Crook County Medical Services District Long Term C

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.

Staffing

How full it usually is: this home is certified for 32 beds and averages 29.8 residents a day — about 93% occupied, or roughly 2 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the hour requirements in April 2025 (CMS has appealed), Congress then barred enforcement until 2034, and CMS formally repealed them by rule effective February 2026.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 4.77 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 0.93 is at or above the 0.55-hour RN benchmark and nurse-aide staffing of 3.31 is at or above the 2.45-hour aide benchmark. What federal law does require today is unchanged: “sufficient” nursing staff for residents’ needs and an RN on duty at least 8 consecutive hours a day, 7 days a week (42 CFR 483.35). Those are judged by inspectors on site, not by these averages, so read this comparison alongside the inspection record rather than as a pass/fail.

Weekend coverage: total nurse staffing is 4.05 hrs/resident/day on weekends vs 5.07 on weekdays — 20% thinner on weekends — a notable drop. RN hours go from 1.06 to 0.61 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)

This home’s total nursing-staff turnover of 78% is well above the national median of 45%.

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

Inspection trend

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

Inspection deficiencies

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

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 11 most serious are shown; the remaining 14 are one tap away and print in full.

• Actual harm · G2024-09-05 · tag F0600 — failed to protect residents from abuse and neglect — isolated
  Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on medical record review, resident representative and staff interview, and policy and procedure review, the facility failed to protect the resident's right to be free from physical abuse by a resident for 1 of 2 sample residents (#1 and #2) reviewed for allegations of abuse. The findings were: 1. Review of an incident report dated 7/30/24 showed resident #2 assaulted his/her roommate, resident #1, with the metal clip of a pair of suspenders. Further review showed the clip caused a 1centimeter (cm) laceration to resident #1's left cheek and the resident required treatment in the emergency room (ER). The following concerns were identified: a. Review of medical record dated 7/31/24 showed resident #1 was transferred to the ER and received treatment of the wound with steristrips. Bruising also developed at the site of the wound. b. Interview with CNA #6 on 9/4/24 at 5:30 PM confirmed CNA #6 had assisted resident #1 to the restroom and walked resident #1 into the bedroom when resident #2 ran across the room, jumped up and swung suspenders at resident #1, hitting resident #1 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.

  Freedom from Abuse, Neglect, and Exploitation Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Fcited before2025-08-14 · tag F0727 — failed to provide required RN coverage — widespread
  Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
  What the surveyor found here — the official record, unedited, may be distressing

  Based on staff schedule review, payroll based journal (PBJ) review, and staff interview, the facility failed to ensure an RN was on duty for 8 consecutive hours per day, 7 days per week during 1 of 4 quarters reviewed (1st quarter of fiscal year 2025). The census was 27. The findings were: 1. Review of the PBJ Staffing Data Report for quarter 1 of fiscal year 2025 (October 1,2024 through December 31, 2025) showed there was no RN on duty for 8 consecutive hours for 2 days in November 2024, 11/9 and 11/23. Further review showed there was no RN on duty for 8 consecutive hours for 5 days in December 2024, 12/7, 12/14, 12/21, 12/22, and 12/29:2. Review of the staff schedule for November and December of 2024 confirmed there were no RNs on duty for 8 consecutive hours on 11/9, 11/23, 12/7, 12/14, 12/21, 12/22, and 12/29. 3. Interview with the DON on 8/14/25 at 10:46 AM confirmed the facility did not have RN coverage 7 days a week for at least 8 consecutive hours a day on the days identified.

  Nursing and Physician Services Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2025-08-14 · tag F0700 — isolated
  Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
  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, resident and staff interview, medical record review, and policy and procedure review, the facility failed to ensure a safety assessment, including entrapment risk, of bedrails was completed for 1 of 5 sample residents (#21). The findings were: 1. Review of the quarterly MDS assessment dated [DATE] showed resident #21 had diagnoses which included cerebrovascular accident, and a BIMS score of 8 out of 15, which indicated moderate cognitive impairment. Interview with the DON on 8/13/25 at 2:39 PM confirmed there should have been a safety assessment for the bedrails. The following concerns were identified: a. Observation on 8/11/25 at 4:42 PM showed resident #21 had bilateral bed canes built into the frame of his/her bed. b. Review of the resident's medical record showed no evidence a bedrail assessment, which included entrapment risks, had been completed. c. Interview with resident #21 on 8/13/25 at 3:15 PM revealed s/he used the bedrails for positioning. 2. Review of the policy Proper use of…

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

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Dcited before2025-08-14 · tag F0880 — failed to prevent and control infections — isolated
  Provide and implement an infection prevention and control program.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observations, staff interview, policy and procedure review, the facility failed to ensure infection prevention was maintained in 1 of 2 dining observations and 1 of 4 residents (#22) with urinary catheter observations. The findings were: Regarding urinary catheter drainage bags: 1. Observation on 8/13/25 at 2:15 PM showed LPN #1 and LPN #2 entered resident #22's room and the resident's catheter drainage bag was positioned on the floor at the foot of the bed, without a cover or other type of protection. Interview with LPN #2, at that time, revealed the facility expected the bag to not be on the floor and to be covered. 2. Interview with the IP on 8/14/25 at 9:32 AM revealed the expectation was for the urinary catheter drainage bag to be positioned below the bladder and covered. She confirmed the bag should not be placed on the floor, and there were basins provided to prevent placement of the bag on the floor. 3. Review of a education form Proper Catheter Care for CNAs hand delivered on 8/14/25 at 8:25 AM by the DON showed .General Guidelines .Ensure the drainage bag is…

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

  Infection Control Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Dcited before2024-11-05 · 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 — the official record, unedited, may be distressing

  Based on staff interview and state agency incident database review, the facility failed to ensure investigations for abuse allegations were reported within 5 working days for 1 of 1 sample residents (#3). The findings were: 1. Review of the state survey agency incident database showed an allegation of staff to resident abuse was made by resident #3 to the facility charge nurse on 9/20/24. Further review showed the initial report was sent to the State Survey Agency on 9/23/24; however, there was no evidence the facility's investigative findings were reported as of 11/5/24. 2. Interview with the director of nursing on 11/5/24 at 5:17 PM confirmed the investigation had not been reported. Further interview revealed she did know she needed to report the investigation to the state survey agency.

  Freedom from Abuse, Neglect, and Exploitation Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2024-09-05 · tag F0744 — failed to care for residents with dementia — isolated
  Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on medical record review, staff interview, and policy and procedure review, the facility failed to develop and implement interventions to address the residents' dementia care needs for 1 of 2 sample residents (#2) reviewed for dementia treatment and services. The findings were: 1. Review of the admission Minimun Data Set (MDS) dated [DATE] showed resident #2 had moderately impaired cognitive skills, inattention/disorganized thinking behavior present, inability to recall staff names/faces, inability to recall s/he lived in a nursing home, and a mood interview score of 21, indicating severe depression. The following concerns were identified: a. Review of progress note dated 7/23/24 showed resident #2 arrived in the facility and verbally expressed his/her displeasure at his/her arrival. Resident #2 was disheveled, ungroomed and wore unclean clothing. Resident #2's family stated it had been 2 weeks since they were able to get him/her to shower, and reported s/he was becoming more incontinent and refused 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.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · F2024-05-09 · tag F0812 — failed to store, cook, and serve food safely — widespread
  Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, staff interview, review of the dishwasher and refrigerator/freezer temperature log sheets, manufacturer's instructions, and the 2022 FDA Food Code, the facility failed to ensure a sanitary environment in 1 of 1 kitchen. The census was 20. The findings were: 1. Observation on 5/6/24 at 2:39 PM showed the facility used a [NAME] chemical sanitizing dishwashing machine. The temperature of the water and the concentration of the chlorine sanitizer solution were to be monitored at breakfast, lunch and dinner. Review of the [NAME] dishwashing machine manufacturer's instructions showed the minimum temperature of the wash and rinse water was 120 degrees Fahrenheit (F), with a recommended temperature of 140 degrees F. The concentration of the chlorine sanitizer should be between 50 and 100 parts per million (ppm). The following concerns were identified: a. Review of the March 2024 dish machine log sheet showed the required concentration of the sanitizer and temperature of the wash and rinse water was…

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

  Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Fcited before2024-05-09 · tag F0851 — widespread
  Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
  What the surveyor found here — the official record, unedited, may be distressing

  Based on Payroll Base Journal (PBJ) review and staff interview, the facility failed to ensure direct care staffing information was submitted on schedule specified by CMS for 2 of 4 quarterly periods (1st quarter, 10/2023-12/2023, 3rd quarter, 4/2023-6/2023). The findings were: 1. Review of the [NAME] Payroll Base Journal showed the facility failed to submit data for quarter 1 (10/2023- 12/2023) and quarter 3 (4/2023-6/2023). 2. Interview with payroll management on 5/8/24 at 2:42 PM revealed the facility had missed the deadlines for submission of the data on both quarters. 3. Interview with the administrator on 5/9/24 at 10 AM confirmed the facility had missed the deadlines for submission to the PBJ on the 2 quarters.

  Administration Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Dcited before2024-05-09 · 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 staff interview, medical record review, and review of the Resident Assessment Instrument (RAI) manual, the facility failed to ensure MDS assessment information was an accurate reflection of resident status for 1 of 12 sample residents (#8) reviewed. The findings were: 1. Review of the 3/6/24 quarterly MDS assessment for resident #8 showed the resident was admitted to the facility on [DATE] and had a diagnosis of atrial fibrillation. Review of the November 2023, December 2023, January 2024, February 2024, and March 2024 medication administration records showed the resident was administered 5 milligrams of Eliquis (an anticoagulant) every 12 hours. The findings were: a. Review of the 12/6/23 and 3/6/24 quarterly MDS assessments showed the resident was not coded as receiving an anticoagulant during the 7-day look-back period. b. Interview with the ADON on 5/9/24 at 9:57 AM confirmed the MDS assessments had been coded incorrectly. 2. According to the MDS 3.0 RAI Manual version 1.18.11 page 483 N0415E1.…

  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 · D2024-05-09 · tag F0657 — failed to keep the care plan current — isolated
  Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on medical record review and staff interview, the facility failed to ensure the comprehensive care plan was revised as needed to reflect the resident's current needs for 2 of 12 sample residents (#8, #9). The findings were: 1. Review of the 3/20/24 quarterly MDS assessment showed resident #9 was admitted on [DATE] with diagnoses which included a primary medical condition of moderate dementia without psychotic disturbance, heart failure, and depression. Review of an 3/19/24 Office Clinic Note Physician report showed the resident had been recently placed on comfort cares as his/her dementia seems to be progressing and [s/he] is no longer eating well and is losing weight. A discussion was had with the POA and a mutual decision was made to discontinue medications with the exception of liquid Tylenol. The following concerns were identified: a. Review of the care plan, last reviewed 3/20/24, failed to show revisions related to comfort care. b. Interview with the ADON on 5/9/24 at 9:54 AM confirmed the care plan…

  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 before2024-05-09 · tag F0880 — failed to prevent and control infections — isolated
  Provide and implement an infection prevention and control program.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observation, staff interview, and professional standards review, the facility failed to ensure infection prevention techniques were followed during 1 of 1 wound care observation(#8). The findings were: 1. Observation of wound care for resident #8 on 5/8/24 at 11:27 AM showed RN #1 donned gloves, placed a barrier under the resident's legs, and set unopened supplies on the table. She removed an old dressing from the right leg. She cleaned the wound with gauze and wound cleaner. Doffing her gloves, she fanned the wound with a dressing packet. She performed hand hygiene, donned gloves and opened the packet and placed the calcium alginate. She then opened the abd pad packet and placed it over the calcium alginate and then opened the kerlix gauze packet and wrapped the right lower leg. The nurse then moved to the left lower leg, doffing, hand hygiene, donning gloves. She removed the old dressing, cleaned the wound with wound cleaner and gauze, and fanned the wound with an unopened dressing packet. She offed her gloves, performed hand hygiene, and donned new gloves. She then…

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

  Infection Control Deficiencies · Deficient, Provider has date of correction

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

Fines & penalties

$8,981 in federal fines across 1 penalty.

• $8,981 — penalty dated 2024-09-05

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.

Who owns this facility

CMS files one row per role, so the 17 rows in the source record cover these 9 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.

What families pay in WY