3 health deficiencies
Top issue: Nursing and Physician Services (1 deficiency)
17 fire-safety deficiencies
Top issue: Emergency Preparedness (5 deficiencies)
Natick, MA
3-star overall rating with 4-star inspections with $10,517 in total fines with 3 recent health deficiencies with 17 fire-safety deficiencies in the latest cycle
3 Vision Drive, Natick, MA
(508) 651-9200
Overall
3 / 5
CMS overall stars
Health inspections
4 / 5
Survey and complaint cycles
Staffing
1 / 5
RN + nurse staffing
Quality measures
2 / 5
Resident outcomes and process measures
Quick facts
Beds
53
Certified beds
Average residents
46
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
No chain reported
Operator or chain grouping
Approved since
1997-06-02
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Changed ownership
No
Within the last 12 months
Family council
No
Resident and family council reported
Sprinklers
Yes
Automatic sprinklers in all required areas
Staffing
RN hours / resident day
0.32
Registered nurse staffing · state 0.65 · national 0.68
LPN hours / resident day
1.78
Licensed practical nurse staffing · state 0.96 · national 0.87
Aide hours / resident day
2.14
Nurse aide staffing · state 2.26 · national 2.35
Total nurse hours
4.24
All reported nurse hours · state 3.86 · national 3.89
Licensed hours
2.10
RN + LPN hours · state 1.60 · national 1.54
Weekend hours
3.88
Weekend nurse staffing · state 3.45 · national 3.43
Weekend RN hours
0.24
Weekend registered nurse coverage · state 0.46 · national 0.47
Physical therapist
0.10
Reported PT staffing · state 0.08 · national 0.07
Adjusted RN hours
0.33
CMS adjusted RN staffing hours
Adjusted total hours
4.40
CMS adjusted total nurse staffing hours
Case-mix index
1.32
Higher values indicate more complex resident acuity
RN turnover
83%
Annual RN turnover · state 45% · national 45%
Total nurse turnover
32%
Annual nurse turnover · state 40% · national 46%
SNF VBP
Program rank
8,459
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
26.69
Composite VBP score used to determine payment impact.
Payment multiplier
0.9843
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
Readmission
0
Baseline 20.61% · Performance 22.73% · Measure score 0 · Achievement 0 · Improvement 0
Healthcare-associated infections
3.98
Baseline 6.18% · Performance 6.65% · Measure score 3.98 · Achievement 3.98 · Improvement 0
Total nurse turnover
3.60
Performance 48.98% · Measure score 3.60 · Achievement 3.60 · This facility did not have sufficient data to calculate a baseline period measure result.
Adjusted total nurse staffing
3.10
Baseline 3.69 hours · Performance 3.96 hours · Measure score 3.10 · Achievement 3.10 · Improvement 0.78
SNF QRP
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 10.88% |
10.72%
0.2 pts worse
|
No Different than the National Rate · Eligible stays 100 · Observed rate 12% · Lower 95% interval 7.47% |
| Discharge to community | 58.4% |
50.57%
7.8 pts better
|
No Different than the National Rate · Eligible stays 100 · Observed rate 47% · Lower 95% interval 48% |
| Medicare spending per beneficiary | 0.78 |
1.02
0.2 pts better
|
|
| Drug regimen review with follow-up | 100% |
95.27%
4.7 pts better
|
Numerator 47 · Denominator 47 |
| Falls with major injury | 2.13% |
0.77%
1.4 pts worse
|
Numerator 1 · Denominator 47 |
| Discharge self-care score | 54.29% |
53.69%
0.6 pts better
|
Numerator 19 · Denominator 35 |
| Discharge mobility score | 48.57% |
50.94%
2.4 pts worse
|
Numerator 17 · Denominator 35 |
| Pressure ulcers or injuries, new or worsened | 12.77% |
2.29%
10.5 pts worse
|
Numerator 6 · Denominator 47 · Adjusted rate 9.47% |
| Healthcare-associated infections requiring hospitalization | 6.65% |
7.12%
0.5 pts better
|
No Different than the National Rate · Eligible stays 62 · Observed rate 6.45% · Lower 95% interval 3.7% |
| Staff COVID-19 vaccination coverage | 18.37% |
8.2%
10.2 pts better
|
Numerator 9 · Denominator 49 |
| Staff flu vaccination coverage | 42.05% |
42%
About the same
|
Numerator 37 · Denominator 88 |
| Discharge function score | 51.43% |
56.45%
5 pts worse
|
Numerator 18 · Denominator 35 |
| Transfer of health information to provider | Not Available |
95.95%
|
Numerator Not Available · Denominator 12 · Too few residents or stays to report publicly. |
| Transfer of health information to patient | Not Available |
96.28%
|
Numerator Not Available · Denominator 19 · Too few residents or stays to report publicly. |
| Resident COVID-19 vaccinations up to date | 83.33% |
25.2%
58.1 pts better
|
Numerator 25 · Denominator 30 |
Quality measures
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 2.8 |
1.9
0.9 pts worse
|
1.9
0.9 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 2.8 · Observed 2.1 · Expected 1.4 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 1.8 |
1.5
0.3 pts worse
|
1.8
About the same
|
Long Stay · 20240701-20250630 · Adjusted 1.8 · Observed 1.5 · Expected 1.4 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 98.2% |
92.2%
6 pts better
|
93.4%
4.8 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 95.1% · Q2 100.0% · Q3 100.0% · Q4 97.7% · 4Q avg 98.2% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 100.0% |
94.8%
5.2 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 | 4.7% |
3.5%
1.2 pts worse
|
3.3%
1.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 4.9% · Q2 4.8% · Q3 4.4% · Q4 4.7% · 4Q avg 4.7% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 1.6% |
12.0%
10.4 pts better
|
11.4%
9.8 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 3.0% · Q2 2.9% · Q3 0.0% · Q4 0.0% · 4Q avg 1.6% |
| Percentage of long-stay residents who lose too much weight | 5.2% |
5.2%
About the same
|
5.4%
0.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 7.1% · Q2 11.5% · Q3 0.0% · Q4 3.3% · 4Q avg 5.2% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 15.0% |
19.2%
4.2 pts better
|
19.6%
4.6 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 17.9% · Q2 16.7% · Q3 9.4% · Q4 16.7% · 4Q avg 15.0% |
| Percentage of long-stay residents who received an antipsychotic medication | 26.7% |
22.5%
4.2 pts worse
|
16.7%
10 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 21.7% · Q2 31.8% · Q3 27.6% · Q4 25.9% · 4Q avg 26.7% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 1.2% |
0.1%
1.1 pts worse
|
0.1%
1.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 2.4% · Q2 2.4% · Q3 0.0% · Q4 0.0% · 4Q avg 1.2% |
| Percentage of long-stay residents whose ability to walk independently worsened | 32.2% |
17.7%
14.5 pts worse
|
16.3%
15.9 pts worse
|
Long Stay · 2024Q4-2025Q3 · 4Q avg 32.2% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 27.9% |
17.6%
10.3 pts worse
|
14.9%
13 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 50.0% · Q2 25.0% · Q3 25.0% · Q4 14.3% · 4Q avg 27.9% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.0% |
1.0%
1 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 | 1.8% |
2.0%
0.2 pts better
|
1.7%
0.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 2.4% · Q2 0.0% · Q3 4.5% · Q4 0.0% · 4Q avg 1.8% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 15.5% |
21.7%
6.2 pts better
|
19.8%
4.3 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 11.9% · Q2 18.3% · Q3 15.7% · Q4 16.4% · 4Q avg 15.5% |
| Percentage of long-stay residents with pressure ulcers | 3.7% |
4.6%
0.9 pts better
|
5.1%
1.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 5.1% · Q2 1.5% · Q3 3.4% · Q4 4.7% · 4Q avg 3.7% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 81.8% |
77.1%
4.7 pts better
|
81.7%
0.1 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 76.7% · Q2 80.0% · Q3 79.3% · Q4 92.6% · 4Q avg 81.8% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 13.8% |
11.8%
2 pts worse
|
12.0%
1.8 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 13.8% · Observed 16.0% · Expected 12.9% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 1.8% |
1.3%
0.5 pts worse
|
1.6%
0.2 pts worse
|
Short Stay · 2024Q4-2025Q3 · 4Q avg 1.8% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 94.4% |
77.7%
16.7 pts better
|
79.7%
14.7 pts better
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 94.4% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 20.7% |
25.8%
5.1 pts better
|
23.9%
3.2 pts better
|
Short Stay · 20240701-20250630 · Adjusted 20.7% · Observed 24.0% · Expected 27.7% · Used in QM five-star |
Survey summary
Top issue: Nursing and Physician Services (1 deficiency)
17 fire-safety deficiencies
Top issue: Emergency Preparedness (5 deficiencies)
Top issue: Nursing and Physician Services (2 deficiencies)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Top issue: Infection Control (2 deficiencies)
2 fire-safety deficiencies
Top issue: Emergency Preparedness (1 deficiency)
Fire safety
Fire Safety
Develop Emergency Preparedness policies and procedures.
Corrected 2025-02-21
Fire Safety
Develop a communication plan.
Corrected 2025-02-21
Fire Safety
Establish emergency prep training and testing.
Corrected 2025-02-21
Fire Safety
Develop and maintain an Emergency Preparedness Program (EP).
Corrected 2025-02-21
Fire Safety
Implement emergency and standby power systems.
Corrected 2025-02-21
Fire Safety
Meet requirements for sections of health care facilities separated by fire resistive construction.
Corrected 2025-02-21
Fire Safety
Install emergency lighting that can last at least 1 1/2 hours.
Corrected 2025-02-21
Fire Safety
Have an enclosure around a vertical opening shaft.
Corrected 2025-02-21
Fire Safety
Provide properly protected cooking facilities.
Corrected 2025-02-21
Fire Safety
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Corrected 2025-02-21
Fire Safety
Have simulated fire drills held at unexpected times.
Corrected 2025-02-21
Fire Safety
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Corrected 2025-02-21
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2025-02-21
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 2025-02-21
Fire Safety
Have approved installation, maintenance and testing program for fire alarm systems.
Corrected 2025-02-21
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2025-02-21
Fire Safety
Provide a written emergency evacuation plan.
Corrected 2025-02-21
Fire Safety
Implement emergency and standby power systems.
Corrected 2022-07-22
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2022-07-22
Inspection history
Health
Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
Corrected 2025-07-16
Health
Ensure each resident receives an accurate assessment.
Corrected 2025-01-27
Health
Post nurse staffing information every day.
Corrected 2025-01-27
Health
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected 2024-06-28
Health
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected 2024-02-14
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2024-02-14
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 2023-12-28
Health
Post nurse staffing information every day.
Corrected 2023-12-28
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2022-06-17
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2022-06-17
Health
Provide and implement an infection prevention and control program.
Corrected 2022-06-17
Health
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Corrected 2022-06-17
Penalties and ownership
Fine · fine $10,517
Fine
5% Or Greater Direct Ownership Interest · Individual
W-2 Managing Employee · Individual
Operational/Managerial Control · Organization
General Partnership Interest · Individual
Corporate Officer · Individual
W-2 Managing Employee · Individual
General Partnership Interest · Individual
Nearby options
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Natick, MA
2-star overall rating with 2-star inspections with 13 recent health deficiencies with 7 fire-safety deficiencies in the latest cycle
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