Cycle 1
Health 2024-09-19 · Fire 2024-09-19
0 health deficiencies
No concentrated health issue counts in this cycle.
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Middlesboro, KY
Middlesboro Nursing and Rehabilitation Facility
5-star overall rating with 5-star inspections
235 New Wilson Lane, Middlesboro, KY
(606) 298-0091
Overall
5 / 5
CMS overall stars
Health inspections
5 / 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
95
Certified beds
Average residents
91
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
Bluegrass Health Ky
Operator or chain grouping
Approved since
1991-01-22
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Chain footprint
15 facilities
Chain averages 3 overall / 3 health / 1 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
0.43
Registered nurse staffing · state 0.77 · national 0.68
LPN hours / resident day
1.06
Licensed practical nurse staffing · state 0.81 · national 0.87
Aide hours / resident day
2.37
Nurse aide staffing · state 2.43 · national 2.35
Total nurse hours
3.86
All reported nurse hours · state 4.01 · national 3.89
Licensed hours
1.50
RN + LPN hours · state 1.58 · national 1.54
Weekend hours
3.36
Weekend nurse staffing · state 3.50 · national 3.43
Weekend RN hours
0.22
Weekend registered nurse coverage · state 0.52 · national 0.47
Physical therapist
0.01
Reported PT staffing · state 0.06 · national 0.07
Adjusted RN hours
0.36
CMS adjusted RN staffing hours
Adjusted total hours
3.22
CMS adjusted total nurse staffing hours
Case-mix index
1.64
Higher values indicate more complex resident acuity
RN turnover
27%
Annual RN turnover · state 43% · national 45%
Total nurse turnover
46%
Annual nurse turnover · state 47% · national 46%
SNF VBP
Value-based purchasing
Program rank
10,692
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
19.46
Composite VBP score used to determine payment impact.
Payment multiplier
0.9822
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
2.76
Baseline 17.48% · Performance 20.15% · Measure score 2.76 · Achievement 2.76 · Improvement 0
Healthcare-associated infections
0
Baseline 6.70% · Performance 8.26% · Measure score 0 · Achievement 0 · Improvement 0
Total nurse turnover
3.83
Baseline 47.27% · Performance 48.04% · Measure score 3.83 · Achievement 3.83 · Improvement 0
Adjusted total nurse staffing
1.20
Baseline 3.57 hours · Performance 3.42 hours · Measure score 1.20 · Achievement 1.20 · Improvement 0
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 10.72% |
10.72%
About the same
|
No Different than the National Rate · Eligible stays 99 · Observed rate 10.1% · Lower 95% interval 7.51% |
| Discharge to community | 52.25% |
50.57%
1.7 pts better
|
No Different than the National Rate · Eligible stays 81 · Observed rate 48.15% · Lower 95% interval 42.18% |
| Medicare spending per beneficiary | 1.72 |
1.02
0.7 pts worse
|
|
| Drug regimen review with follow-up | 100% |
95.27%
4.7 pts better
|
Numerator 38 · Denominator 38 |
| Falls with major injury | 5.26% |
0.77%
4.5 pts worse
|
Numerator 2 · Denominator 38 |
| Discharge self-care score | 34.78% |
53.69%
18.9 pts worse
|
Numerator 8 · Denominator 23 |
| Discharge mobility score | 43.48% |
50.94%
7.5 pts worse
|
Numerator 10 · Denominator 23 |
| Pressure ulcers or injuries, new or worsened | 0% |
2.29%
2.3 pts better
|
Numerator 0 · Denominator 38 · Adjusted rate 0% |
| Healthcare-associated infections requiring hospitalization | 8.26% |
7.12%
1.1 pts worse
|
No Different than the National Rate · Eligible stays 48 · Observed rate 10.42% · Lower 95% interval 4.88% |
| Staff COVID-19 vaccination coverage | 0.68% |
8.2%
7.5 pts worse
|
Numerator 1 · Denominator 147 |
| Staff flu vaccination coverage | 32.86% |
42%
9.1 pts worse
|
Numerator 46 · Denominator 140 |
| Discharge function score | 43.48% |
56.45%
13 pts worse
|
Numerator 10 · Denominator 23 |
| 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 15 · Too few residents or stays to report publicly. |
| Resident COVID-19 vaccinations up to date | Not Available |
25.2%
|
Numerator Not Available · Denominator 18 · 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 | 0.8 |
1.9
1.1 pts better
|
1.9
1.1 pts better
|
Long Stay · 20240701-20250630 · Adjusted 0.8 · Observed 0.7 · Expected 1.6 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 2.0 |
2.2
0.2 pts better
|
1.8
0.2 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 2.0 · Observed 1.8 · Expected 1.5 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 100.0% |
94.3%
5.7 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% |
96.2%
3.8 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 | 4.5% |
3.8%
0.7 pts worse
|
3.3%
1.2 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 2.5% · Q2 4.7% · Q3 6.0% · Q4 4.6% · 4Q avg 4.5% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 11.8% |
15.2%
3.4 pts better
|
11.4%
0.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 8.3% · Q2 13.2% · Q3 18.3% · Q4 7.7% · 4Q avg 11.8% |
| Percentage of long-stay residents who lose too much weight | 5.0% |
6.7%
1.7 pts better
|
5.4%
0.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 7.8% · Q2 6.2% · Q3 3.7% · Q4 2.4% · 4Q avg 5.0% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 41.5% |
29.6%
11.9 pts worse
|
19.6%
21.9 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 59.7% · Q2 52.4% · Q3 30.5% · Q4 25.0% · 4Q avg 41.5% |
| Percentage of long-stay residents who received an antipsychotic medication | 8.3% |
17.6%
9.3 pts better
|
16.7%
8.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 11.7% · Q2 13.0% · Q3 4.4% · Q4 4.4% · 4Q avg 8.3% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.2%
0.2 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 | 14.3% |
17.3%
3 pts better
|
16.3%
2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 15.6% · Q2 16.7% · Q3 9.8% · Q4 15.0% · 4Q avg 14.3% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 14.2% |
15.6%
1.4 pts better
|
14.9%
0.7 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 21.4% · Q2 14.1% · Q3 7.0% · Q4 14.3% · 4Q avg 14.2% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.0% |
0.7%
0.7 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 | 2.4% |
1.7%
0.7 pts worse
|
1.7%
0.7 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 6.2% · Q2 1.2% · Q3 2.4% · Q4 0.0% · 4Q avg 2.4% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 17.1% |
19.8%
2.7 pts better
|
19.8%
2.7 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 19.4% · Q2 17.5% · Q3 13.4% · Q4 18.1% · 4Q avg 17.1% |
| Percentage of long-stay residents with pressure ulcers | 2.5% |
5.5%
3 pts better
|
5.1%
2.6 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 3.5% · Q2 3.4% · Q3 0.9% · Q4 2.4% · 4Q avg 2.5% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 97.5% |
83.8%
13.7 pts better
|
81.7%
15.8 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 96.0% · Q2 96.0% · Q3 98.1% · Q4 100.0% · 4Q avg 97.5% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 12.9% |
13.9%
1 pts better
|
12.0%
0.9 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 12.9% · Observed 11.1% · Expected 9.6% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 0.0% |
1.8%
1.8 pts better
|
1.6%
1.6 pts better
|
Short 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 short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 98.1% |
83.6%
14.5 pts better
|
79.7%
18.4 pts better
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 98.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 27.9% |
24.5%
3.4 pts worse
|
23.9%
4 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 27.9% · Observed 25.0% · Expected 21.4% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2019-09-26 · Fire 2019-09-26
1 health deficiencies
Top issue: Nutrition and Dietary (1 deficiency)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Cycle 3
Health 2018-07-12 · Fire 2018-07-12
0 health deficiencies
No concentrated health issue counts in this cycle.
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Inspection history
Recent health citations
E · Potential for more than minimal harm
2019-09-26
F804 · Nutrition and Dietary Deficiencies
Health
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Corrected 2019-10-11
Penalties and ownership
What sits behind the stars
Ownership
Landa, Benjamin
5% Or Greater Direct Ownership Interest · Individual
Ky Equity Partners LLC
5% Or Greater Direct Ownership Interest · Organization
Grinspan, Eli
5% Or Greater Direct Ownership Interest · Individual
Kennedy Ky Holdings LLC
5% Or Greater Direct Ownership Interest · Organization
Fischl, Mayer
5% Or Greater Direct Ownership Interest · Individual
Fischl, Mayer
Operational/Managerial Control · Individual
Fischl, Mayer
Corporate Officer · Individual
Greystone Servicing Company, LLC, A Delaware Limited Liability Company
5% Or Greater Mortgage Interest · Organization
Grinspan, Eli
Operational/Managerial Control · Individual
Grinspan, Eli
Corporate Officer · Individual
Middlesboro Realty LLC
5% Or Greater Mortgage Interest · Organization
Prater, Jimmie
Operational/Managerial Control · Individual
Valley Stream Operator I LLC
Operational/Managerial Control · Organization
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#3
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2-star overall rating with 2-star inspections with $8,021 in total fines with 7 recent health deficiencies with 8 fire-safety deficiencies in the latest cycle
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