Cycle 1
Health 2025-02-27 · Fire 2025-02-27
2 health deficiencies
Top issue: Resident Assessment and Care Planning (1 deficiency)
4 fire-safety deficiencies
Top issue: Smoke (2 deficiencies)
Deland, FL
Alliance Health And Rehabilitation Center
4-star overall rating with 4-star inspections with 2 recent health deficiencies with 4 fire-safety deficiencies in the latest cycle
130 W Armstrong Avenue, Deland, FL
(386) 734-6401
Overall
4 / 5
CMS overall stars
Health inspections
4 / 5
Survey and complaint cycles
Staffing
4 / 5
RN + nurse staffing
Quality measures
4 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
130
Certified beds
Average residents
107
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
No chain reported
Operator or chain grouping
Approved since
1978-08-01
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
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
0.48
Registered nurse staffing · state 0.73 · national 0.68
LPN hours / resident day
1.45
Licensed practical nurse staffing · state 0.79 · national 0.87
Aide hours / resident day
2.31
Nurse aide staffing · state 2.34 · national 2.35
Total nurse hours
4.24
All reported nurse hours · state 3.86 · national 3.89
Licensed hours
1.93
RN + LPN hours · state 1.52 · national 1.54
Weekend hours
3.84
Weekend nurse staffing · state 3.51 · national 3.43
Weekend RN hours
0.51
Weekend registered nurse coverage · state 0.53 · national 0.47
Physical therapist
0.08
Reported PT staffing · state 0.10 · national 0.07
Adjusted RN hours
0.52
CMS adjusted RN staffing hours
Adjusted total hours
4.61
CMS adjusted total nurse staffing hours
Case-mix index
1.26
Higher values indicate more complex resident acuity
RN turnover
53%
Annual RN turnover · state 46% · national 45%
Total nurse turnover
46%
Annual nurse turnover · state 42% · national 46%
SNF VBP
Value-based purchasing
Program rank
4,248
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
40.70
Composite VBP score used to determine payment impact.
Payment multiplier
0.9936
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
3.33
Baseline 23.15% · Performance 20.80% · Measure score 3.33 · Achievement 1.35 · Improvement 3.33
Healthcare-associated infections
0.50
Baseline 7.54% · Performance 7.68% · Measure score 0.50 · Achievement 0.50 · Improvement 0
Total nurse turnover
8.18
Baseline 46.51% · Performance 30.23% · Measure score 8.18 · Achievement 8.18 · Improvement 7.02
Adjusted total nurse staffing
4.26
Baseline 4.45 hours · Performance 4.29 hours · Measure score 4.26 · Achievement 4.26 · Improvement 0
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 10.4% |
10.72%
0.3 pts better
|
No Different than the National Rate · Eligible stays 260 · Observed rate 9.23% · Lower 95% interval 7.74% |
| Discharge to community | 68.57% |
50.57%
18 pts better
|
Better than the National Rate · Eligible stays 232 · Observed rate 63.79% · Lower 95% interval 61.97% |
| Medicare spending per beneficiary | 1.26 |
1.02
0.2 pts worse
|
|
| Drug regimen review with follow-up | 94.42% |
95.27%
0.8 pts worse
|
Numerator 254 · Denominator 269 |
| Falls with major injury | 1.12% |
0.77%
0.4 pts worse
|
Numerator 3 · Denominator 269 |
| Discharge self-care score | 54.31% |
53.69%
0.6 pts better
|
Numerator 107 · Denominator 197 |
| Discharge mobility score | 51.78% |
50.94%
0.8 pts better
|
Numerator 102 · Denominator 197 |
| Pressure ulcers or injuries, new or worsened | 0.37% |
2.29%
1.9 pts better
|
Numerator 1 · Denominator 269 · Adjusted rate 0.4% |
| Healthcare-associated infections requiring hospitalization | 7.68% |
7.12%
0.6 pts worse
|
No Different than the National Rate · Eligible stays 196 · Observed rate 7.65% · Lower 95% interval 5.34% |
| Staff COVID-19 vaccination coverage | 0.9% |
8.2%
7.3 pts worse
|
Numerator 2 · Denominator 222 |
| Staff flu vaccination coverage | 5.88% |
42%
36.1 pts worse
|
Numerator 19 · Denominator 323 |
| Discharge function score | 52.79% |
56.45%
3.7 pts worse
|
Numerator 104 · Denominator 197 |
| Transfer of health information to provider | 98.55% |
95.95%
2.6 pts better
|
Numerator 68 · Denominator 69 |
| Transfer of health information to patient | 99.27% |
96.28%
3 pts better
|
Numerator 136 · Denominator 137 |
| Resident COVID-19 vaccinations up to date | 11.89% |
25.2%
13.3 pts worse
|
Numerator 17 · Denominator 143 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 1.8 |
2.1
0.3 pts better
|
1.9
0.1 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.8 · Observed 1.6 · Expected 1.7 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 1.0 |
1.2
0.2 pts better
|
1.8
0.8 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.0 · Observed 0.9 · Expected 1.5 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 100.0% |
97.8%
2.2 pts better
|
93.4%
6.6 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 100.0% · Q3 100.0% · Q4 100.0% · 4Q avg 100.0% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 100.0% |
99.2%
0.8 pts better
|
95.5%
4.5 pts better
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 100.0% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 2.8% |
2.6%
0.2 pts worse
|
3.3%
0.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 2.8% · Q2 2.8% · Q3 2.7% · Q4 2.8% · 4Q avg 2.8% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 1.9% |
3.7%
1.8 pts better
|
11.4%
9.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 7.5% · 4Q avg 1.9% |
| Percentage of long-stay residents who lose too much weight | 1.5% |
5.9%
4.4 pts better
|
5.4%
3.9 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.9% · Q2 3.9% · Q3 0.0% · Q4 0.0% · 4Q avg 1.5% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 24.5% |
15.7%
8.8 pts worse
|
19.6%
4.9 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 25.0% · Q2 21.8% · Q3 23.1% · Q4 28.6% · 4Q avg 24.5% |
| Percentage of long-stay residents who received an antipsychotic medication | 7.5% |
9.8%
2.3 pts better
|
16.7%
9.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 9.1% · Q2 7.0% · Q3 7.0% · Q4 7.0% · 4Q avg 7.5% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.0%
About the same
|
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 | 34.4% |
11.7%
22.7 pts worse
|
16.3%
18.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 53.0% · 4Q avg 34.4% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 33.2% |
9.8%
23.4 pts worse
|
14.9%
18.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 41.5% · Q2 46.0% · Q3 24.0% · Q4 19.6% · 4Q avg 33.2% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 1.0% |
0.4%
0.6 pts worse
|
1.0%
About the same
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 1.3% · Q3 0.9% · Q4 1.7% · 4Q avg 1.0% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 0.4% |
0.8%
0.4 pts better
|
1.7%
1.3 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 1.4% · Q4 0.0% · 4Q avg 0.4% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 21.8% |
12.5%
9.3 pts worse
|
19.8%
2 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 30.7% · Q2 25.1% · Q3 16.8% · Q4 14.5% · 4Q avg 21.8% |
| Percentage of long-stay residents with pressure ulcers | 2.9% |
5.1%
2.2 pts better
|
5.1%
2.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 2.4% · Q2 4.6% · Q3 3.0% · Q4 1.7% · 4Q avg 2.9% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 99.2% |
94.3%
4.9 pts better
|
81.7%
17.5 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 99.1% · Q2 99.1% · Q3 99.5% · Q4 99.0% · 4Q avg 99.2% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 6.5% |
9.3%
2.8 pts better
|
12.0%
5.5 pts better
|
Short Stay · 20240701-20250630 · Adjusted 6.5% · Observed 6.0% · Expected 10.3% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 1.1% |
1.5%
0.4 pts better
|
1.6%
0.5 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 2.3% · Q2 0.0% · Q3 0.7% · Q4 1.4% · 4Q avg 1.1% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 95.0% |
94.7%
0.3 pts better
|
79.7%
15.3 pts better
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 95.0% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 23.3% |
26.2%
2.9 pts better
|
23.9%
0.6 pts better
|
Short Stay · 20240701-20250630 · Adjusted 23.3% · Observed 19.0% · Expected 19.4% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2023-03-09 · Fire 2023-03-09
4 health deficiencies
Top issue: Resident Rights (2 deficiencies)
3 fire-safety deficiencies
Top issue: Smoke (2 deficiencies)
Cycle 3
Health 2021-07-29 · Fire 2021-07-29
1 health deficiencies
Top issue: Nutrition and Dietary (1 deficiency)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Fire safety
Fire-safety citations
D · Potential for more than minimal harm
2025-02-27
K291 · Egress Deficiencies
Fire Safety
Install emergency lighting that can last at least 1 1/2 hours.
Corrected 2025-03-27
D · Potential for more than minimal harm
2025-02-27
K324 · Smoke Deficiencies
Fire Safety
Provide properly protected cooking facilities.
Corrected 2025-03-27
D · Potential for more than minimal harm
2025-02-27
K345 · Smoke Deficiencies
Fire Safety
Have approved installation, maintenance and testing program for fire alarm systems.
Corrected 2025-03-27
D · Potential for more than minimal harm
2025-02-27
K761 · Miscellaneous Deficiencies
Fire Safety
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Corrected 2025-03-27
D · Potential for more than minimal harm
2023-03-09
K345 · Smoke Deficiencies
Fire Safety
Have approved installation, maintenance and testing program for fire alarm systems.
Corrected 2023-04-09
D · Potential for more than minimal harm
2023-03-09
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2023-04-09
D · Potential for more than minimal harm
2023-03-09
K923 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have proper medical gas storage and administration areas.
Corrected 2023-04-09
Inspection history
Recent health citations
D · Potential for more than minimal harm
2025-02-27
F623 · Resident Rights Deficiencies
Health
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Corrected 2025-03-27
D · Potential for more than minimal harm
2025-02-27
F656 · Resident Assessment and Care Planning Deficiencies
Health
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected 2025-03-27
F · Potential for more than minimal harm
2023-03-09
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 2023-04-09
D · Potential for more than minimal harm
2023-03-09
F558 · Resident Rights Deficiencies
Health
Reasonably accommodate the needs and preferences of each resident.
Corrected 2023-04-09
D · Potential for more than minimal harm
2023-03-09
F583 · Resident Rights Deficiencies
Health
Keep residents' personal and medical records private and confidential.
Corrected 2023-04-09
D · Potential for more than minimal harm
2023-03-09
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2023-04-09
F · Potential for more than minimal harm
2021-07-29
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 2021-08-29
Penalties and ownership
What sits behind the stars
Ownership
Cleveland, Jeffrey
5% Or Greater Indirect Ownership Interest · Individual
Deland Senior Investments I, LLC
5% Or Greater Direct Ownership Interest · Organization
Deland Senior Investments Ii, LLC
5% Or Greater Direct Ownership Interest · Organization
Fraser, Geoffrey
5% Or Greater Indirect Ownership Interest · Individual
Cleveland, Jeffrey
Corporate Officer · Individual
Deland Senior Investments I, LLC
Operational/Managerial Control · Organization
Deland Senior Investments Ii, LLC
Operational/Managerial Control · Organization
Edwards, Samuel
Operational/Managerial Control · Individual
Fraser, Geoffrey
Corporate Officer · Individual
Hurta, Chad
Operational/Managerial Control · Individual
Huston, Taylor
Operational/Managerial Control · Individual
Nearby options
Other facilities in reach
#1
Parkside Health And Rehabilitation Center
Deland, FL
4-star overall rating with 4-star inspections with 2 recent health deficiencies with 5 fire-safety deficiencies in the latest cycle
#2
Athens Post Acute LLC
Deland, FL
3-star overall rating with 4-star inspections with $61,744 in total fines with 14 fire-safety deficiencies in the latest cycle
#3
Villa Healthcare & Rehabilitation Center
Deland, FL
5-star overall rating with 4-star inspections with 2 recent health deficiencies with 8 fire-safety deficiencies in the latest cycle
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