Cycle 1
Health 2024-11-01 · Fire 2024-11-01
22 health deficiencies
Top issue: Resident Rights (8 deficiencies)
20 fire-safety deficiencies
Top issue: Smoke (7 deficiencies)
Pleasant Hill, MO
Aspire Senior Living Pleasant Hill
2-star overall rating with 2-star inspections with $14,433 in total fines with 22 recent health deficiencies with 20 fire-safety deficiencies in the latest cycle
1300 Broadway, Pleasant Hill, MO
(816) 540-2116
Overall
2 / 5
CMS overall stars
Health inspections
2 / 5
Survey and complaint cycles
Staffing
2 / 5
RN + nurse staffing
Quality measures
4 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
90
Certified beds
Average residents
81
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
Aspire Senior Living
Operator or chain grouping
Approved since
1994-02-22
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Chain footprint
14 facilities
Chain averages 3 overall / 3 health / 2 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
0.25
Registered nurse staffing · state 0.46 · national 0.68
LPN hours / resident day
0.76
Licensed practical nurse staffing · state 0.68 · national 0.87
Aide hours / resident day
2.34
Nurse aide staffing · state 2.33 · national 2.35
Total nurse hours
3.35
All reported nurse hours · state 3.47 · national 3.89
Licensed hours
1.01
RN + LPN hours · state 1.14 · national 1.54
Weekend hours
2.86
Weekend nurse staffing · state 3.04 · national 3.43
Weekend RN hours
0.17
Weekend registered nurse coverage · state 0.33 · national 0.47
Physical therapist
0.06
Reported PT staffing · state 0.05 · national 0.07
Adjusted RN hours
0.31
CMS adjusted RN staffing hours
Adjusted total hours
4.07
CMS adjusted total nurse staffing hours
Case-mix index
1.13
Higher values indicate more complex resident acuity
RN turnover
91%
Annual RN turnover · state 51% · national 45%
Total nurse turnover
68%
Annual nurse turnover · state 57% · national 46%
SNF VBP
Value-based purchasing
Program rank
9,461
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
23.60
Composite VBP score used to determine payment impact.
Payment multiplier
0.9832
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
0
Baseline 21.38% · Performance 21.24% · Measure score 0 · Achievement 0 · Improvement 0
Healthcare-associated infections
3.30
Baseline 8.32% · Performance 7.06% · Measure score 3.30 · Achievement 2.60 · Improvement 3.30
Total nurse turnover
3.71
Performance 48.53% · Measure score 3.71 · Achievement 3.71 · This facility did not have sufficient data to calculate a baseline period measure result.
Adjusted total nurse staffing
2.43
Baseline 3.57 hours · Performance 3.77 hours · Measure score 2.43 · Achievement 2.43 · Improvement 0.42
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 10.57% |
10.72%
0.2 pts better
|
No Different than the National Rate · Eligible stays 62 · Observed rate 9.68% · Lower 95% interval 6.83% |
| Discharge to community | 45.07% |
50.57%
5.5 pts worse
|
No Different than the National Rate · Eligible stays 47 · Observed rate 36.17% · Lower 95% interval 33.29% |
| Medicare spending per beneficiary | 0.99 |
1.02
About the same
|
|
| Drug regimen review with follow-up | 98.25% |
95.27%
3 pts better
|
Numerator 56 · Denominator 57 |
| Falls with major injury | 0% |
0.77%
0.8 pts better
|
Numerator 0 · Denominator 57 |
| Discharge self-care score | 76.32% |
53.69%
22.6 pts better
|
Numerator 29 · Denominator 38 |
| Discharge mobility score | 81.58% |
50.94%
30.6 pts better
|
Numerator 31 · Denominator 38 |
| Pressure ulcers or injuries, new or worsened | 3.51% |
2.29%
1.2 pts worse
|
Numerator 2 · Denominator 57 · Adjusted rate 4.26% |
| Healthcare-associated infections requiring hospitalization | 7.06% |
7.12%
0.1 pts better
|
No Different than the National Rate · Eligible stays 53 · Observed rate 7.55% · Lower 95% interval 4.08% |
| Staff COVID-19 vaccination coverage | 0% |
8.2%
8.2 pts worse
|
Numerator 0 · Denominator 56 |
| Staff flu vaccination coverage | 8.15% |
42%
33.9 pts worse
|
Numerator 15 · Denominator 184 |
| Discharge function score | 78.95% |
56.45%
22.5 pts better
|
Numerator 30 · Denominator 38 |
| Transfer of health information to provider | 90.91% |
95.95%
5 pts worse
|
Numerator 20 · Denominator 22 |
| Transfer of health information to patient | Not Available |
96.28%
|
Numerator Not Available · Denominator 14 · Too few residents or stays to report publicly. |
| Resident COVID-19 vaccinations up to date | 0% |
25.2%
25.2 pts worse
|
Numerator 0 · Denominator 25 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 2.6 |
2.1
0.5 pts worse
|
1.9
0.7 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 2.6 · Observed 2.3 · Expected 1.7 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 1.3 |
2.3
1 pts better
|
1.8
0.5 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.3 · Observed 1.3 · Expected 1.6 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 84.1% |
84.8%
0.7 pts worse
|
93.4%
9.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 71.2% · Q2 89.2% · Q3 88.5% · Q4 87.0% · 4Q avg 84.1% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 87.3% |
90.9%
3.6 pts worse
|
95.5%
8.2 pts worse
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 87.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 7.3% |
4.1%
3.2 pts worse
|
3.3%
4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 6.8% · Q2 6.8% · Q3 9.0% · Q4 6.5% · 4Q avg 7.3% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 3.2% |
14.7%
11.5 pts better
|
11.4%
8.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 6.2% · Q2 4.8% · Q3 0.0% · Q4 1.7% · 4Q avg 3.2% |
| Percentage of long-stay residents who lose too much weight | 1.2% |
5.5%
4.3 pts better
|
5.4%
4.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 1.6% · Q4 3.4% · 4Q avg 1.2% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 24.2% |
25.3%
1.1 pts better
|
19.6%
4.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 23.8% · Q2 27.7% · Q3 22.1% · Q4 23.4% · 4Q avg 24.2% |
| Percentage of long-stay residents who received an antipsychotic medication | 7.5% |
25.0%
17.5 pts better
|
16.7%
9.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 8.7% · Q2 6.1% · Q3 5.7% · Q4 9.6% · 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 | 2.6% |
20.3%
17.7 pts better
|
16.3%
13.7 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 6.8% · Q2 3.9% · Q3 0.0% · Q4 0.0% · 4Q avg 2.6% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 12.2% |
19.8%
7.6 pts better
|
14.9%
2.7 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 15.0% · Q2 14.5% · Q3 3.1% · Q4 16.7% · 4Q avg 12.2% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.0% |
1.4%
1.4 pts better
|
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% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 0.3% |
2.6%
2.3 pts better
|
1.7%
1.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.4% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.3% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 14.9% |
18.1%
3.2 pts better
|
19.8%
4.9 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 15.5% · Q2 12.5% · Q3 14.7% · Q4 16.8% · 4Q avg 14.9% |
| Percentage of long-stay residents with pressure ulcers | 7.9% |
5.0%
2.9 pts worse
|
5.1%
2.8 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 12.2% · Q2 6.0% · Q3 7.3% · Q4 6.1% · 4Q avg 7.9% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 73.9% |
66.4%
7.5 pts better
|
81.7%
7.8 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 68.3% · Q2 79.2% · Q3 73.3% · Q4 75.5% · 4Q avg 73.9% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 17.1% |
13.4%
3.7 pts worse
|
12.0%
5.1 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 17.1% · Observed 18.0% · Expected 11.8% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 0.8% |
2.2%
1.4 pts better
|
1.6%
0.8 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 2.7% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.8% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 78.2% |
63.5%
14.7 pts better
|
79.7%
1.5 pts worse
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 78.2% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 23.9% |
25.3%
1.4 pts better
|
23.9%
About the same
|
Short Stay · 20240701-20250630 · Adjusted 23.9% · Observed 22.0% · Expected 22.0% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2023-03-17 · Fire 2023-03-17
15 health deficiencies
Top issue: Resident Rights (6 deficiencies)
19 fire-safety deficiencies
Top issue: Smoke (8 deficiencies)
Cycle 3
Health 2020-10-27 · Fire 2020-10-27
22 health deficiencies
Top issue: Quality of Life and Care (6 deficiencies)
11 fire-safety deficiencies
Top issue: Emergency Preparedness (4 deficiencies)
Fire safety
Fire-safety citations
F · Potential for more than minimal harm
2024-11-01
E15 · Emergency Preparedness Deficiencies
Fire Safety
Address subsistence needs for staff and patients.
Corrected 2024-12-15
F · Potential for more than minimal harm
2024-11-01
E20 · Emergency Preparedness Deficiencies
Fire Safety
Establish policies and procedures including evacuation.
Corrected 2024-12-15
F · Potential for more than minimal harm
2024-11-01
E25 · Emergency Preparedness Deficiencies
Fire Safety
Create arrangements with other facilities to receive patients.
Corrected 2024-12-15
F · Potential for more than minimal harm
2024-11-01
E30 · Emergency Preparedness Deficiencies
Fire Safety
List the names and contact information of those in the facility.
Corrected 2024-12-15
F · Potential for more than minimal harm
2024-11-01
E4 · Emergency Preparedness Deficiencies
Fire Safety
Develop and maintain an Emergency Preparedness Program (EP).
Corrected 2024-12-15
F · Potential for more than minimal harm
2024-11-01
E41 · Emergency Preparedness Deficiencies
Fire Safety
Implement emergency and standby power systems.
Corrected 2024-12-15
F · Potential for more than minimal harm
2024-11-01
K700 · Miscellaneous Deficiencies
Fire Safety
Meet requirements for operating features, such as evacuation plans, fire drills, smoking regulations, draperies, decorations and the inspection, testing and maintenance of fire doors.
Corrected 2024-12-15
F · Potential for more than minimal harm
2024-11-01
K712 · Miscellaneous Deficiencies
Fire Safety
Have simulated fire drills held at unexpected times.
Corrected 2024-12-15
E · Potential for more than minimal harm
2024-11-01
K161 · Construction Deficiencies
Fire Safety
Use approved construction type or materials.
Corrected 2024-12-15
E · Potential for more than minimal harm
2024-11-01
K271 · Egress Deficiencies
Fire Safety
Have exits that are accessible at all times.
Corrected 2024-12-15
E · Potential for more than minimal harm
2024-11-01
K311 · Smoke Deficiencies
Fire Safety
Have an enclosure around a vertical opening shaft.
Corrected 2024-12-15
E · Potential for more than minimal harm
2024-11-01
K321 · Smoke Deficiencies
Fire Safety
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Corrected 2024-12-15
E · Potential for more than minimal harm
2024-11-01
K324 · Smoke Deficiencies
Fire Safety
Provide properly protected cooking facilities.
Corrected 2024-12-15
E · Potential for more than minimal harm
2024-11-01
K325 · Smoke Deficiencies
Fire Safety
Have properly installed hallway dispensers for alcohol-based hand rub.
Corrected 2024-12-15
E · Potential for more than minimal harm
2024-11-01
K341 · Smoke Deficiencies
Fire Safety
Install a fire alarm system that can be heard throughout the facility.
Corrected 2024-12-15
E · Potential for more than minimal harm
2024-11-01
K363 · Smoke Deficiencies
Fire Safety
Install corridor and hallway doors that block smoke.
Corrected 2024-12-15
E · Potential for more than minimal harm
2024-11-01
K372 · Smoke Deficiencies
Fire Safety
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Corrected 2024-12-15
E · Potential for more than minimal harm
2024-11-01
K741 · Miscellaneous Deficiencies
Fire Safety
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Corrected 2024-12-15
E · Potential for more than minimal harm
2024-11-01
K919 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Meet requirements for the use of electrical equipment.
Corrected 2024-12-15
E · Potential for more than minimal harm
2024-11-01
K923 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have proper medical gas storage and administration areas.
Corrected 2024-12-15
F · Potential for more than minimal harm
2023-03-17
E30 · Emergency Preparedness Deficiencies
Fire Safety
List the names and contact information of those in the facility.
Corrected 2023-04-17
F · Potential for more than minimal harm
2023-03-17
E32 · Emergency Preparedness Deficiencies
Fire Safety
Provide primary/alternate means for communication.
Corrected 2023-04-17
F · Potential for more than minimal harm
2023-03-17
E41 · Emergency Preparedness Deficiencies
Fire Safety
Implement emergency and standby power systems.
Corrected 2023-05-11
F · Potential for more than minimal harm
2023-03-17
K281 · Egress Deficiencies
Fire Safety
Install proper backup exit lighting.
Corrected 2023-05-11
F · Potential for more than minimal harm
2023-03-17
K324 · Smoke Deficiencies
Fire Safety
Provide properly protected cooking facilities.
Corrected 2023-04-17
F · Potential for more than minimal harm
2023-03-17
K341 · Smoke Deficiencies
Fire Safety
Install a fire alarm system that can be heard throughout the facility.
Corrected 2023-04-17
F · Potential for more than minimal harm
2023-03-17
K345 · Smoke Deficiencies
Fire Safety
Have approved installation, maintenance and testing program for fire alarm systems.
Corrected 2023-06-05
F · Potential for more than minimal harm
2023-03-17
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2023-06-02
F · Potential for more than minimal harm
2023-03-17
K354 · Smoke Deficiencies
Fire Safety
Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.
Corrected 2023-04-17
F · Potential for more than minimal harm
2023-03-17
K711 · Miscellaneous Deficiencies
Fire Safety
Provide a written emergency evacuation plan.
Corrected 2023-04-17
F · Potential for more than minimal harm
2023-03-17
K712 · Miscellaneous Deficiencies
Fire Safety
Have simulated fire drills held at unexpected times.
Corrected 2023-04-17
F · Potential for more than minimal harm
2023-03-17
K761 · Miscellaneous Deficiencies
Fire Safety
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Corrected 2023-05-11
F · Potential for more than minimal harm
2023-03-17
K771 · Miscellaneous Deficiencies
Fire Safety
Ensure that smoke control systems are tested and documented in accordance with established engineering principles.
Corrected 2023-04-17
F · Potential for more than minimal harm
2023-03-17
K914 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
Corrected 2023-04-17
F · Potential for more than minimal harm
2023-03-17
K918 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2023-05-11
E · Potential for more than minimal harm
2023-03-17
K321 · Smoke Deficiencies
Fire Safety
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Corrected 2023-04-17
E · Potential for more than minimal harm
2023-03-17
K347 · Smoke Deficiencies
Fire Safety
Properly provide smoke detection systems in areas open to corridors.
Corrected 2023-04-17
E · Potential for more than minimal harm
2023-03-17
K363 · Smoke Deficiencies
Fire Safety
Install corridor and hallway doors that block smoke.
Corrected 2023-05-11
E · Potential for more than minimal harm
2023-03-17
K521 · Services Deficiencies
Fire Safety
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Corrected 2023-04-17
F · Potential for more than minimal harm
2020-10-27
E1 · Emergency Preparedness Deficiencies
Fire Safety
Establish an Emergency Preparedness Program (EP).
Corrected 2020-12-11
F · Potential for more than minimal harm
2020-10-27
E22 · Emergency Preparedness Deficiencies
Fire Safety
Establish policies and procedures for sheltering.
Corrected 2020-12-11
F · Potential for more than minimal harm
2020-10-27
E32 · Emergency Preparedness Deficiencies
Fire Safety
Provide primary/alternate means for communication.
Corrected 2020-12-11
F · Potential for more than minimal harm
2020-10-27
E7 · Emergency Preparedness Deficiencies
Fire Safety
Address patient/client population and determine types of services needed.
Corrected 2020-12-11
F · Potential for more than minimal harm
2020-10-27
K343 · Smoke Deficiencies
Fire Safety
Have a fire alarm with audible and visual signals that transmits the alarm automatically to notify emergency forces in event of fire.
Corrected 2020-12-11
F · Potential for more than minimal harm
2020-10-27
K354 · Smoke Deficiencies
Fire Safety
Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.
Corrected 2020-12-11
F · Potential for more than minimal harm
2020-10-27
K711 · Miscellaneous Deficiencies
Fire Safety
Provide a written emergency evacuation plan.
Corrected 2020-12-11
F · Potential for more than minimal harm
2020-10-27
K761 · Miscellaneous Deficiencies
Fire Safety
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Corrected 2020-12-11
E · Potential for more than minimal harm
2020-10-27
K222 · Egress Deficiencies
Fire Safety
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
Corrected 2020-12-11
E · Potential for more than minimal harm
2020-10-27
K355 · Smoke Deficiencies
Fire Safety
Properly select, install, inspect, or maintain portable fire extinguishes.
Corrected 2020-12-11
E · Potential for more than minimal harm
2020-10-27
K741 · Miscellaneous Deficiencies
Fire Safety
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Corrected 2020-12-11
Inspection history
Recent health citations
D · Potential for more than minimal harm
2025-11-18
F627 · Resident Rights Deficiencies
Health
Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge.
Corrected 2025-12-05
D · Potential for more than minimal harm
2025-05-27
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 2025-07-07
D · Potential for more than minimal harm
2025-05-27
F755 · Pharmacy Service Deficiencies
Health
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected 2025-07-07
F · Potential for more than minimal harm
2025-03-14
F839 · Administration Deficiencies
Health
Employ staff that are licensed, certified, or registered in accordance with state laws.
Corrected 2025-02-04
D · Potential for more than minimal harm
2025-01-02
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected 2024-12-28
F · Potential for more than minimal harm
2024-11-01
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 2024-12-15
F · Potential for more than minimal harm
2024-11-01
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2024-12-15
E · Potential for more than minimal harm
2024-11-01
F567 · Resident Rights Deficiencies
Health
Honor the resident's right to manage his or her financial affairs.
Corrected 2024-12-15
E · Potential for more than minimal harm
2024-11-01
F582 · Resident Rights Deficiencies
Health
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Corrected 2024-12-15
E · Potential for more than minimal harm
2024-11-01
F584 · Resident Rights Deficiencies
Health
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Corrected 2024-12-15
E · Potential for more than minimal harm
2024-11-01
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 2024-12-15
E · Potential for more than minimal harm
2024-11-01
F695 · Quality of Life and Care Deficiencies
Health
Provide safe and appropriate respiratory care for a resident when needed.
Corrected 2024-12-15
E · Potential for more than minimal harm
2024-11-01
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 2024-12-15
E · Potential for more than minimal harm
2024-11-01
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 2024-12-15
D · Potential for more than minimal harm
2024-11-01
F553 · Resident Rights Deficiencies
Health
Allow resident to participate in the development and implementation of his or her person-centered plan of care.
Corrected 2024-12-15
D · Potential for more than minimal harm
2024-11-01
F578 · Resident Rights Deficiencies
Health
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Corrected 2024-12-15
D · Potential for more than minimal harm
2024-11-01
F580 · Resident Rights Deficiencies
Health
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Corrected 2024-12-15
D · Potential for more than minimal harm
2024-11-01
F625 · Resident Rights Deficiencies
Health
Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
Corrected 2024-12-15
D · Potential for more than minimal harm
2024-11-01
F679 · Quality of Life and Care Deficiencies
Health
Provide activities to meet all resident's needs.
Corrected 2024-12-15
D · Potential for more than minimal harm
2024-11-01
F691 · Quality of Life and Care Deficiencies
Health
Provide appropriate colostomy, urostomy, or ileostomy care/services for a resident who requires such services.
Corrected 2024-12-15
D · Potential for more than minimal harm
2024-11-01
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 2024-12-15
D · Potential for more than minimal harm
2024-11-01
F698 · Quality of Life and Care Deficiencies
Health
Provide safe, appropriate dialysis care/services for a resident who requires such services.
Corrected 2024-12-15
D · Potential for more than minimal harm
2024-11-01
F804 · Nutrition and Dietary Deficiencies
Health
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Corrected 2024-12-15
D · Potential for more than minimal harm
2024-04-03
F550 · Resident Rights Deficiencies
Health
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected 2024-03-26
J · Immediate jeopardy
2024-03-20
F678 · Quality of Life and Care Deficiencies
Health
Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.
Corrected 2024-03-21
F · Potential for more than minimal harm
2023-03-17
F838 · Administration Deficiencies
Health
Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.
Corrected 2023-04-17
E · Potential for more than minimal harm
2023-03-17
F567 · Resident Rights Deficiencies
Health
Honor the resident's right to manage his or her financial affairs.
Corrected 2023-04-17
E · Potential for more than minimal harm
2023-03-17
F607 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Corrected 2023-04-17
D · Potential for more than minimal harm
2023-03-17
F578 · Resident Rights Deficiencies
Health
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Corrected 2023-04-17
D · Potential for more than minimal harm
2023-03-17
F580 · Resident Rights Deficiencies
Health
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Corrected 2023-02-20
D · Potential for more than minimal harm
2023-03-17
F582 · Resident Rights Deficiencies
Health
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Corrected 2023-04-17
D · Potential for more than minimal harm
2023-03-17
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 2023-04-17
D · Potential for more than minimal harm
2023-03-17
F644 · Resident Assessment and Care Planning Deficiencies
Health
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Corrected 2023-04-17
D · Potential for more than minimal harm
2023-03-17
F661 · Resident Assessment and Care Planning Deficiencies
Health
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
Corrected 2023-04-17
D · Potential for more than minimal harm
2023-03-17
F695 · Quality of Life and Care Deficiencies
Health
Provide safe and appropriate respiratory care for a resident when needed.
Corrected 2023-04-17
D · Potential for more than minimal harm
2023-03-17
F700 · Quality of Life and Care Deficiencies
Health
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.
Corrected 2023-04-17
D · Potential for more than minimal harm
2023-03-17
F849 · Administration Deficiencies
Health
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
Corrected 2023-04-17
G · Actual harm
2020-10-27
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 2020-12-11
E · Potential for more than minimal harm
2020-10-27
F582 · Resident Rights Deficiencies
Health
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Corrected 2020-12-11
E · Potential for more than minimal harm
2020-10-27
F607 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Corrected 2020-12-11
E · Potential for more than minimal harm
2020-10-27
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 2020-12-11
E · Potential for more than minimal harm
2020-10-27
F725 · Nursing and Physician Services Deficiencies
Health
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Corrected 2020-12-11
E · Potential for more than minimal harm
2020-10-27
F727 · Nursing and Physician Services Deficiencies
Health
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.
Corrected 2020-12-11
E · Potential for more than minimal harm
2020-10-27
F755 · Pharmacy Service Deficiencies
Health
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected 2020-12-11
E · Potential for more than minimal harm
2020-10-27
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 2020-12-11
E · Potential for more than minimal harm
2020-10-27
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 2020-12-11
E · Potential for more than minimal harm
2020-10-27
F838 · Administration Deficiencies
Health
Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations (including nights and weekends) and emergencies.
Corrected 2020-12-11
E · Potential for more than minimal harm
2020-10-27
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2020-12-11
D · Potential for more than minimal harm
2020-10-27
F578 · Resident Rights Deficiencies
Health
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Corrected 2020-12-11
D · Potential for more than minimal harm
2020-10-27
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 2020-12-11
D · Potential for more than minimal harm
2020-10-27
F625 · Resident Rights Deficiencies
Health
Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
Corrected 2020-12-11
D · Potential for more than minimal harm
2020-10-27
F655 · Resident Assessment and Care Planning Deficiencies
Health
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Corrected 2020-12-11
D · Potential for more than minimal harm
2020-10-27
F657 · Resident Assessment and Care Planning Deficiencies
Health
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected 2020-12-11
D · Potential for more than minimal harm
2020-10-27
F660 · Resident Assessment and Care Planning Deficiencies
Health
Plan the resident's discharge to meet the resident's goals and needs.
Corrected 2020-12-11
D · Potential for more than minimal harm
2020-10-27
F661 · Resident Assessment and Care Planning Deficiencies
Health
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
Corrected 2020-12-11
D · Potential for more than minimal harm
2020-10-27
F679 · Quality of Life and Care Deficiencies
Health
Provide activities to meet all resident's needs.
Corrected 2020-12-11
D · Potential for more than minimal harm
2020-10-27
F684 · Quality of Life and Care Deficiencies
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2020-12-11
D · Potential for more than minimal harm
2020-10-27
F686 · Quality of Life and Care Deficiencies
Health
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Corrected 2020-12-11
D · Potential for more than minimal harm
2020-10-27
F698 · Quality of Life and Care Deficiencies
Health
Provide safe, appropriate dialysis care/services for a resident who requires such services.
Corrected 2020-12-11
Penalties and ownership
What sits behind the stars
$14,433
2024-03-20
Fine
Fine · fine $14,433
Fine
Ownership
Nearby options
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2-star overall rating with 3-star inspections with 11 recent health deficiencies with 5 fire-safety deficiencies in the latest cycle
#3
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