The Lev at Town Park

Location & what’s nearby

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

Quality measures — how residents actually fare

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

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

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

Therapy staffing: this home’s payroll records show 0.33 therapist hours per resident per day in 2026Q1 — more than 55% of the 13,892 homes that report any therapy hours at all.

Weekend therapy: weekend therapy hours are 3% of this home’s weekday level — it runs therapy on weekdays, with essentially none at the weekend. The median home that reports therapy runs 13% — weekday-focused therapy is the industry norm, not a shortfall. But recovery does not pause on a Saturday: ask what the weekend actually looks like here.

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

Staffing

How full it usually is: this home is certified for 180 beds and averages 86.1 residents a day — about 48% occupied, or roughly 94 beds typically open. It often has substantial empty capacity — worth asking why, since low census can reflect either a new or shrinking home or one families are avoiding. This is a CMS average, not live availability — no public source publishes real-time vacancies, and a home can be full the day you call. Confirm with the home, and if you need a Medicaid bed specifically, ask about that separately: a home with open beds may still not have an open Medicaid bed.

Against a benchmark — not a legal minimum. In May 2024 CMS finalized the first federal staffing floor for nursing homes: 3.48 total nurse hours per resident per day, including 0.55 RN hours and 2.45 nurse-aide hours. Its hour requirements never took effect and are no longer on the books. Homes had until 2026 (2027 if rural) to comply, and that deadline never arrived: a federal court vacated the hour requirements in April 2025 (CMS has appealed), Congress then barred enforcement until 2034, and CMS formally repealed them by rule effective February 2026. This home is not required to meet these numbers, and is not violating anything by missing them. We still show the comparison because the figures are CMS’s own published estimate of adequate staffing, which makes them a useful yardstick — but they are our benchmark, not federal law: this home’s total nurse staffing of 2.92 hrs/resident/day is below the 3.48-hour benchmark and RN staffing of 0.41 is below the 0.55-hour RN benchmark and nurse-aide staffing of 1.53 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 2.50 hrs/resident/day on weekends vs 3.09 on weekdays — 19% thinner on weekends. RN hours go from 0.43 to 0.36 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)

This home’s total nursing-staff turnover of 42% is about the same as the national median of 45%.

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

Inspection trend

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

Inspection deficiencies

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

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

25 citations, most serious first. The 13 most serious are shown; the remaining 12 are one tap away and print in full.

• Immediate jeopardy · K2025-11-17 · tag F0580 — failed to tell family and doctor about changes — pattern
  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 interviews, and record reviews, the facility failed to immediately consult with the resident's physician when there was a significant change in the resident's condition or need to alter treatment significantly for 1 of 10 residents (CR#1) reviewed for physician notification. 1. The facility failed to notify or seek medical guidance from the Medical Doctor or Nurse Practitioner for a change of condition after CR #1 complained of pain and a swollen knee on 11/5/25 at approximately 10:00pm. 2. The facility failed to immediately notify or seek medical guidance from the Medical Doctor or Nurse Practitioner after CR #1's left knee was observed swollen and painful at level 8 out of 10 (most severe) on 11/07/2025 at approximately 2:27 p.m, 3:41pm, and 4:18pm. 3. The facility failed to immediately seek medical guidance from the Medical Doctor or Nurse Practitioner for CR#1 after receiving results of an x-ray, which revealed, CR#1 had a Displaced distal femoral shaft spiral fracture. 4. The facility failed 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.

  Resident Rights Deficiencies · Deficient, Provider has date of correction
• Immediate jeopardy · K2025-11-17 · tag F0684 — failed to provide proper treatment and quality of care — pattern
  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, interviews and record review, the facility failed to ensure that residents received treatment and care in accordance with professional standards of practice and the residents' choices for 1 of 10 residents (CR# 1) reviewed for quality of care. 1. The facility failed to immediately seek medical guidance or send CR#1 out for higher level of care (ER) after receiving results of CR#1's x-ray, which revealed a Left Displaced distal femoral shaft spiral fracture . 2. The facility failed to notify the physician or NP of CR#1's change in condition, failed to monitor, and complete assessments on 11/5/25 and 11/6/25. 3. The facility failed to immediately transport CR#1 to the hospital on [DATE] after becoming aware of the result of an xray, which reflected an acute fracture. The facility waited approximately 13 hours to transport CR#1 to the hospital, where CR#1 was diagnosed with a spiral fracture of his femur and required emergency surgery. These failures could place residents at risk for continued…

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

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Actual harm · G2024-04-11 · tag F0600 — failed to protect residents from abuse and neglect — isolated
  Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interviews, and record review, the facility failed to ensure residents were free from abuse for 1 resident (Resident #2) of 8 residents reviewed for abuse. The facility failed to ensure each resident was free from abuse when Resident #2 was physically abused by CNA E on 10/16/2023 during her shift. This failure placed residents at risk of physical harm, emotional distress, mental anguish and death from possible abuse and neglect. The noncompliance was identified as past noncompliance and began on 10/16/2023 and ended on 10/18/2023. The facility corrected the noncompliance before the investigation began. Findings Include: Record review of Resident #2's face sheet dated 04/11/2024 revealed a [AGE] year-old female who was initially admitted to the facility on [DATE] and re-admitted [DATE] with diagnoses including cellulitis (deep infection caused by bacteria), in of right lower limb, cerebral infarction (disrupted blood flow to the brain), type 2 diabetes mellitus (when cells in your muscles, fat, 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.

  Freedom from Abuse, Neglect, and Exploitation Deficiencies · Past Non-Compliance
• Potential for harm · E2025-06-13 · tag F0583 — failed to protect personal privacy — pattern
  Keep residents' personal and medical records private and confidential.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observation, interview, and record review the facility failed to protect the personal and medical records of residents reviewed for privacy and confidentiality in that: On 06/11/25 MA B was not at her medication cart when her computer screen was showing numerous profiles on the computer screen of resident's pictures. This failure placed residents at risk of breach in confidentiality of medical information. Findings: Observation on 06/11/25 at 10:43AM revealed MA B left her computer open with resident records easily accessible showing their photo and names. In an interview on 06/11/25 at 10:44AM MA B said she had forgotten to lock her computer when she walked away from it to go to the medication room to check for a medication. MA B said she should not have done that because it placed the resident at risk for their medical records being exposed to the public. MA B said this was a HIPAA violation. MA B said she had received in-service on protecting the residents' medical records and that she did not mean to leave her computer unlocked. In an interview on 06/11/25 at 3:15PM 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 · E2025-06-13 · tag F0656 — failed to write and follow a full care plan — pattern
  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

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview and record review, the facility failed to develop and implement a comprehensive person-centered care plan to meet a resident's medical, mental, and psychosocial needs for 3 (Resident #17, Resident #31, Resident #48) of 5 residents reviewed for comprehensive care plans. - Resident #17 was not care-planned for exit-seeking when she was documented in her progress notes as pushing on the exit door by her room as a behavior. - Resident #31 did not have a comprehensive care plan in place with interventions to address oxygen use or anticoagulant use. -Resident #48 did not have a comprehensive care plan to address his advanced directive status of DNR This deficient practice could place residents at risk of their behaviors and needs being monitored and cared for at the facility. Findings included: Record review of Resident #17's face sheet dated 06/11/2025, reflected she was a [AGE] year-old female originally admitted on [DATE]. Her medical diagnoses included basal cell carcinoma of 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 Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Ecited before2025-06-13 · tag F0677 — failed to help fully-dependent residents with daily care — pattern
  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 observation, interview, and record review the facility failed to ensure a resident who is unable to carry out activities of daily living receives the necessary services to provide necessary services to maintain good grooming and personal hygiene for 1 (Resident #21) of 6 residents reviewed for activities of daily living in that: -The NF failed to remove unwanted facial hair from Resident #21's chin area and above the resident's top lip. This failure placed resident at risk for psychological embarrassment, sadness, and decrease in quality of life. Findings: Record review of Resident #21's face sheet dated 06/12/25 revealed a [AGE] year-old female admitted to the facility initially on 12/02/2013 and again on 07/17/23. The resident's diagnoses included the following: Alzheimer's Disease (a disease that destroys memory and other important memory function), muscle weakness, Parkinson's disease (disorder that affects the brain that can cause tremor, slowness of movement, limb stiffness, and gait and balance…

  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 · Ecited before2025-06-13 · tag F0755 — failed to provide safe pharmacy services — pattern
  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

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview and record review, the facility failed to provide pharmaceutical services including procedures that assure the accurate acquiring, receiving, dispensing and administering of all drugs and biologicals to meet the needs of each resident for 2 (Med Carts A and B) of 3 medication carts reviewed for pharmacy services. 1. Med Cart A had 3 blister packs of Tramadol 50 mg tablets totaling 68 tablets with an expiration date of 05/20/2025 for Resident #53. 2. Med Cart B had 1 blister pack with 9 tablets of Hyoscyamine Sulfate .125 mg tablets totaling 1 tablet and 1 blister pack of Haloperidol 1 mg oral tablet totaling 1 tablet with an expiration date of 05/25/2025 for Resident #68. This deficient practice could place residents at risk for not receiving the intended therapeutic benefit of their medications. Findings included: 1. Observation of Med Cart A and interview with RN G on 6/12/2025 at 4:28pm, revealed there were 3 blister packs of Tramadol 50 mg tabs (medication given to treat mild…

  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 before2025-06-13 · 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

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review the facility failed to maintain an infection program designed to provide safe, sanitary and comfortable environment and to help prevent the development and transmission of communicable disease and infections for 2 (Resident #29, Resident #42) of 7 residents and two staff members reviewed for infection control in that: -CNA KK was observed on 06/10/24 coming out of Resident # 42's room with a folded sheet placing the sheet back on the clean cart. -CNA D and Restorative Aide CNA E did not wear a disposable gown when providing Foley catheter for Resident #42 who was on enhanced barrier precautions. -CNA D and CNA E was not familair with EBP. -Resident #29's bathroom there was a gray wash pan sitting on side of the commode on the floor and a urinal sitting on top of the sink countertop not labeled or bag. -LVN P was observed on 06/10/25 coming out of room with a packet of used disposable wipes placing them on her medication cart. -Resident #29 and Resident #42 did…

  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 · Dcited before2025-06-13 · 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, interview, and record review the facility failed to ensure resident who is incontinent of bladder receives appropriate treatment and service to prevent urinary tract infections for 1 (Resident #42) of 6 residents reviewed for incontinent care in that: -CNA D placed Resident #42s Foley bag on the bed during Foley catheter care. This failure placed resident at risk for urinary tract infection, unwanted antibiotic therapy, and decrease in quality of life. Findings: Record review of Resident #42's face sheet dated 06/11/25 revealed an [AGE] year-old female admitted to the facility initially on 04/09/20 and again on 01/02/25. The resident's diagnoses included urinary tract infection, dementia (memory loss), acute kidney failure (when the kidneys suddenly cannot filter waste from the blood), severe sepsis (a life-threatening complication of an infection), and neuralgia (pain resulting from damaged or irritated nerves). Record review of Resident #42's quarterly MDS dated [DATE] reflected a BIMS…

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

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Dcited before2025-06-13 · tag F0693 — failed to provide proper feeding-tube care — isolated
  Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review the facility failed to ensure residents who are fed by enteral means receive the appropriate treatment and services to prevent complications of enteral feeding including but not limited to aspiration pneumonia, diarrhea, vomiting, dehydration, metabolic abnormalities, and nasal-pharyngeal ulcers for 1 (Resident #29) of 7 residents for the administration of medication via gastrostomy in that: -LVN A did not check for gastrostomy placement, per the facility policy, prior to administering Resident #29's medication on 06/10/25. This failure placed resident at risk for aspiration, unwanted hospitalization, and decrease in quality of life. Findings: Record review of Resident #29's face sheet dated 06/13/25 reveled an [AGE] year-old female admitted to the facility on [DATE] and again on 08/16/23. The resident's diagnoses included the following: dysphagia (difficulty swallowing), protein calorie malnutrition, cerebral infraction (condition where the brain tissue dies…

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

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2025-06-13 · tag F0919 — failed to provide a working call system — isolated
  Make sure that a working call system is available in each resident's bathroom and bathing area.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, interviews and record review, the facility failed to ensure the facility was adequately equipped to allow residents to call for staff assistance through a communication system which relays the call directly to a staff member or to a centralized staff work area for one resident (Resident #48) of 10 residents reviewed for resident call system in that: The facility failed to ensure Resident #48's call light was in working order. This failure could place residents at risk of being unable to obtain assistance for activities of daily living or in the event of an emergency. Findings included: Record review of Resident #48's facility admission record dated 6/11/25 revealed that Resident #48 had an original admission date of 3/2/21 and re-admission date of 5/1/25. Resident #48 was a [AGE] year-old male with diagnoses that included lobar pneumonia (a type of pneumonia where a large portion or entire lobe of one or both lungs becomes inflamed and consolidated, meaning it fills with inflammatory fluid…

  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.

  Environmental Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2025-05-16 · 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 interview, and record review the facility failed to ensure the assessment accurately reflected the resident's status for 1 (CR #1) of 5 residents reviewed for accuracy of assessments. The facility failed to ensure CR#1's behavior was coded on the quarterly MDS dated [DATE]. This failure could place residents with behavior at risk of not receiving care and intervention that could meet their behavioral needs. Findings included: Record review of CR #1's face sheet dated 05/16/2025 reflected CR#1 was a [AGE] year-old male who was admitted to the facility on [DATE] and discharged on 5/15/2025. CR#1's diagnoses included muscle wasting and atrophy (decrease or wasting of tissue, muscle or organs), lack of coordination (pattern walking or moving on foot), non- Alzheimer's disease (a type of dementia/neurodegenerative disease that affects the brain causing memory loss, confusion, and changes in behavior), hypertension (high blood pressure), diabetes (high blood sugar) hyperlipidemia (high levels of fat 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.

  Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Ecited before2024-05-08 · 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

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review, the facility failed to ensure that the medication error rate was not five percent (%) or greater. The facility had a medication error rate of 18% based on 6 errors out of 32 opportunities, which involved 3 of 9 residents (Resident #57, Resident #55 and Resident #13) reviewed for medication errors. MA A did not administered Metoprolol (a prescription medicine used to lower blood pressure and heart rate) and Metformin ( medication used to decrease the amount of glucose - a type of sugar released into the blood stream) to Resident #57 as ordered by the physician. MA B administered Levetiracetam ( a drug used to treated seizures( involuntary muscle movements -caused by epilepsy ( a group of brain disorders) to Resident #55 instead of Levetiracetam 5ml as ordered by the Physician. MA C administered Minocycline ( a drug works by killing bacteria or preventing their growth), with one daily Multi-Vitamin and Iron tablet to Resident #13 when the label indicatted: While…

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

  Pharmacy Service Deficiencies · Deficient, Provider has date of correction

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

Fines & penalties

$31,031 in federal fines across 1 penalty.

• $31,031 — penalty dated 2025-11-17

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 OAKBEND MEDICAL CENTER — 5 facilities. Here is how its ratings compare with the chain’s average across all its homes: See the whole chain — ratings, flags, fines and finances →

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

Who owns this facility

CMS files one row per role, so the 7 rows in the source record cover these 6 parties — each is shown once here with every role it holds. Nothing is omitted.

3 organizational owners listed — a facility can be part of a larger chain. CMS ownership data is known to under-report private-equity and REIT ties; treat as a starting point.

Follow the money — this home’s finances

Where a nursing home’s revenue comes from and where it goes — including money paid to companies under the same ownership. Most consumer sites never show this; we reproduce it straight from the Medicare cost report.

About 76% 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. A reported operating loss is common in this industry and is not by itself a sign of trouble — but paired with large related-party payments it can mean profit is being taken elsewhere in the ownership structure.

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

Cost & finances

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

What families pay in TX