATE] revealed the resident had a left below the knee amputation with 35 surgical staples measuring 7.82 centimeters (cm) by by 2.87 cm. Review of Resident #48's…

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

    Quality of Life and Care Deficiencies · Deficient, Provider has plan of correction
  • Potential for harm · Dcited before2025-04-21 · 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

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review, observation, interview, and policy review the facility failed to implement interventions to promote skin integrity for a resident ordered to wear a knee brace. This affected one resident (#48) of one resident reviewed for skin integrity. Findings Include: Review of the medical record for Resident #48, revealed an admission date of 3/20/25 (from the hospital). Diagnoses included but were not limited to acquired absence of left leg below knee, need for assistance with personal care, weakness, cerebral infarction, atherosclerosis of native arteries of extremities with gangrene, left leg, hemiplegia, affecting left nondominant side, dementia, and chronic obstructive pulmonary disease. Review of the hospital discharge paperwork dated 03/20/25 for Resident #48 revealed a left knee immobilizer to be on at all times. Review of the plan of care dated 03/20/25 for Resident #48 revealed the resident had impaired skin integrity related to recent surgery; mobility status as evidenced by: assist…

    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
  • Potential for harm · Dcited before2025-04-21 · 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, record review, interview and facility policy and procedure review, the facility failed to ensure physician ordered fall interventions were in implemented as ordered for two residents (#6 and #40) with known falls. This affected two residents of six residents reviewed for accidents. The facility census was 81. Findings Include: 1. Review of the medical record for Resident #6 revealed an initial admission date of 12/26/22 with the diagnoses including but not limited to Alzheimer's disease, atherosclerotic heart disease of native coronary artery, hypothyroidism, anxiety disorder, diverticulosis, dementia with other behavioral disturbances, psychosis, mood disorder, hyperlipidemia, insomnia, polyneuropathy, osteoarthritis, gastro-esophageal reflux disease, cardiomyopathy and dysphagia. Review of the plan of care dated 07/28/23 and last revised on 04/16/25 revealed the resident was at risk for falls/injury related to bladder incontinence, generalized weakness, history of falls, impaired…

    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
  • Potential for harm · D2025-04-21 · tag F0695 — failed to provide proper breathing / tracheostomy care — isolated
    Provide safe and appropriate respiratory care for a resident when needed.
    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, record review, and facility policy review, the facility failed to obtain a physician's order for the administration of oxygen therapy and post an oxygen warning sign. This affected one resident (#48) of one resident reviewed for respiratory care. The facility census was 81. Findings include: Review of the medical record for Resident #48, revealed an admission date of 3/20/25. Diagnoses included but were not limited to acquired absence of left leg below knee, need for assistance with personal care, weakness, cerebral infarction, atherosclerosis of native arteries of extremities with gangrene, left leg, hemiplegia, affecting left nondominant side and chronic obstructive pulmonary disease. Review of the most recent Minimum Data Set (MDS) 3.0 assessment dated [DATE] revealed a Brief Interview for Mental Status (BIMS) of 14 which suggests moderate cognitive impairment. The resident was assessed to require substantial/maximal assistance with shower/bathe self, bed mobility and total…

    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
  • Potential for harm · D2025-04-21 · tag F0699 — isolated
    Provide care or services that was trauma informed and/or culturally competent.
    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, interviews and facility policy and procedure review, the facility failed to comprehensively assess and develop a comprehensive plan of care for one resident (#31) with post traumatic stress disorder (PTSD). This affected one of four residents reviewed for mood/behavior. The facility census was 81. Findings Include: Review of the medical record for Resident #31 revealed an initial admission date of 01/12/23 with the diagnoses including but not limited to psychosis, schizoaffective disorder, depressive type, hypertension, hypothyroidism, drug induced subacute dyskinesia, obstructive sleep apnea, tremor, anxiety disorder, severe morbid obesity, constipation, dissociative and conversion disorder, post-traumatic stress disorder, chronic kidney disease, insomnia, borderline personality disorder, major depressive disorder, bipolar disorder, osteoarthritis and overactive bladder. Review of the resident's initial social service history dated 01/19/23 revealed the resident did not have PTSD. Review…

    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
  • Potential for harm · D2025-04-21 · tag F0847 — isolated
    Inform resident or representatives choice to enter into binding arbitration agreement and right to refuse.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on review of facility alternative dispute resolution agreements, resident interview, staff interview, record review, and policy review, the facility failed to ensure residents understood the agreement they signed. This affected two of three residents reviewed for arbitration agreements (Residents #15 and #68). The facility census was 81. Findings include: 1. Review of the record for Resident #68 revealed an admission date of 01/23/25. Review of a Minimum Data Set (MDS) assessment completed 01/27/25 revealed a Brief Interview for Mental Status (BIMS) score of 15, indicating intact cognition. Review of a facility Alternative Dispute Resolution Agreement dated 01/23/25 revealed Resident #68 signed the agreement on 02/14/25. The agreement stated it demonstrated a mutual intention to resolve disputes between them outside of court and to submit their disputes to Alternative Dispute Resolution through mediation and/or arbitration. The form also stated that the resident had been offered to, or had been able to view an audio/visual recorded video that details this agreement and what it…

    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 plan of correction
  • Potential for harm · E2023-07-05 · tag F0880 — failed to prevent and control infections — pattern
    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 review of the facility's infection control logs, record review, staff interview, and policy review, the facility failed to ensure they maintained an effective infection control program that adequately identified organisms causing infections within the facility and properly track those infections to identify any trends or patterns. This had the potential to affect all residents residing in the facility. The facility's census was 80. Findings include: A review of the facility's infection control logs for the past 12 months revealed the facility's infection preventionist was utilizing a floor plan to identify where infections were noted throughout the facility for each month. She had a floor plan for the second floor and a floor plan for the third floor. The floor plan was color coded to show the locations of the rooms in which different types of infections occurred. One color was used to signify each type of the following infections: urine, respiratory, skin, and other. The floor plan did not indicate what organisms were present for the different types of infections…

    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 · Ecited before2023-07-05 · tag F0881 — failed to use antibiotics responsibly — pattern
    Implement a program that monitors antibiotic use.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on review of the facility's infection control log, infection reports, record review, review of the McGeer's criteria, staff interview, and policy review, the facility failed to maintain and implement an effective antibiotic stewardship program to ensure residents only received antibiotics when warranted and antibiotics prescribed were appropriate for the infections being treated. This affected four (Resident #33, #75, #77, and #235) of five residents reviewed for infections. The facility census was 80. Findings include: 1. A review of Resident #33's medical record revealed she was admitted to the facility on [DATE]. Her diagnoses included adult onset diabetes mellitus and peripheral vascular disease. A review of Resident #33's physician's orders revealed she had an order in place to cleanse a wound to the left sole of her foot, pat dry, apply Betadine to the wound bed, and cover with a foam dressing daily. The treatment was ordered on 05/04/23. A review of Resident #33's skin and wound assessments revealed…

    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 11 citations
  • Potential for harm · Dcited before2023-07-05 · tag F0600 — failed to protect residents from abuse and neglect — isolated
    Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on review of resident medical record, facility's self-reported incident report, facility's abuse policy and procedure, staff personnel file, and staff interview, this facility failed to ensure residents were free from verbal and physical abuse while receiving assistance with care by a staff member. This affected one (Resident #25) of two residents reviewed for abuse. The facility census was 80. Findings include: Review of the medical record for Resident #25 revealed an admission date of 10/13/14 and a re-entry date of 07/01/20. Diagnoses included multiple sclerosis, dementia with behavioral disturbances, need for assistance with personal care, contracture of the right hand, and schizoaffective disorder bipolar type. Review of the plan of care dated 05/09/17 and revised 10/11/19 revealed Resident #25 displayed behaviors including attention-seeking related to resident has repetitive behaviors such as combing hair, wanting ice, and tying of shoes. Interventions included, cognitive/communication skill…

    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 · D2023-07-05 · tag F0641 — isolated
    Ensure each resident receives an accurate assessment.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record reviews and interviews the facility failed to ensure Minimum Data Set (MDS) assessments were accurately completed to reflect physician documentation of contraindications to Gradual Dose Reductions (GDR's). This affected two residents (#31 and #42) out of the five residents reviewed for unnecessary medications during the annual survey. The facility census was 80. Findings include: 1. Record review for Resident #43 revealed this resident was admitted to the facility on [DATE] and had diagnoses including chronic obstructive pulmonary disease, chronic respiratory failure with hypercapnia, anemia, dependence on supplemental oxygen, bipolar disorder, adult failure to thrive, shizoaffective disorder, contracture of left hand and elbow, muscle wasting, tremor, and muscle weakness. Review of the significant change MDS assessment, dated 06/20/23, revealed this resident was rarely/never understood. This resident was assessed to require extensive assistance from two staff members for bed mobility 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.

    Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2023-07-05 · 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 record review, observation, resident interview, staff interview, and policy review, the facility failed to ensure a resident who was depended on staff for assistance with activities of daily living (ADL's) received the assistance needed with the trimming of his fingernails. This affected one (Resident #52) of two residents reviewed for ADL's. The facility census was 80. Findings include: A review of Resident #52's medical record revealed he was originally admitted to the facility on [DATE]. His diagnoses included heart failure, osteoarthritis, chronic pain, chronic fatigue, weakness, need for assistance with personal care, schizo-affective disorder, and major depressive disorder. A review of Resident #52's annual Minimum Data Set (MDS) assessment dated [DATE] revealed the resident did not have any communication issues and he was cognitively intact. He was not known to display any behaviors nor was he known to reject care during the seven days of the assessment period. He required a limited assist of one…

    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 · D2023-07-05 · tag F0692 — failed to prevent malnutrition and dehydration — isolated
    Provide enough food/fluids to maintain a resident's health.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on medical record review, resident and staff interview and facility's hydration review, this facility failed to ensure residents with a fluid restriction was monitored for appropriate fluid intake. This affected one (Resident #38) of one resident reviewed for fluid intake. Facility census was 80. Findings include: Review of the medical record for Resident #38 revealed an initial admission date of 11/24/21 and a re-entry date of 03/01/22. Diagnoses included end stage renal disease, heart failure, and difficulty in walking. Review of the plan of care created 03/26/21 and revised 04/27/23 revealed Resident #38 had a potential fluid volume overload related to kidney failure, dialysis, non complaint with fluid restrictions such as drinking pop as desired, wants cups with ice and-or water at bedside. Interventions included to administer medication as ordered and monitor, provide diet as ordered, encourage that all snacks and beverages offered at activities comply with diet and fluid restrictions, monitor vital…

    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 · D2023-07-05 · tag F0758 — failed to limit and justify psychotropic drugs — isolated
    Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review and interview the facility failed to provide an appropriate diagnosis for the use of an antipsychotic. This affected one resident (Resident #7) out of five residents reviewed for unnecessary medications. The facility census was 80. Findings include: Record Review of Resident #7 revealed this resident was admitted to the facility on [DATE] with the following medical diagnoses: dementia, atherosclerosis, hypothyroidism, spondylosis, anxiety, Alzheimer's disease, mood disorder, polyneuropathy, osteoporosis, falls, lack of coordination, cognitive communication deficit, and muscle weakness. Review of the Minimum Data Set(MDS) assessment completed on 06/16/23 revealed this resident is rarely/never understood. Review of Physician Orders revealed this resident is receiving the following medication: Seroquel 50 milligram (mg) 1 tablet by mouth three times a day for unspecified dementia. Review of current resident diagnoses revealed this resident does not have an active diagnosis of psychosis in 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 · Ecited before2021-06-08 · tag F0881 — failed to use antibiotics responsibly — pattern
    Implement a program that monitors antibiotic use.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on medical record review, staff interview, review of Food and Drug Administration (FDA) information, review of a Health Day News Study, and facility policy and review, the facility failed to provide adequate justification for the use of antibiotics for COVID-19 positive residents. This affected 17 residents (Residents #1, #2, #3, #4, #10, #20, #22, #24, #27, #32, #49, #50, #53, #55, #56, #60 and #61) of 56 residents who were COVID-19 positive. Findings Include: Review of medical records of Residents #1, #2, #3, #4, #10, #20, #22, #24, #27, #32, #49, #50, #53, #55, #56, #60 and #61 from 01/18/21 to 02/28/21 revealed the residents received the antibiotic Azithromycin prior to the results of a positive COVID-19 test result. There was also no documentation or evidence to support McGeer's criteria or any other assessment was utilized to determine if an antibiotic should be prescribed and administered; it was simply used for the symptoms of COVID-19. On 06/08/21 at 2:58 P.M. interview with Registered Nurse (RN) #53 verified the facility treated residents who were COVID-19 positive…

    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 · D2021-06-08 · tag F0561 — failed to honor residents' choices — isolated
    Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on medical record review and interview, the facility failed to honor one resident's bathing preference related to frequency and timeliness. This affected one of one resident (Resident #42) reviewed for choices. Findings Include: Review of Resident #42's medical record revealed an admission date of 03/25/21. Diagnoses included gastroparesis, end stage renal disease, congestive heart failure, anemia, diabetes mellitus, blindness, hypertension, malignant neoplasm of the left breast, insomnia osteoarthritis and major depressive disorder. Review of the resident's quarterly MDS 3.0 assessment dated [DATE] revealed the resident has clear speech, understood others, made herself understood and had no cognitive deficit as indicated by a BIMS score of 15. The resident was dependent on two staff for bathing. Review of the resident's preferences for customary routine and activities dated 03/30/21 revealed the resident prefers a shower daily on the P.M. shift. Review of the second floor shower schedule revealed 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.

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2021-06-08 · tag F0580 — failed to tell family and doctor about changes — isolated
    Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review, staff interview and policy review, the facility failed to ensure the physician was notified of a resident's weight gain of two or more pounds in 24 hours in accordance to his plan of care. This affected one (Resident #63) of one residents reviewed for dialysis. Findings include: A review of Resident #63's medical record revealed he was admitted to the facility on [DATE]. His diagnoses included end stage renal disease, dependence on renal dialysis and congestive heart failure. A review of Resident #63's physician's orders revealed he was to be weighed daily. The order had been in place since 05/11/21. A review of Resident #63's care plans revealed he had a care plan in place chronic renal failure related to end stage renal disease requiring dialysis. The care plan was initiated on 05/11/21. One of the goals included the resident would not have any signs or symptoms of any complications related to fluid overload. The interventions included the need to monitor/ document/ report to 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.

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2021-06-08 · 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

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, medical record review, staff interview and facility policy and procedure review, the facility failed to consistently and adequately assess one resident's Stage II (Partial thickness loss of dermis presenting as a shallow open ulcer with a red-pink wound bed, without slough or bruising. May also present as an intact or open/ ruptured blister.) pressure ulcer. This affected one of one resident (Resident #59) reviewed for pressure ulcers. The facility identified two residents with pressure ulcers. Findings Include: Review of Resident #59's medical record revealed an original admission date of 07/28/20 with the latest readmission of 02/21/21. Diagnoses included congestive heart failure, chronic obstructive pulmonary disease, chronic kidney disease, anemia, cardiomyopathy, atrial fibrillation, history of COVID-19, chronic pain, major depressive disorder, overactive bladder and insomnia. Review of the resident's quarterly MDS 3.0 assessment dated [DATE] revealed the resident had clear speech,…

    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 · D2021-06-08 · tag F0698 — failed to provide proper dialysis care — isolated
    Provide safe, appropriate dialysis care/services for a resident who requires such services.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review, staff interview, and policy review, the facility failed to ensure a resident receiving dialysis, who had an order to be weighed daily, was weighed in accordance to his orders and plan of care and failed to follow the parameters included with the daily weight order by not notifying the physician when the resident had a weight gain of two or more pounds in 24 hours. They also failed to ensure the dialysis center completed the dialysis communication record to include a pre and post assessment of the resident's weights/ vital signs, medications received during his treatment and any other pertinent problems or complications that may have occurred during his dialysis treatment. This affected one (Resident #63) of one residents reviewed for dialysis. Findings include: A review of Resident #63's medical record revealed he was admitted to the facility on [DATE]. His diagnoses included end stage renal disease, dependence on renal dialysis, and congestive heart failure. A review of Resident #63's…

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

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2021-06-08 · tag F0756 — failed to review each resident's drug regimen — isolated
    Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY 2. Review of the medical record for Resident #57 revealed an admission date of 10/05/18. Diagnoses included dementia with behavioral disturbances, cognitive communication deficit, and aneurysm of the carotid artery. Review of Resident #57's quarterly Minimum Data Set (MDS) 3.0 assessment dated [DATE] revealed a Brief Interview for Mental Status (BIMS) score of 08 indicating a moderately impaired cognition for decision making abilities. Resident #57 was noted to express verbal behaviors directed towards others. Resident #57 required extensive assistance from two staff members for bed mobility, transfers, dressing, and toilet use. Review of Resident #57's physician orders for May 2021 revealed: -Protonix (proton pump inhibitor to treat reflux disease) 40 milligram (mg) tablet, give daily for heartburn, -Tagament (antacid to reduce acis in the stomach) 200 mg tablet, give one tablet, twice a day for sexual behaviors. Review of the pharmacy recommendation dated 07/16/20 revealed, This resident has been taking…

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

    Pharmacy Service Deficiencies · Deficient, Provider has date of correction

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

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

No federal fines in the current CMS record.

Part of a chain

This home belongs to ARBORS AT OHIO — 16 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 52.6-0.6 vs chain
Health inspection 2 of 52.3-0.3 vs chain
Staffing 4 of 52.9+1.1 vs chain
Quality measures 3 of 54.2-1.2 vs chain
The other 15 homes this chain runs (chain average 2.6★, per CMS)

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
ARK OPCO GROUP, LLCOrganization5% OR GREATER DIRECT OWNERSHIP INTEREST100%since 07/01/2015
B&Y HEALTHCARE S CORPOrganization5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDEDsince 07/01/2015
B&Y TRUSTOrganization5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDEDsince 07/01/2015
CODY HEALTHCARE S CORPOrganization5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDEDsince 07/01/2015
CRAIG FLASHNER 2007 TRUSTOrganization5% OR GREATER INDIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDEDsince 07/01/2015
NORCROSS, ROBERTIndividualCONTRACTED MANAGING EMPLOYEEsince 07/01/2015
ROGERS, STACEYIndividualCONTRACTED MANAGING EMPLOYEEsince 07/01/2015
KIRK, KRISTINEIndividualW-2 MANAGING EMPLOYEEsince 09/01/2016
FLASHNER, CRAIGIndividualCORPORATE DIRECTOR; OPERATIONAL/MANAGERIAL CONTROLsince 07/01/2015
PERLSTEIN, YITZCHOKIndividualCORPORATE DIRECTOR; OPERATIONAL/MANAGERIAL CONTROLsince 07/01/2015
NOBLE HEALTHCARE MANAGEMENT, LLCOrganizationOPERATIONAL/MANAGERIAL CONTROLsince 07/01/2015
PRESTIGE ADMINISTRATIVE SERVICES, LLCOrganizationOPERATIONAL/MANAGERIAL CONTROLsince 01/01/2016

CMS files one row per role, so the 14 rows in the source record cover these 12 parties — each is shown once here with every role it holds. Nothing is omitted.

7 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.

$8.8M
Net patient revenuemost recent cost report
+13.2%
Operating marginrevenue minus expenses
$650K
Related-party expense9% of expenses
Who pays — share of resident-days
Medicaid 69%Medicare 7%Other / private 24%

This home reported $650K 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

$248per resident / day
operating cost
$7,527per month
≈ monthly operating cost
$285per 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 OH

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 Ohio Medicaid page.

Typical monthly cost in Ohio
$9,186/mo
Nursing home (semi-private)
$10,389/mo
Nursing home (private)
$6,103/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 365348. CMS refreshes its data monthly, and the star rating rests on the last standard inspection — dated 2025-04-21, 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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