13 health deficiencies
Top issue: Nutrition and Dietary (3 deficiencies)
2 fire-safety deficiencies
Top issue: Construction (1 deficiency)
Middletown, OH
1-star overall rating with 2-star inspections with 13 recent health deficiencies with 2 fire-safety deficiencies in the latest cycle
5414 Hankins Road, Middletown, OH
(513) 863-7775
Overall
1 / 5
CMS overall stars
Health inspections
2 / 5
Survey and complaint cycles
Staffing
1 / 5
RN + nurse staffing
Quality measures
4 / 5
Resident outcomes and process measures
Quick facts
Beds
74
Certified beds
Average residents
63
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
Lionstone Care
Operator or chain grouping
Approved since
1990-11-16
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Chain footprint
22 facilities
Chain averages 3 overall / 2 health / 2 staffing / 5 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
RN hours / resident day
0.58
Registered nurse staffing · state 0.63 · national 0.68
LPN hours / resident day
0.78
Licensed practical nurse staffing · state 0.96 · national 0.87
Aide hours / resident day
1.83
Nurse aide staffing · state 2.14 · national 2.35
Total nurse hours
3.19
All reported nurse hours · state 3.72 · national 3.89
Licensed hours
1.36
RN + LPN hours · state 1.59 · national 1.54
Weekend hours
2.80
Weekend nurse staffing · state 3.29 · national 3.43
Weekend RN hours
0.40
Weekend registered nurse coverage · state 0.41 · national 0.47
Physical therapist
0.09
Reported PT staffing · state 0.05 · national 0.07
Adjusted RN hours
0.58
CMS adjusted RN staffing hours
Adjusted total hours
3.23
CMS adjusted total nurse staffing hours
Case-mix index
1.35
Higher values indicate more complex resident acuity
RN turnover
67%
Annual RN turnover · state 47% · national 45%
Total nurse turnover
71%
Annual nurse turnover · state 50% · national 46%
SNF VBP
Program rank
13,135
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
8.02
Composite VBP score used to determine payment impact.
Payment multiplier
0.9807
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
Readmission
Not reported
This facility did not meet this measure's case minimum policy requirement and therefore no measure data is publicly reported.
Healthcare-associated infections
Not reported
This facility did not meet this measure's case minimum policy requirement and therefore no measure data is publicly reported.
Total nurse turnover
0
Baseline 51.79% · Performance 61.67% · Measure score 0 · Achievement 0 · Improvement 0
Adjusted total nurse staffing
1.60
Baseline 3.42 hours · Performance 3.53 hours · Measure score 1.60 · Achievement 1.60 · Improvement 0
SNF QRP
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 10.78% |
10.72%
0.1 pts worse
|
No Different than the National Rate · Eligible stays 31 · Observed rate 12.9% · Lower 95% interval 7.4% |
| Discharge to community | 50.88% |
50.57%
0.3 pts better
|
No Different than the National Rate · Eligible stays 31 · Observed rate 38.71% · Lower 95% interval 35.7% |
| Medicare spending per beneficiary | 0.81 |
1.02
0.2 pts better
|
|
| Drug regimen review with follow-up | 100% |
95.27%
4.7 pts better
|
Numerator 33 · Denominator 33 |
| Falls with major injury | 0% |
0.77%
0.8 pts better
|
Numerator 0 · Denominator 33 |
| Discharge self-care score | 54.55% |
53.69%
0.9 pts better
|
Numerator 12 · Denominator 22 |
| Discharge mobility score | 40.91% |
50.94%
10 pts worse
|
Numerator 9 · Denominator 22 |
| Pressure ulcers or injuries, new or worsened | 0% |
2.29%
2.3 pts better
|
Numerator 0 · Denominator 33 · Adjusted rate 0% |
| Healthcare-associated infections requiring hospitalization | Not Available |
7.12%
|
Not Available · Eligible stays 24 · Observed rate Not Available · Lower 95% interval Not Available · Too few residents or stays to report publicly. |
| Staff COVID-19 vaccination coverage | 0% |
8.2%
8.2 pts worse
|
Numerator 0 · Denominator 108 |
| Staff flu vaccination coverage | 13.41% |
42%
28.6 pts worse
|
Numerator 22 · Denominator 164 |
| Discharge function score | 59.09% |
56.45%
2.6 pts better
|
Numerator 13 · Denominator 22 |
| Transfer of health information to provider | Not Available |
95.95%
|
Numerator Not Available · Denominator 9 · Too few residents or stays to report publicly. |
| Transfer of health information to patient | Not Available |
96.28%
|
Numerator Not Available · Denominator 8 · Too few residents or stays to report publicly. |
| Resident COVID-19 vaccinations up to date | Not Available |
25.2%
|
Numerator Not Available · Denominator 14 · Too few residents or stays to report publicly. |
Quality measures
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 79.0% |
92.4%
13.4 pts worse
|
93.4%
14.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 78.6% · Q2 70.2% · Q3 79.2% · Q4 89.6% · 4Q avg 79.0% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 53.3% |
94.5%
41.2 pts worse
|
95.5%
42.2 pts worse
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 53.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 2.3% |
3.3%
1 pts better
|
3.3%
1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.8% · Q2 1.8% · Q3 3.8% · Q4 2.1% · 4Q avg 2.3% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 19.2% |
26.1%
6.9 pts better
|
11.4%
7.8 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 9.8% · Q2 18.8% · Q3 26.7% · Q4 20.9% · 4Q avg 19.2% |
| Percentage of long-stay residents who lose too much weight | 15.1% |
6.2%
8.9 pts worse
|
5.4%
9.7 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 11.6% · Q2 20.4% · Q3 13.3% · Q4 14.3% · 4Q avg 15.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 24.0% |
25.4%
1.4 pts better
|
19.6%
4.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 31.9% · Q2 24.5% · Q3 20.0% · Q4 19.0% · 4Q avg 24.0% |
| Percentage of long-stay residents who received an antipsychotic medication | 13.3% |
11.5%
1.8 pts worse
|
16.7%
3.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 15.2% · Q2 14.7% · Q3 14.3% · Q4 9.1% · 4Q avg 13.3% · 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 | 6.1% |
7.7%
1.6 pts better
|
16.3%
10.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 4.5% · Q2 13.8% · Q3 0.0% · 4Q avg 6.1% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 5.4% |
6.2%
0.8 pts better
|
14.9%
9.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 4.8% · Q2 9.3% · Q3 4.8% · Q4 2.5% · 4Q avg 5.4% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.7% |
0.2%
0.5 pts worse
|
1.0%
0.3 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 2.5% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.7% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 0.0% |
0.5%
0.5 pts better
|
1.7%
1.7 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 new or worsened bowel or bladder incontinence | 16.9% |
21.7%
4.8 pts better
|
19.8%
2.9 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 16.6% · Q2 25.9% · Q3 5.5% · Q4 19.2% · 4Q avg 16.9% |
| Percentage of long-stay residents with pressure ulcers | 7.4% |
3.7%
3.7 pts worse
|
5.1%
2.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 5.3% · Q2 6.4% · Q3 11.6% · Q4 6.5% · 4Q avg 7.4% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 55.8% |
78.1%
22.3 pts worse
|
81.7%
25.9 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 46.3% · Q2 55.6% · Q3 61.8% · Q4 58.6% · 4Q avg 55.8% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 13.0% |
12.5%
0.5 pts worse
|
12.0%
1 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 13.0% · Observed 13.3% · Expected 11.5% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 4.7% |
1.2%
3.5 pts worse
|
1.6%
3.1 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 4.8% · Q2 3.3% · Q3 3.7% · Q4 7.1% · 4Q avg 4.7% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 43.6% |
75.6%
32 pts worse
|
79.7%
36.1 pts worse
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 43.6% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 21.0% |
25.1%
4.1 pts better
|
23.9%
2.9 pts better
|
Short Stay · 20240701-20250630 · Adjusted 21.0% · Observed 23.3% · Expected 26.4% · Used in QM five-star |
Survey summary
Top issue: Nutrition and Dietary (3 deficiencies)
2 fire-safety deficiencies
Top issue: Construction (1 deficiency)
Top issue: Quality of Life and Care (4 deficiencies)
14 fire-safety deficiencies
Top issue: Emergency Preparedness (6 deficiencies)
Top issue: Quality of Life and Care (6 deficiencies)
10 fire-safety deficiencies
Top issue: Egress (3 deficiencies)
Fire safety
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2025-09-03
Fire Safety
Meet requirements for outpatient facilities located next to inpatient facilities separated by fire resistive construction.
Corrected 2025-11-21
Fire Safety
Address subsistence needs for staff and patients.
Corrected 2022-07-11
Fire Safety
Establish policies and procedures for volunteers.
Corrected 2022-07-11
Fire Safety
Establish roles under a Waiver declared by secretary.
Corrected 2022-07-11
Fire Safety
Develop a communication plan.
Corrected 2022-07-11
Fire Safety
Develop and maintain an Emergency Preparedness Program (EP).
Corrected 2022-07-11
Fire Safety
Conduct risk assessment and an All-Hazards approach.
Corrected 2022-07-11
Fire Safety
Provide properly protected cooking facilities.
Corrected 2022-07-11
Fire Safety
Have approved installation, maintenance and testing program for fire alarm systems.
Corrected 2022-07-11
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2022-07-11
Fire Safety
Have properly installed electrical wiring and gas equipment.
Corrected 2022-07-11
Fire Safety
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Corrected 2022-07-11
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2022-07-11
Fire Safety
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Corrected 2022-07-11
Fire Safety
Have an alternate power supply for its alarm system.
Corrected 2022-07-11
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 2019-12-09
Fire Safety
Have exits that are accessible at all times.
Corrected 2019-12-09
Fire Safety
Install emergency lighting that can last at least 1 1/2 hours.
Corrected 2019-12-09
Fire Safety
Have an alternate power supply for its alarm system.
Corrected 2019-12-09
Fire Safety
Install an approved automatic sprinkler system.
Corrected 2019-12-09
Fire Safety
Have properly installed electrical wiring and gas equipment.
Corrected 2019-12-09
Fire Safety
Have simulated fire drills held at unexpected times.
Corrected 2019-12-09
Fire Safety
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Corrected 2019-12-09
Fire Safety
Develop and maintain an Emergency Preparedness Program (EP).
Corrected 2019-12-09
Fire Safety
Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.
Corrected 2019-12-09
Inspection history
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2025-09-03
Health
PASARR screening for Mental disorders or Intellectual Disabilities
Corrected 2025-09-03
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 2025-09-03
Health
Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.
Corrected 2025-09-03
Health
Give residents a notice of rights, rules, services and charges.
Corrected 2025-09-03
Health
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected 2025-09-03
Health
Respond appropriately to all alleged violations.
Corrected 2025-09-03
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 2025-09-03
Health
Provide safe and appropriate respiratory care for a resident when needed.
Corrected 2025-09-03
Health
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
Corrected 2025-09-03
Health
Provide the appropriate treatment and services to a resident who displays or is diagnosed with mental disorder or psychosocial adjustment difficulty, or who has a history of trauma and/or post-traumatic stress disorder.
Corrected 2025-09-03
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 2025-09-03
Health
Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law.
Corrected 2025-09-03
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2024-12-27
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2024-09-06
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2023-06-16
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 2023-06-16
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 2023-04-28
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 2023-04-28
Health
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected 2023-04-28
Health
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
Corrected 2023-03-31
Health
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected 2023-03-31
Health
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected 2023-03-31
Health
Provide and implement an infection prevention and control program.
Corrected 2023-03-31
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 2022-07-11
Health
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected 2022-07-11
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 2022-07-11
Health
Provide and implement an infection prevention and control program.
Corrected 2022-07-11
Health
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected 2022-07-11
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 2022-07-11
Health
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected 2022-07-11
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2022-07-11
Health
Provide safe and appropriate respiratory care for a resident when needed.
Corrected 2022-07-11
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 2022-07-11
Health
Ensure staff are vaccinated for COVID-19
Corrected 2022-07-11
Health
Provide and implement an infection prevention and control program.
Corrected 2019-12-09
Health
Implement a program that monitors antibiotic use.
Corrected 2019-12-09
Health
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Corrected 2019-12-09
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 2019-12-09
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 2019-12-09
Health
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Corrected 2019-12-09
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2019-12-09
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 2019-12-09
Health
Ensure medication error rates are not 5 percent or greater.
Corrected 2019-12-09
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 2019-12-09
Health
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected 2019-12-09
Penalties and ownership
5% Or Greater Indirect Ownership Interest · Individual
5% Or Greater Indirect Ownership Interest · Individual
5% Or Greater Mortgage Interest · Organization
Operational/Managerial Control · Individual
Corporate Director · Individual
Corporate Officer · Individual
5% Or Greater Direct Ownership Interest · Organization
Operational/Managerial Control · Organization
Operational/Managerial Control · Individual
Operational/Managerial Control · Individual
Corporate Director · Individual
Corporate Officer · Individual
Nearby options
Middletown, OH
2-star overall rating with 1-star inspections with $108,164 in total fines with 6 recent health deficiencies with 18 fire-safety deficiencies in the latest cycle
Monroe, OH
4-star overall rating with 3-star inspections with 8 recent health deficiencies with 21 fire-safety deficiencies in the latest cycle
Hamilton, OH
5-star overall rating with 5-star inspections with 4 recent health deficiencies with 1 fire-safety deficiencies in the latest cycle
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