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Rainelle Healthcare Center

276 Pennsylvania Avenue, Rainelle, WV 25962 · For profit - Corporation · 60 certified beds · (304) 438-6127 Medicare & Medicaid certified

Call the home — (304) 438-6127 Need help choosing, fast? Free, unbiased: Eldercare Locator 1-800-677-1116
Abuse/neglect citation on record (F0602) — cited May 20261 actual-harm citation
Insights

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

In its favor
  • a strong health-inspection score (4/5) — the hardest rating to game (though it’s ranked within its own state, not nationally)
  • 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
  • it has an abuse, neglect, or exploitation citation (F0602), cited May 2026
  • it has citations for its abuse-prevention policies, restraint use, or reporting and investigating of allegations (F0609, F0610) — cited below the harm level, meaning inspectors found the process wanting but did not find a resident harmed
  • it has 1 actual-harm citation
  • a high number of inspection citations overall (24) — worth reading through, though larger and more-often-surveyed homes tend to accrue more lower-severity tags

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.

4/5
CMS overall
4 of 5
Health inspectionSurveyor-assigned, ranked within your stateInspector-verified 4 of 5
StaffingFrom payroll records (PBJ) 4 of 5
Quality measuresSelf-reported by the facility 3 of 5

Location & what’s nearby

Hospital
Emergency dept. usually open 24/7 · ER 24/7
Urgent care / clinic
645 Kanawha Ave · (304) 438-6188 · Call to confirm hours
Pharmacy
Walgreens0.3 mi
1250 Kanawha Ave · (304) 438-9204 · Call to confirm hours
Grocery
Kroger0.3 mi
406 John Raine Dr · (304) 438-8951 · 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 1 of 5

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

Trend — is this home getting better or worse?

Over 2025-02 to 2026-06, this home’s CMS overall rating held steady at 4 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 rating4★
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 increased16.8%14.7%15.4%typical
Long-stay residents who lose too much weight5.4%6.3%5.4%typical
Long-stay residents with a catheter left in their bladder0.0%0.4%0.9%better than state — see note marked double-dagger below the table
Long-stay residents with a urinary tract infection1.5%1.6%2.0%better
Long-stay residents with depressive symptoms3.8%7.6%6.5%better
Long-stay residents who were physically restrained0.0%0.2%0.1%better
Long-stay residents with falls causing major injury8.5%4.4%3.3%worse
Long-stay residents whose ability to walk worsened19.5%15.9%16.1%worse
Long-stay residents on antianxiety or hypnotic medication26.8%27.0%18.9%worse
Long-stay residents given the seasonal flu vaccine97.9%97.6%95.3%typical
Long-stay residents with pressure ulcers0.9%4.2%4.7%better
Long-stay residents with worsening bladder/bowel control28.6%22.1%21.2%worse
Long-stay residents who got an antipsychotic medication — see the note below the table8.4%13.4%17.1%better
Short-stay residents who newly got an antipsychotic medication0.0%1.0%1.4%better
Short-stay residents given the seasonal flu vaccine92.7%79.4%79.4%better

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.

42.3% 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 33 Medicare stays in Oct 2022–Sep 2024, and CMS’s own comparison — not ours.

42.3%U.S. median 51.5%
Got home and stayed home
10.8%U.S. median 10.7%
Went back to hospital
56.0%U.S. median 56.6%
Met the expected recovery
0.24U.S. median 0.31
Therapy hours / resident / day
0.06hours / resident / day
Physical therapy
0.10hours / resident / day
Occupational therapy
0.08hours / resident / day
Speech therapy

Met the expected recovery: 56.0% 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 25 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 0.24 therapist hours per resident per day in 2026Q1 — more than 33% of the 13,892 homes that report any therapy hours at all.

Weekend therapy: weekend therapy hours are 16% 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 SNF42.3%CMS range 27.8–56.251.5%Oct 2022–Sep 2024no different from U.S.
Went back to hospitalRate of potentially preventable hospital readmissions 30 days after discharge from a SNF10.8%CMS range 7.2–17.210.7%Oct 2022–Sep 2024no different from U.S.
Met the expected recoveryPercentage of residents who are at or above an expected ability to care for themselves and move around at discharge56.0%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 discharge36.0%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 discharge40.0%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 identified60.0%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 stay0.0%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 worsened5.0%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 hospitalization6.7%CMS range 3.9–12.97.1%Oct 2023–Sep 2024no different from U.S.
Medicare spending per stayMedicare Spending Per Beneficiary (MSPB) for residents in SNFs1.151.02Oct 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

0.63
RN hours/ resident / day
1.09
LPN hours/ resident / day
2.15
Aide hours/ resident / day
3.87
Total nurse hours/ resident / day
0.22
RN hoursweekends
27.1%
Total nursing turnover
37.5%
RN turnover

How full it usually is: this home is certified for 60 beds and averages 54.3 residents a day — about 90% occupied, or roughly 6 beds typically open. It runs fairly full. This is a CMS average, not live availability — no public source publishes real-time vacancies, and a home can be full the day you call. Confirm with the home, and if you need a Medicaid bed specifically, ask about that separately: a home with open beds may still not have an open Medicaid bed.

Against a benchmark — not a legal minimum. In May 2024 CMS finalized the first federal staffing floor for nursing homes: 3.48 total nurse hours per resident per day, including 0.55 RN hours and 2.45 nurse-aide hours. Its hour requirements never took effect and are no longer on the books. Homes had until 2026 (2027 if rural) to comply, and that deadline never arrived: a federal court vacated the hour requirements in April 2025 (CMS has appealed), Congress then barred enforcement until 2034, and CMS formally repealed them by rule effective February 2026. This home is not required to meet these numbers, and is not violating anything by missing them. We still show the comparison because the figures are CMS’s own published estimate of adequate staffing, which makes them a useful yardstick — but they are our benchmark, not federal law: this home’s total nurse staffing of 3.87 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 0.63 is at or above the 0.55-hour RN benchmark and nurse-aide staffing of 2.15 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 3.44 hrs/resident/day on weekends vs 4.04 on weekdays — 15% thinner on weekends. RN hours go from 0.80 to 0.22 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)

This home’s total nursing-staff turnover of 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

5
deficiencies at the latest standard inspection (2026-05-21)
5
at the previous standard inspection (2024-12-12)

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

Inspection deficiencies

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

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.

24 citations, most serious first. The 11 most serious are shown; the remaining 13 are one tap away and print in full.

  • Actual harm · Gcited before2023-01-05 · 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 — the official record, unedited, may be distressing

    Deficiency Text Not Available

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · E2026-05-21 · tag F0602 — failed to protect residents from theft of their belongings — pattern
    Protect each resident from the wrongful use of the resident's belongings or money.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Reference complaint# 2667227 Based on Record review and staff interview, the facility failed to ensure the safety and security of resident property; specifically medication. This was discovered during the normal Long Term Survey Process and has the ability to affect more than a limited number of residents. Resident Identifiers #1, 15, 39, 56, 64, 65. Census 55.Based on Record review and staff interview, the facility failed to ensure the safety and security of resident property; specifically, medication. This was discovered during the normal Long Term Survey Process and had the ability to affect more than a limited number of residents. This citation was issued at past noncompliance. Resident identifier: #64. Facility census: 55. Findings included: a) Resident #64 On 10/21/25 it was discovered that LPN #100 was not giving out as needed (PRN) medications to the residents assigned to them. There were multiple accounts of the medications being marked as given on the Medication administration Record (MAR), but when residents were asked about their PRN medication need or use, they stated…

    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 · Ecited before2026-05-21 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — pattern
    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

    Based on observation, record review, and staff interview the facility failed to provide an environment free from accident hazards including, provide bed side floor mat for a resident that was in a care plan and ordered by physician and non-locking doors to general shower room and linen room. This was true for Resident #23 and has the potential affect a larger number of residents. Resident identifier: #23. Facility census: 55. Findings included: a) Resident #23 Review of Resident #23's physician orders on 05/19/26 revealed the following: Fall mat to patient's left side. Order date: 04/23/26. Review of the care plan on pages 19 and 20 revealed: Focus -Resident is at risk for falls related to, but not limited to history of falls, Parkinson's, Tremor etc Interventions- include fall mat to patients left side of bed when in bed. Date initiated 02/02/26 On 05/20/26 at 4:02 PM Resident #23 was observed lying in bed with eyes closed, call light within reach, bilateral bed bolsters but the fall mat was absent from the left side. On 05/20/26 at 4:04 PM the administrator was interviewed…

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

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2026-05-21 · tag F0645 — isolated
    PASARR screening for Mental disorders or Intellectual Disabilities
    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 staff interviews the facility failed to ensure each resident in a nursing facility is screened for a mental disorder (MD) or intellectual disability (ID) prior to admission by not ensuring Pre-admission screening and resident review (PASSR) reflected the medical diagnosis prior to admission to facility and updated the PASSR. This was found true for one (1) of four (4) reviewed during the Long Term Care Survey process. Resident identifier: #17. Facility census: 55. Findings Include: a) Resident #17 During record review completed on 05/20/26 at 11:00 Am found resident # 17 has a diagnoses of Major Depressive Disorder Recurrent unspecified on 11/17/23 resident was admitted to the facility on [DATE]. Further record review revealed the most recent Pre-admission screening and Resident Review (PASSR) created on 04/20/26 did not have the diagnosis of Major Depressive Disorder Recurrent unspecified. An interview with the facility's administrator was completed on 05/20/26 at 1:00 PM 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 · Dcited before2026-05-21 · tag F0656 — failed to write and follow a full care plan — isolated
    Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
    What the surveyor found here — the official record, unedited, may be distressing

    Based on observation, staff interview and and record review, the Facility failed to implement a resident's care plan by failing to use a floor mat for Resident #23 with a a history of falls. Resident identifier: #23. Facility Census 55. a) Resident #23 A review of Resident #23's physician orders on 05/19/26 revealed the following: Fall mat to patients left side. Order date 04/23/26. A review of the care plan on pages 19 and 20 revealed: Focus -Resident is at risk for falls related but not limited to history of falls, Parkinson's, Tremor etc Interventions- include fall mat to patients left side of bed when in bed. Date initiated 02/02/26. On 05/20/26 at 4:02 PM Resident #23 was observed lying in bed with eyes closed, bulb call light in reach, bilateral bed bolsters but absence of fall mat to left side. On 05/20/26 at 4:04 PM interview with administrator who observed Resident #23, and acknowledged the mat was not in place. At 4:10 PM the Administrator returned and reported the floor mat was behind the bed but had since been put into place.

    Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2026-05-21 · 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 — the official record, unedited, may be distressing

    Based on interview, record review and observation the facility failed to ensure resident #10 was provided sunscreen prior to an outside activity. Resident identifier #10. Facility Census: 55. Findings Include: a) Resident #10 After observation of Resident #10 it was evident that the resident had a sunburn. Resident #10 stated that she had been outside for an activity and was not offered sunscreen prior to going outside, therefore Resident #10 suffered a sunburn. Resident #10 sunburn resulted in an order for aloe vera to be applied to affected areas. This deficient practice was verified by the Administrator on 5/20/26 at 2:39 PM.

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2024-12-12 · tag F0576 — isolated
    Ensure residents have reasonable access to and privacy in their use of communication methods.
    What the surveyor found here — the official record, unedited, may be distressing

    Based on resident interview, staff interview and record review the facility failed to protect the resident's rights to communicate with individuals confidentially by opening Resident #15's package before giving it to her. This failed practice was a random opportunity for discovery during the Long-Term Care Survey Process. Resident identifier #15. Facility Census 52. Findings include: a) Resident #15 During an interview, on 12/11/24 at 9:40 AM, Resident #15 stated, Yesterday I got a package Resident #15 then showed me the package. It was a box that she had received through mail delivery services. Resident #15 further stated, I don't like them opening my stuff without me. A record review on 12/11/24 at 10:02 AM, of Resident #15's Brief Interview for Mental Status (BIMS) assessment revealed that Resident #15, had a BIMS score of (9) nine. During an interview on 12/11/24 at 10:13 AM, The Activity Director (AD) stated, I opened it and put it in there, because she is on a special diet, and she sometimes gets hard candy so I wanted to make sure she didn't get that.

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2024-12-12 · tag F0656 — failed to write and follow a full care plan — isolated
    Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on record review and staff interview, the facility failed to implement the comprehensive care plan in the area of falls. This deficient practice had the potential to affect one (1) of six (6) residents investigated for the care area of falls. Resident identifier: #12. Facility census: 52. Findings included: a) Resident #12 Review of Resident #12's comprehensive care plan showed a focus relating to potential injury from falls was initiated on 04/05/17. The following intervention was initiated on 04/07/23, Staff to ensure clothes fit properly when dressing resident. If elastic is worn out in pants notify nurse and use a different pair. Review of Resident #12's medical records showed the resident experienced a fall on 11/30/24. A nursing note written on 11/30/2024 at 7:47 PM stated, Resident was observed to have hipsters in place, only one shoe was in place (right shoe.) Resident did not have properly fitting pajama pants as they were observed to have no elastic in the waistband. Pants were observed to be around her ankles and possibly the cause of this fall. New fall…

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

    Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2024-12-12 · 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

    Based on record review and staff interview, the facility failed to ensure residents received treatment and care in accordance with professional standards of practice. Neurological checks were not performed according to professional standards of practice after an unwitnessed fall. This deficient practice had the potential to affect one (1) of six (6) residents reviewed for the care area of falls. Resident identifier: #12. Facility census: 52. Findings included: a) Resident #12 The facility's policy and standard procedure titled Neurological Checks, no implementation date given, stated neurological checks would be performed for falls with unknown head injury as follows: - Every 15 minutes for four (4) times - Every 60 minutes for four (4) times - Every four (4) hours for four (4) times - Daily for four (4) times Review of Resident #12's medical records showed the resident had an unwitnessed fall with a head laceration on 11/13/24. The resident was evaluated in the emergency room where the head laceration was sutured. A computed tomography showed no abnormalities. Neurological…

    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 before2024-12-12 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolated
    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review and staff interview, the facility failed to ensure the resident environment over which it had control was as free from accident hazards as possible. This deficient practice affected one (1) of six (6) residents investigated for the care area of falls. Resident #12 experienced actual harm from the fall because she experienced pain after the fall and required evaluation in the emergency room. X-ray examination showed an abnormality of the hip and further evaluation was recommended. However, the resident experienced another fall before further imaging could be obtained. After the second fall, the resident was found to have a hip fracture, requiring surgical intervention. Resident identifier: #12. Facility census: 52. Findings included: a) Resident #12 Review of Resident #12's comprehensive care plan showed a focus relating to potential for injury from falls was initiated on 04/05/2017. The focus stated, Potential for injury from falls r/t [related to] weakness, difficulty walking, hx…

    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 before2024-12-12 · tag F0842 — failed to keep accurate, complete medical records — isolated
    Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on record review and staff interview, the facility failed to ensure medical records were complete and accurate regarding fall risk evaluations for one (1) of six (6) residents reviewed for the care area of falls. Resident identifier: #54. Facility census: 52. Findings included: a) Resident #54 Review of Resident #54's medical records showed the resident had been admitted to the facility after a falling at home and fracturing her hip. A Fall Risk Observation Tool assessment was performed on 07/19/24 and documented the resident required minimum transfer assistance with gait belt. The assessment also documented the resident had a balance problem while walking and was unable to lift her head. The assessment also documented the resident had a fall history, currently took one (1) or two (2) medications that could contribute to a fall, and had one (1) or two (2) medical conditions that could contribute to falls. A Fall Risk Observation Tool assessment was repeated on 07/31/24 and documented the resident required minimum transfer assistance with gait belt. The assessment also…

    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
Show the remaining 13 citations
  • Potential for harm · D2024-11-06 · tag F0610 — failed to investigate and act on abuse reports — isolated
    Respond appropriately to all alleged violations.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on record review and staff interview, the facility failed to thoroughly investigate an allegation of verbal abuse. This failed practice was found true for (1) one of (3) three residents reviewed for abuse during the survey process. Resident identifier: #53. Facility census: 49. Findings included: a) Resident #53 A review of the facilities reportables on 11/04/24 at 12:15 PM, revealed a reportable dated 01/25/24 made by Resident #53 that reads as follows: Resident reported to social worker that the day prior, he had finished using the restroom. He then states he asked the Certified Nursing Assistant (CNA) to assist him with getting cleaned up and the CNA told him, Do it yourself. Further review revealed that the alleged perpetrator was Nursing Assistant (NA) #8, and that the allegation was unsubstantiated. There was only one employee statement in the reportable. That statement was made by NA #8 and read as follows: I gave (Resident #53 name) a shower on Monday the 22nd. I changed his pullup for him on Tuesday the 23rd. I asked him if he could do it himself and he said, No, so I…

    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 · Ecited before2023-09-26 · 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 staff interview and record review the facility failed to follow physician's orders. The facility failed to administer medication as ordered, failed to complete the Neuro checks after a fall, and failed to follow physician's orders for low Blood Sugars. Resident identifiers: # 41, #19, #34, #23, #9, and #44. Facility census 53. Findings included: a) Resident #41 Resident #41 is alert and has capacity. Resident #41 has a medical history (HX) of pertinent diagnosis: Parkinson's disease, Artificial knee joint bilateral, type 2 diabetes mellitus (DM), Hypokalemia, dysphagia following cerebral infarction, Hypothyroidism, Cornea transplant, bipolar II disorder, Congestive heart failure, Major depression, Anxiety, and Atrial Fibrillation. During a review of the medical records for Resident #41 the admission medications dated 09/16/23 at 5:30 PM, found the list of admission medications are as follows: 1. Acetaminophen- Codeine oral tablet 300/30 mg continue taking as at home, for pain (fracture right foot).…

    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 · E2023-09-26 · 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 record review, resident and family interview, and staff interview the facility failed to obtain and maintain timely and appropriate pharmaceutical services that support residents' healthcare needs, goals, and quality of life that are consistent with current standards of practice. This was true for one (1) out of four (4) reviewed for receiving medications from the pharmacy in a timely manner. Resident identifier: Resident #41. Facility census 54. Findings included: a) Resident #41 Resident #41 is alert and has capacity. Resident #41 has a medical history (HX) of pertinent diagnosis: Parkinson's disease, Artificial knee joint bilateral, type 2 diabetes mellitus (DM), Hypokalemia, dysphagia following cerebral infarction, Hypothyroidism, Cornea transplant, bipolar II disorder, Congestive heart failure, Major depression, Anxiety, and Atrial Fibrillation. A review of the medical records for Resident #41 found the resident was admitted to the facility on [DATE] at 5:30 PM. The list of admission medications…

    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 · D2023-09-26 · 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 and staff interview, the facility failed to notify the physician when the Resident's oxygen saturation dropped outside of the specified physician's order for notification. This was a random opportunity for discovery. Resident identifier: #54. Facility census: 53. Findings included: a) Resident #54 Record review revealed Resident #54 was admitted to the facility on [DATE] and was discharged on 09/08/23. Diagnoses included: End Stage Renal Disease, Congestive Heart Failure, Type II Diabetes, Anemia, and Dependence Renal Dialysis. Review of the medication administration record for September 2023, found an order for: Oxygen at 2L/min via nasal cannula as needed for shortness of breath or oxygen less than 88% Documentation review of Weights and Vitals Summary revealed the following information: An oxygen saturation was recorded at 5:33 AM of 82% on 09/06/23. There was no documentation available to reflect the physician had been notified of decreased oxygen saturation. The medication…

    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 · D2023-09-26 · tag F0624 — isolated
    Prepare residents for a safe transfer or discharge from the nursing home.
    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 staff interview, the facility failed to ensure a resident was provided a safe and orderly discharge from the facility. This was found for one (1) of two (2) residents reviewed for the care area of discharges. Resident identifier #54. Facility census: 53. Findings included: a) Resident #54 Record review revealed Resident #54 was admitted to the facility on [DATE] and was discharged home on [DATE]. Diagnoses included: End Stage Renal Disease, Congestive Heart Failure, Type II Diabetes, Anemia, and Dependence Renal Dialysis. (Resident had been at the facility prior to 04/19/23, but had a hospital admission and was readmitted to the facility on [DATE].) Review of a Physician Progress Note, dated 09/05/23, found the Resident was planning to go home on peritoneal dialysis and patient feels she needs her oxygen and will have to qualify. Review of a social worker note dated 09/07/23 at 11:04 AM, revealed a referral for Home Health for evaluation. A follow-up appointment was made for Friday…

    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 before2023-09-26 · tag F0842 — failed to keep accurate, complete medical records — isolated
    Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on record review and staff interview the facility failed to ensure the medical record was complete and accurately documented. This failed practice was true for one (1) out of four (4) residents reviewed for insulin. Resident identifiers: #34. Facility census 54 Finding included: a) Resident #34 A medical record review found Resident #34 had a blood sugar (BS) (this is a test to check the level of glucose in the blood system by collecting a small amount of blood normally from a finger) of 402 on 09/23/23. The order reads contact the physician if BS is above 400. The only nursing note found by this surveyor was, BS was above 400. There was no mention of any new orders. On 09/25/23 at 12:04 PM, the Director of Nursing (DON) was informed of the above. At 1:32 PM DON stated she corrected the nursing note and added information the facility physician was made aware of the BS. The DON provided a piece of paper with the name of Resident #34 on it. The paper appeared to be a screenshot of Text messaging. The DON said this was a method the nurses use to notify the physician and called 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.

    Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · E2023-01-05 · tag F0732 — pattern
    Post nurse staffing information every day.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on record review and staff interview the facility failed to ensure an accurate staff posting with the total number and the actual hours worked by licensed and unlicensed nursing staff directly responsible for resident care per shift. This was true for 10 out of 14 days reviewed. Facility census 54. Findings included: a) Staff Posting A review of the staff posting revealed, on following dates had less hours then what was posted: -12/24/22, posted hours-3.89. accrual hours worked 3.0. -12/26/22, posted hours-4.8, accrual hours worked 4.15. -12/27/22, posted hours 4.6, accrual hours worked 4.25. -12/28/22, posted hours 4.4, hours worked 4.2 -12/29/22, posted hours 4.8, hours worked 4.2. -12/30/22, posted hours 4.8, hours worked 3.7. -12/31/22, posted hours 4.8, hours worked 3.7. -01/02/23, posted hours 5.0, hours worked 4. -01/03/23, posted hours 4.5, hours worked 3.9. -01/04/23, posted hours 4.5, hours worked 3.9. During an interview on 01/05/23 at 1:31 PM, with Administrator, he stated the facility needed to develop a plan for corrected the postings on every shift. A brief…

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

    Nursing and Physician Services Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2023-01-05 · tag F0609 — failed to report abuse allegations — isolated
    Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on medical record review, resident and staff interviews, the facility failed to report an allegation of neglect to the appropriate state entities within the timeframe's a outlined in the regulation and guidelines. This was true for one (1) resident reviewed for abuse/neglect. Resident identifier: #45. Facility census: 54. Findings included: a) Resident #45 In an interview with Resident #45 on 01/03/22 at 2:45 PM, the resident stated that she went home for Christmas and had a terrible experience with her blood sugar. Review of Resident #45's medical records found the following nurses notes: --On 12/24/22 at 9:30 AM, written by Employee #18, a licensed Practical Nurse (LPN) Resident out of facility at this time with daughter. --On 12/24/2022 at 1:34 PM by LPN #18,Medication Administration Note: Resident is at home with daughter on a scheduled overnight and has all medications except narcotics with her per physicians orders. -- On 12/25/2022 at 3:46 AM by LPN #24, Daughter called with concern that resident was exhibiting hypoglycemic symptoms. She did not mention what her reading…

    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 · D2023-01-05 · 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 medical records and staff interview, the facility failed to identify and treat Resident #17's pressure ulcers present on admission. This was true for one (1) of one (1) reviewed for care area of pressure ulcers. Resident identifier: #17. Facility census: 54. Findings include: a) Resident #17 Review of Resident #17's medical records found the resident was in the hospital from [DATE] till 12/30/22 for treatment for a fracture of left femur with surgical intervention following a fall in the facility. Review of Resident #17's discharge records show on 12/25/22 a consult ordered on 12/25/22 for an advanced wound care team to assess and treat open wound, pressure ulcer on sacrum. Consult completed on 12/27/22 found as follows: --Wound #1- Stage II pressure ulcer on left buttocks, measuring 0.5 centimeters (cm) in length, 1 cm in width and 0.2 cm in depth, wound base dry and granulation, wound edges smooth and reddened, no drainage. Peri wound with blanchable erythema/discoloration. --Wound #2- Stage II…

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

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2023-01-05 · 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

    Based on observations, medical record review and staff interviews the facility failed to provide supervision to prevent accidents and a safe environment for other residents. This failed practice had a potential to affect more than an isolated number of residents. Resident Identifiers: Resident #42. Facility Census: 54 Findings Included: A review of the facility policy titled Elopement with a revision date of 05/31/22 found the following. The Center will strive to prevent unsafe wandering while maintaining the least restrictive environment for the patients who are at risk for elopement. a) Resident #42 Several observation made throughout the Long-Term Care Survey Resident #42 was ambulating continuously aimlessly throughout the facility. During a review on 01/04/23 revealed Resident # 42 had the follow incidents: -On 12/29/22 at 9:30 AM Resident # 42 was found ingesting three (3) in one (1) foaming peri wash. Witness Statement dated 12/29/22 Nurses Aide (NA) #33 typed as written I went to her room to see if she needed changed and she did. I needed wipes and left the room for 1…

    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 · D2023-01-05 · 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 medical record review and staff interview, the facility failed to ensure a resident who require dialysis receive such services, consistent with professional standards of practice, the comprehensive person-centered care plan. Facility failed to send a communication form completed by dialysis, failed to complete a pre and post assessment by licensed nurses consistently and failed to address a recommendation by dialysis facility. This was true for one (1) of one (1) resident reviewed for the care area of dialysis during the annual Long-Term Care Survey Process (LTCSP). Resident identifier: #45. Facility census: 54. Findings include: a) Resident #45 Review of Resident # 45's medical records found he was readmitted to the facility on [DATE]. She was ordered to receive hemodialysis treatment three (3) times weekly on Mondays, Wednesdays, and Fridays for diagnosis of end stage renal disease. Review of Resident #45's Dialysis Communication forms since 11/01/22 (the forms are sent from facility to the dialysis…

    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 · D2023-01-05 · tag F0868 — isolated
    Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
    What the surveyor found here — the official record, unedited, may be distressing

    Based on review of the Quality Assessment and Assurance (QA&A) Committee sign-in sheets and staff interview, the facility failed to ensure the required staff (Infection Preventionist (IP) and two (2) other staff members) attended the meetings as required. This had the potential to affect all residents residing at the facility. Facility census: 58. Findings include: Review of the QA&A committee sign-in sheets found the facility held meetings on the following dates: --03/30/22- Infection Preventionist and one (1) other leadership staff did not attend --05/06/22- Two (2) other leadership staff did not attend. --07/26/22- Two (2) other leadership staff did not attend. --08/30/22- Infection Preventionist did not attend. --11/29/22- Infection Preventionist and one (1) other leadership staff did not attend Interview with the Nursing Home Administrator (NHA) on 01/05/23 at 11:30 am. He confirmed the above-mentioned meeting the required number of staff did not attend the meeting. He further clarified the staff was either on the floor working and/or on leave and/or vacation. .

    Administration Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2023-01-05 · tag F0947 — failed to train nurse aides adequately — isolated
    Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
    What the surveyor found here — the official record, unedited, may be distressing

    Based on record review and staff interview, the facility failed to ensure the continuing competence of nurse aides, must be no less than 12 hours per year. This failed practice was true for one (1) out of five (5) staff reviewed for continuing competences of nurse aides. Facility census 54. Findings included: a) Nurse Aide #26 During a review of employee files, it was discovered, Nurse Aide #26 had completed 10 hours of the yearly competences, instead of the minimum of 12 hours. An interview on 01/05/23 at 1:33 PM, Director of Nursing (DON) reported the NA #26 is behind on her education and only completed 10 hours. DON agreed the minimum required hours has not been met. .

    Nursing and Physician Services Deficiencies · Deficient, Provider has date of correction

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

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 COMMUNICARE HEALTH — 110 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 4 of 53.2+0.8 vs chain
Health inspection 4 of 52.7+1.3 vs chain
Staffing 4 of 52.6+1.4 vs chain
Quality measures 3 of 54.5-1.5 vs chain
The other 109 homes this chain runs (chain average 3.2★, per CMS)
1 of 5Allen View Healthcare CenterSpringfield, OH 1 of 5Annandale Healthcare CenterAnnandale, VA 1 of 5Canfield Healthcare CenterYoungstown, OH 1 of 5Dixon Healthcare CenterWintersville, OH 1 of 5Holbrook Healthcare CenterBuckhannon, WV 1 of 5Mount Vernon Healthcare CenterAlexandria, VA 1 of 5Southwood Healthcare CenterTerre Haute, IN 1 of 5Summers Healthcare CenterHinton, WV 1 of 5Valley View Healthcare CenterElkhart, IN 2 of 5Allison Pointe Healthcare CenterIndianapolis, IN 2 of 5Battlefield Park Healthcare CenterPetersburg, VA 2 of 5Beckley Healthcare CenterBeckley, WV 2 of 5Belmont Healthcare CenterBelmont, WV 2 of 5Berkeley Springs Healthcare CenterBerkeley Springs, WV 2 of 5Cedars Healthcare CenterCharlottesville, VA 2 of 5Columbus Healthcare CenterColumbus, OH 2 of 5Crestwood Care CenterShelby, OH 2 of 5Cumberland Healthcare CenterCumberland, MD 2 of 5Eagle Pointe Healthcare CenterParkersburg, WV 2 of 5Ellicott City Healthcare CenterEllicott City, MD 2 of 5Evergreen Crossing And The LoftsIndianapolis, IN 2 of 5Grande Pointe Healthcare CommuRichmond Heights, OH 2 of 5Great Lakes Healthcare CenterDyer, IN 2 of 5Greenbrier Health CenterParma Heights, OH 2 of 5Hagerstown Healthcare CenterHagerstown, MD 2 of 5Hanover Healthcare CenterMassillon, OH 2 of 5Holly Hill Healthcare CenterTowson, MD 2 of 5Keyser Healthcare CenterKeyser, WV 2 of 5Mercer Healthcare CenterBluefield, WV 2 of 5Morgantown Healthcare CenterMorgantown, WV 2 of 5Mount Airy Nursing and Rehab CenterMount Airy, MD 2 of 5Petersburg Healthcare CenterPetersburg, VA 2 of 5Riverside Nursing And Rehabilitation CenterDayton, OH 2 of 5Rolling Hills Healthcare CenterNew Albany, IN 2 of 5Salem West Healthcare CenterSalem, OH 2 of 5Wedgewood Healthcare CenterClarksville, IN 2 of 5Westminster Rehabilitation and Wellness CenterWestminster, MD 2 of 5Wildwood Healthcare CenterIndianapolis, IN 2 of 5Worthington Healthcare CenterParkersburg, WV 2 of 5Wyant Woods Healthcare CenterAkron, OH

Showing 40 of 109; lowest-rated first.

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

Who owns this facility

Owner / managerTypeRoleSince
ROMEO, DOMINICIndividualCORPORATE OFFICER; OPERATIONAL/MANAGERIAL CONTROLsince 04/01/2023
STOLTZ, CHARLESIndividualCORPORATE OFFICERsince 07/01/2022
WILHEIM, RONALDIndividualCORPORATE OFFICERsince 07/01/2022
PENNSYLVANIA PARK MGT CO., LLCOrganizationOPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 04/16/2025
ANDERSON, CONSTANCEIndividualOPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 08/01/2023
GROVES, DONNAIndividualOPERATIONAL/MANAGERIAL CONTROLsince 04/14/2023
STUMP, BRADLEYIndividualOPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNFsince 01/02/2025

CMS files one row per role, so the 11 rows in the source record cover these 7 parties — each is shown once here with every role it holds. Nothing is omitted. The source lists no ownership percentage for any of them — PECOS records a share only for equity interests, not for board or management roles.

1 organizational owner 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.

$8.4M
Net patient revenuemost recent cost report
+5.7%
Operating marginrevenue minus expenses
$825K
Related-party expense10% of expenses
Who pays — share of resident-days
Medicaid 82%Medicare 4%Other / private 14%

About 82% of this home’s resident-days are paid by Medicaid, which reimburses well below the cost of care in most states. Heavily Medicaid-dependent homes run on thinner budgets — a context worth holding next to the staffing and inspection record, not a fault in itself. This home reported $825K paid to related parties — landlords or management companies under common ownership — equal to about 10% of its total expenses. Money routed to affiliated companies can leave a home’s own books looking lean while owners still profit; it is the mechanism regulators watch most closely in private-equity and REIT deals.

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

$409per resident / day
operating cost
$12,443per month
≈ monthly operating cost
$434per 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 WV

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 West Virginia Medicaid page.

Typical monthly cost in West Virginia
$12,836/mo
Nursing home (semi-private)
$13,262/mo
Nursing home (private)
$6,340/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 515121. CMS refreshes its data monthly, and the star rating rests on the last standard inspection — dated 2026-05-21, 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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