Cycle 1
Health 2025-12-19 · Fire 2025-12-19
15 health deficiencies
Top issue: Quality of Life and Care (5 deficiencies)
2 fire-safety deficiencies
Top issue: Emergency Preparedness (2 deficiencies)
Newport, RI
AdviniaCare Newport, LLC
3-star overall rating with 2-star inspections with $16,801 in total fines with 15 recent health deficiencies with 2 fire-safety deficiencies in the latest cycle
398 Bellevue Avenue, Newport, RI
(401) 849-6600
Overall
3 / 5
CMS overall stars
Health inspections
2 / 5
Survey and complaint cycles
Staffing
4 / 5
RN + nurse staffing
Quality measures
5 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
114
Certified beds
Average residents
107
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
Athena Healthcare Systems
Operator or chain grouping
Approved since
1975-01-01
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Chain footprint
24 facilities
Chain averages 2 overall / 2 health / 3 staffing / 3 quality stars
Changed ownership
No
Within the last 12 months
Family council
Yes
Resident and family council reported
Sprinklers
Yes
Automatic sprinklers in all required areas
Staffing
Hours and turnover
RN hours / resident day
0.70
Registered nurse staffing · state 0.77 · national 0.68
LPN hours / resident day
0.29
Licensed practical nurse staffing · state 0.51 · national 0.87
Aide hours / resident day
2.06
Nurse aide staffing · state 2.46 · national 2.35
Total nurse hours
3.04
All reported nurse hours · state 3.72 · national 3.89
Licensed hours
0.99
RN + LPN hours · state 1.25 · national 1.54
Weekend hours
2.72
Weekend nurse staffing · state 3.30 · national 3.43
Weekend RN hours
0.51
Weekend registered nurse coverage · state 0.56 · national 0.47
Physical therapist
0.09
Reported PT staffing · state 0.06 · national 0.07
Adjusted RN hours
0.85
CMS adjusted RN staffing hours
Adjusted total hours
3.72
CMS adjusted total nurse staffing hours
Case-mix index
1.12
Higher values indicate more complex resident acuity
RN turnover
17%
Annual RN turnover · state 38% · national 45%
Total nurse turnover
17%
Annual nurse turnover · state 40% · national 46%
SNF VBP
Value-based purchasing
Program rank
3,121
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
45.90
Composite VBP score used to determine payment impact.
Payment multiplier
0.9992
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
3.88
Baseline 19.34% · Performance 19.63% · Measure score 3.88 · Achievement 3.88 · Improvement 0
Healthcare-associated infections
1.48
Baseline 6.21% · Performance 7.39% · Measure score 1.48 · Achievement 1.48 · Improvement 0
Total nurse turnover
10
Baseline 29.23% · Performance 23.29% · Measure score 10 · Achievement 10 · Improvement 9
Adjusted total nurse staffing
3.01
Baseline 4.23 hours · Performance 3.93 hours · Measure score 3.01 · Achievement 3.01 · Improvement 0
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 10.09% |
10.72%
0.6 pts better
|
No Different than the National Rate · Eligible stays 49 · Observed rate 8.16% · Lower 95% interval 6.13% |
| Discharge to community | 48.43% |
50.57%
2.1 pts worse
|
No Different than the National Rate · Eligible stays 42 · Observed rate 42.86% · Lower 95% interval 33.16% |
| Medicare spending per beneficiary | 0.94 |
1.02
0.1 pts better
|
|
| Drug regimen review with follow-up | 100% |
95.27%
4.7 pts better
|
Numerator 40 · Denominator 40 |
| Falls with major injury | 0% |
0.77%
0.8 pts better
|
Numerator 0 · Denominator 40 |
| Discharge self-care score | 50% |
53.69%
3.7 pts worse
|
Numerator 13 · Denominator 26 |
| Discharge mobility score | 61.54% |
50.94%
10.6 pts better
|
Numerator 16 · Denominator 26 |
| Pressure ulcers or injuries, new or worsened | 0% |
2.29%
2.3 pts better
|
Numerator 0 · Denominator 40 · Adjusted rate 0% |
| Healthcare-associated infections requiring hospitalization | 7.39% |
7.12%
0.3 pts worse
|
No Different than the National Rate · Eligible stays 36 · Observed rate 8.33% · Lower 95% interval 4.23% |
| Staff COVID-19 vaccination coverage | 20.41% |
8.2%
12.2 pts better
|
Numerator 30 · Denominator 147 |
| Staff flu vaccination coverage | 55.35% |
42%
13.4 pts better
|
Numerator 88 · Denominator 159 |
| Discharge function score | 65.38% |
56.45%
8.9 pts better
|
Numerator 17 · Denominator 26 |
| Transfer of health information to provider | 100% |
95.95%
4 pts better
|
Numerator 21 · Denominator 21 |
| Transfer of health information to patient | Not Available |
96.28%
|
Numerator Not Available · Denominator 3 · Too few residents or stays to report publicly. |
| Resident COVID-19 vaccinations up to date | Not Available |
25.2%
|
Numerator Not Available · Denominator 16 · Too few residents or stays to report publicly. |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 0.2 |
1.5
1.3 pts better
|
1.9
1.7 pts better
|
Long Stay · 20240701-20250630 · Adjusted 0.2 · Observed 0.2 · Expected 1.8 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 0.4 |
1.7
1.3 pts better
|
1.8
1.4 pts better
|
Long Stay · 20240701-20250630 · Adjusted 0.4 · Observed 0.4 · Expected 1.5 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 96.3% |
93.2%
3.1 pts better
|
93.4%
2.9 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 98.8% · Q2 96.3% · Q3 95.7% · Q4 94.9% · 4Q avg 96.3% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 47.7% |
95.3%
47.6 pts worse
|
95.5%
47.8 pts worse
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 47.7% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 2.2% |
3.6%
1.4 pts better
|
3.3%
1.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.2% · Q2 1.2% · Q3 1.1% · Q4 5.1% · 4Q avg 2.2% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 11.8% |
14.6%
2.8 pts better
|
11.4%
0.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 10.1% · Q2 12.8% · Q3 7.9% · Q4 16.1% · 4Q avg 11.8% |
| Percentage of long-stay residents who lose too much weight | 2.9% |
5.3%
2.4 pts better
|
5.4%
2.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 3.1% · Q2 6.6% · Q3 2.8% · Q4 0.0% · 4Q avg 2.9% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 23.3% |
16.4%
6.9 pts worse
|
19.6%
3.7 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 22.4% · Q2 25.8% · Q3 22.5% · Q4 22.9% · 4Q avg 23.3% |
| Percentage of long-stay residents who received an antipsychotic medication | 26.2% |
23.6%
2.6 pts worse
|
16.7%
9.5 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 30.0% · Q2 26.1% · Q3 23.2% · Q4 25.8% · 4Q avg 26.2% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.1%
0.1 pts better
|
0.1%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | 17.9% |
17.0%
0.9 pts worse
|
16.3%
1.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 22.0% · Q2 19.4% · Q3 10.7% · Q4 19.9% · 4Q avg 17.9% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 17.9% |
18.4%
0.5 pts better
|
14.9%
3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 12.9% · Q2 22.6% · Q3 18.4% · Q4 17.7% · 4Q avg 17.9% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.5% |
1.0%
0.5 pts better
|
1.0%
0.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.1% · Q2 1.1% · Q3 0.0% · Q4 0.0% · 4Q avg 0.5% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 1.4% |
2.2%
0.8 pts better
|
1.7%
0.3 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 2.4% · Q2 3.7% · Q3 0.0% · Q4 0.0% · 4Q avg 1.4% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 26.4% |
22.3%
4.1 pts worse
|
19.8%
6.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 26.1% · Q2 34.0% · Q3 18.1% · Q4 28.6% · 4Q avg 26.4% |
| Percentage of long-stay residents with pressure ulcers | 5.7% |
4.7%
1 pts worse
|
5.1%
0.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 5.6% · Q2 7.4% · Q3 5.2% · Q4 4.7% · 4Q avg 5.7% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 72.1% |
77.2%
5.1 pts worse
|
81.7%
9.6 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 66.7% · Q2 71.6% · Q3 75.7% · Q4 74.1% · 4Q avg 72.1% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 11.1% |
15.8%
4.7 pts better
|
12.0%
0.9 pts better
|
Short Stay · 20240701-20250630 · Adjusted 11.1% · Observed 13.3% · Expected 13.4% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 5.5% |
1.9%
3.6 pts worse
|
1.6%
3.9 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 7.4% · Q2 6.1% · Q3 0.0% · Q4 8.7% · 4Q avg 5.5% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 64.1% |
78.2%
14.1 pts worse
|
79.7%
15.6 pts worse
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 64.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 9.5% |
25.1%
15.6 pts better
|
23.9%
14.4 pts better
|
Short Stay · 20240701-20250630 · Adjusted 9.5% · Observed 10.0% · Expected 25.1% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2024-09-06 · Fire 2024-09-06
16 health deficiencies
Top issue: Quality of Life and Care (5 deficiencies)
4 fire-safety deficiencies
Top issue: Egress (1 deficiency)
Cycle 3
Health 2023-09-13 · Fire 2023-09-13
10 health deficiencies
Top issue: Quality of Life and Care (4 deficiencies)
5 fire-safety deficiencies
Top issue: Gas and Vacuum and Electrical Systems (2 deficiencies)
Fire safety
Fire-safety citations
D · Potential for more than minimal harm
2025-12-19
E13 · Emergency Preparedness Deficiencies
Fire Safety
Develop Emergency Preparedness policies and procedures.
Corrected 2026-01-12
D · Potential for more than minimal harm
2025-12-19
E29 · Emergency Preparedness Deficiencies
Fire Safety
Develop a communication plan.
Corrected 2026-01-12
F · Potential for more than minimal harm
2024-09-06
E4 · Emergency Preparedness Deficiencies
Fire Safety
Develop and maintain an Emergency Preparedness Program (EP).
Corrected 2024-10-01
F · Potential for more than minimal harm
2024-09-06
K291 · Egress Deficiencies
Fire Safety
Install emergency lighting that can last at least 1 1/2 hours.
Corrected 2024-10-01
F · Potential for more than minimal harm
2024-09-06
K324 · Smoke Deficiencies
Fire Safety
Provide properly protected cooking facilities.
Corrected 2024-10-01
F · Potential for more than minimal harm
2024-09-06
K918 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2024-10-01
F · Potential for more than minimal harm
2023-09-13
K351 · Smoke Deficiencies
Fire Safety
Install an approved automatic sprinkler system.
Corrected 2023-11-14
F · Potential for more than minimal harm
2023-09-13
K712 · Miscellaneous Deficiencies
Fire Safety
Have simulated fire drills held at unexpected times.
Corrected 2023-11-14
F · Potential for more than minimal harm
2023-09-13
K918 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2023-11-14
E · Potential for more than minimal harm
2023-09-13
K355 · Smoke Deficiencies
Fire Safety
Properly select, install, inspect, or maintain portable fire extinguishes.
Corrected 2023-11-14
D · Potential for more than minimal harm
2023-09-13
K923 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have proper medical gas storage and administration areas.
Corrected 2023-11-14
Inspection history
Recent health citations
F · Potential for more than minimal harm
2025-12-19
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2026-01-12
F · Potential for more than minimal harm
2025-12-19
F865 · Administration Deficiencies
Health
Have a plan that describes the process for conducting QAPI and QAA activities.
Corrected 2026-01-12
E · Potential for more than minimal harm
2025-12-19
F565 · Resident Rights Deficiencies
Health
Honor the resident's right to organize and participate in resident/family groups in the facility.
Corrected 2026-01-12
E · Potential for more than minimal harm
2025-12-19
F684 · Quality of Life and Care Deficiencies
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2026-01-12
E · Potential for more than minimal harm
2025-12-19
F689 · Quality of Life and Care Deficiencies
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2026-01-12
E · Potential for more than minimal harm
2025-12-19
F921 · Environmental Deficiencies
Health
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Corrected 2026-01-12
D · Potential for more than minimal harm
2025-12-19
F658 · Resident Assessment and Care Planning Deficiencies
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2026-01-12
D · Potential for more than minimal harm
2025-12-19
F677 · Quality of Life and Care Deficiencies
Health
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected 2026-01-12
D · Potential for more than minimal harm
2025-12-19
F690 · Quality of Life and Care Deficiencies
Health
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Corrected 2026-01-12
D · Potential for more than minimal harm
2025-12-19
F693 · Quality of Life and Care Deficiencies
Health
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
Corrected 2026-01-12
D · Potential for more than minimal harm
2025-12-19
F759 · Pharmacy Service Deficiencies
Health
Ensure medication error rates are not 5 percent or greater.
Corrected 2026-01-12
D · Potential for more than minimal harm
2025-12-19
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2026-01-12
B · Minimal harm
2025-12-19
F577 · Resident Rights Deficiencies
Health
Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.
Corrected 2026-01-12
F · Potential for more than minimal harm
2025-11-19
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2025-12-15
E · Potential for more than minimal harm
2025-08-18
F555 · Resident Rights Deficiencies
Health
Honor the resident's right to choose his or her attending physician.
Not marked corrected
L · Immediate jeopardy
2024-09-06
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2024-10-01
G · Actual harm
2024-09-06
F686 · Quality of Life and Care Deficiencies
Health
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Corrected 2024-10-01
F · Potential for more than minimal harm
2024-09-06
F726 · Nursing and Physician Services Deficiencies
Health
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Corrected 2024-10-01
F · Potential for more than minimal harm
2024-09-06
F803 · Nutrition and Dietary Deficiencies
Health
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
Corrected 2024-10-01
F · Potential for more than minimal harm
2024-09-06
F940 · Administration Deficiencies
Health
Develop, implement, and/or maintain an effective training program for all new and existing staff members.
Corrected 2024-10-01
E · Potential for more than minimal harm
2024-09-06
F658 · Resident Assessment and Care Planning Deficiencies
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2024-10-01
E · Potential for more than minimal harm
2024-09-06
F688 · Quality of Life and Care Deficiencies
Health
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
Corrected 2024-10-01
E · Potential for more than minimal harm
2024-09-06
F693 · Quality of Life and Care Deficiencies
Health
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
Corrected 2024-10-01
E · Potential for more than minimal harm
2024-09-06
F695 · Quality of Life and Care Deficiencies
Health
Provide safe and appropriate respiratory care for a resident when needed.
Corrected 2024-10-01
E · Potential for more than minimal harm
2024-09-06
F756 · Pharmacy Service Deficiencies
Health
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Corrected 2024-10-01
E · Potential for more than minimal harm
2024-09-06
F760 · Pharmacy Service Deficiencies
Health
Ensure that residents are free from significant medication errors.
Corrected 2024-10-01
E · Potential for more than minimal harm
2024-09-06
F761 · Pharmacy Service Deficiencies
Health
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Corrected 2024-10-01
E · Potential for more than minimal harm
2024-09-06
F842 · Resident Assessment and Care Planning Deficiencies
Health
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected 2024-10-01
E · Potential for more than minimal harm
2024-09-06
F921 · Environmental Deficiencies
Health
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Corrected 2024-10-01
D · Potential for more than minimal harm
2024-09-06
F805 · Nutrition and Dietary Deficiencies
Health
Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
Corrected 2024-10-01
D · Potential for more than minimal harm
2024-06-13
F689 · Quality of Life and Care Deficiencies
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2024-06-25
F · Potential for more than minimal harm
2023-09-13
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2023-10-04
E · Potential for more than minimal harm
2023-09-13
F658 · Resident Assessment and Care Planning Deficiencies
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2023-10-04
E · Potential for more than minimal harm
2023-09-13
F686 · Quality of Life and Care Deficiencies
Health
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Corrected 2023-10-04
E · Potential for more than minimal harm
2023-09-13
F687 · Quality of Life and Care Deficiencies
Health
Provide appropriate foot care.
Corrected 2023-10-04
E · Potential for more than minimal harm
2023-09-13
F761 · Pharmacy Service Deficiencies
Health
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Corrected 2023-10-04
E · Potential for more than minimal harm
2023-09-13
F791 · Quality of Life and Care Deficiencies
Health
Provide or obtain dental services for each resident.
Corrected 2023-10-04
D · Potential for more than minimal harm
2023-09-13
F610 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Respond appropriately to all alleged violations.
Corrected 2023-10-04
D · Potential for more than minimal harm
2023-09-13
F695 · Quality of Life and Care Deficiencies
Health
Provide safe and appropriate respiratory care for a resident when needed.
Corrected 2023-10-04
E · Potential for more than minimal harm
2023-08-04
F658 · Resident Assessment and Care Planning Deficiencies
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2023-08-22
E · Potential for more than minimal harm
2023-04-06
F758 · Pharmacy Service Deficiencies
Health
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Corrected 2023-04-25
Penalties and ownership
What sits behind the stars
$16,801
2024-09-06
Fine
Fine · fine $16,801
Fine
Ownership
Santilli, Lawrence
5% Or Greater Direct Ownership Interest · Individual
Mosier, Michael
5% Or Greater Direct Ownership Interest · Individual
Chakalos-Santilli, Valerie
5% Or Greater Direct Ownership Interest · Individual
Athena Health Care Associates, Inc.
Operational/Managerial Control · Organization
Curtis, Diane
5% Or Greater Direct Ownership Interest · Individual
Mosier, Michael
W-2 Managing Employee · Individual
Nearby options
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3-star overall rating with 4-star inspections with 10 recent health deficiencies
#2
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#3
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5-star overall rating with 4-star inspections with 1 recent health deficiencies
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