Cycle 1
Health 2025-12-04 · Fire 2025-12-04
1 health deficiencies
Top issue: Quality of Life and Care (1 deficiency)
6 fire-safety deficiencies
Top issue: Smoke (3 deficiencies)
Middleburg Heights, OH
O'neill Healthcare Middleburg Heights
5-star overall rating with 4-star inspections with $166,764 in total fines with 1 recent health deficiencies with 6 fire-safety deficiencies in the latest cycle
7250 Old Oak Blvd, Middleburg Heights, OH
(440) 243-7888
Overall
5 / 5
CMS overall stars
Health inspections
4 / 5
Survey and complaint cycles
Staffing
2 / 5
RN + nurse staffing
Quality measures
5 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
82
Certified beds
Average residents
61
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
O'neill Healthcare
Operator or chain grouping
Approved since
1987-10-20
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Chain footprint
6 facilities
Chain averages 4 overall / 4 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
Hours and turnover
RN hours / resident day
0.38
Registered nurse staffing · state 0.63 · national 0.68
LPN hours / resident day
1.11
Licensed practical nurse staffing · state 0.96 · national 0.87
Aide hours / resident day
1.98
Nurse aide staffing · state 2.14 · national 2.35
Total nurse hours
3.47
All reported nurse hours · state 3.72 · national 3.89
Licensed hours
1.49
RN + LPN hours · state 1.59 · national 1.54
Weekend hours
3.09
Weekend nurse staffing · state 3.29 · national 3.43
Weekend RN hours
0.25
Weekend registered nurse coverage · state 0.41 · national 0.47
Physical therapist
0.14
Reported PT staffing · state 0.05 · national 0.07
Adjusted RN hours
0.34
CMS adjusted RN staffing hours
Adjusted total hours
3.07
CMS adjusted total nurse staffing hours
Case-mix index
1.55
Higher values indicate more complex resident acuity
RN turnover
50%
Annual RN turnover · state 47% · national 45%
Total nurse turnover
42%
Annual nurse turnover · state 50% · national 46%
SNF VBP
Value-based purchasing
Program rank
6,447
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
32.82
Composite VBP score used to determine payment impact.
Payment multiplier
0.9873
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
3.86
Baseline 19.87% · Performance 19.65% · Measure score 3.86 · Achievement 3.86 · Improvement 0.29
Healthcare-associated infections
3.58
Baseline 7.47% · Performance 6.77% · Measure score 3.58 · Achievement 3.58 · Improvement 2.33
Total nurse turnover
4.60
Baseline 64.77% · Performance 44.87% · Measure score 4.60 · Achievement 4.60 · Improvement 4.48
Adjusted total nurse staffing
1.10
Baseline 3.39 hours · Performance 3.39 hours · Measure score 1.10 · Achievement 1.10 · Improvement 0
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 9.96% |
10.72%
0.8 pts better
|
No Different than the National Rate · Eligible stays 197 · Observed rate 10.15% · Lower 95% interval 7.61% |
| Discharge to community | 60.78% |
50.57%
10.2 pts better
|
Better than the National Rate · Eligible stays 205 · Observed rate 52.68% · Lower 95% interval 55.98% |
| Medicare spending per beneficiary | 0.91 |
1.02
0.1 pts better
|
|
| Drug regimen review with follow-up | 98.61% |
95.27%
3.3 pts better
|
Numerator 142 · Denominator 144 |
| Falls with major injury | 0.69% |
0.77%
0.1 pts better
|
Numerator 1 · Denominator 144 |
| Discharge self-care score | 59.78% |
53.69%
6.1 pts better
|
Numerator 55 · Denominator 92 |
| Discharge mobility score | 43.48% |
50.94%
7.5 pts worse
|
Numerator 40 · Denominator 92 |
| Pressure ulcers or injuries, new or worsened | 1.39% |
2.29%
0.9 pts better
|
Numerator 2 · Denominator 144 · Adjusted rate 1.23% |
| Healthcare-associated infections requiring hospitalization | 6.77% |
7.12%
0.4 pts better
|
No Different than the National Rate · Eligible stays 148 · Observed rate 7.43% · Lower 95% interval 4.27% |
| Staff COVID-19 vaccination coverage | 11% |
8.2%
2.8 pts better
|
Numerator 11 · Denominator 100 |
| Staff flu vaccination coverage | 11.49% |
42%
30.5 pts worse
|
Numerator 17 · Denominator 148 |
| Discharge function score | 51.09% |
56.45%
5.4 pts worse
|
Numerator 47 · Denominator 92 |
| Transfer of health information to provider | 97.98% |
95.95%
2 pts better
|
Numerator 97 · Denominator 99 |
| Transfer of health information to patient | Not Available |
96.28%
|
Numerator Not Available · Denominator 13 · Too few residents or stays to report publicly. |
| Resident COVID-19 vaccinations up to date | 6.35% |
25.2%
18.9 pts worse
|
Numerator 4 · Denominator 63 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 94.0% |
92.4%
1.6 pts better
|
93.4%
0.6 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 86.3% · Q2 96.0% · Q3 97.6% · Q4 97.5% · 4Q avg 94.0% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 92.9% |
94.5%
1.6 pts worse
|
95.5%
2.6 pts worse
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 92.9% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 1.1% |
3.3%
2.2 pts better
|
3.3%
2.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 4.0% · Q3 0.0% · Q4 0.0% · 4Q avg 1.1% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 25.4% |
26.1%
0.7 pts better
|
11.4%
14 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 13.0% · Q2 10.6% · Q3 29.3% · Q4 53.8% · 4Q avg 25.4% |
| Percentage of long-stay residents who lose too much weight | 6.2% |
6.2%
About the same
|
5.4%
0.8 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 6.8% · Q2 5.1% · Q3 3.1% · Q4 10.0% · 4Q avg 6.2% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 13.7% |
25.4%
11.7 pts better
|
19.6%
5.9 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 11.4% · Q2 12.5% · Q3 15.6% · Q4 16.7% · 4Q avg 13.7% |
| Percentage of long-stay residents who received an antipsychotic medication | 5.3% |
11.5%
6.2 pts better
|
16.7%
11.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 8.8% · Q2 7.1% · Q3 3.8% · Q4 0.0% · 4Q avg 5.3% · 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 | 14.3% |
7.7%
6.6 pts worse
|
16.3%
2 pts better
|
Long Stay · 2024Q4-2025Q3 · 4Q avg 14.3% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 7.4% |
6.2%
1.2 pts worse
|
14.9%
7.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 12.2% · Q2 13.9% · Q3 0.0% · Q4 0.0% · 4Q avg 7.4% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.0% |
0.2%
0.2 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 | 0.0% |
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 | 17.4% |
21.7%
4.3 pts better
|
19.8%
2.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 27.8% · Q2 13.6% · Q3 8.4% · Q4 18.9% · 4Q avg 17.4% |
| Percentage of long-stay residents with pressure ulcers | 2.1% |
3.7%
1.6 pts better
|
5.1%
3 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.4% · Q2 2.8% · Q3 1.7% · Q4 2.5% · 4Q avg 2.1% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 81.2% |
78.1%
3.1 pts better
|
81.7%
0.5 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 66.5% · Q2 84.2% · Q3 97.4% · Q4 78.8% · 4Q avg 81.2% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 3.2% |
12.5%
9.3 pts better
|
12.0%
8.8 pts better
|
Short Stay · 20240701-20250630 · Adjusted 3.2% · Observed 3.0% · Expected 10.6% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 0.0% |
1.2%
1.2 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 | 81.5% |
75.6%
5.9 pts better
|
79.7%
1.8 pts better
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 81.5% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 21.9% |
25.1%
3.2 pts better
|
23.9%
2 pts better
|
Short Stay · 20240701-20250630 · Adjusted 21.9% · Observed 23.2% · Expected 25.3% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2022-12-27 · Fire 2022-12-27
5 health deficiencies
Top issue: Infection Control (1 deficiency)
7 fire-safety deficiencies
Top issue: Egress (2 deficiencies)
Cycle 3
Health 2020-02-20 · Fire 2020-02-20
5 health deficiencies
Top issue: Resident Assessment and Care Planning (2 deficiencies)
12 fire-safety deficiencies
Top issue: Smoke (4 deficiencies)
Fire safety
Fire-safety citations
F · Potential for more than minimal harm
2025-12-04
K293 · Egress Deficiencies
Fire Safety
Have properly located and lighted "Exit" signs.
Corrected 2025-12-22
F · Potential for more than minimal harm
2025-12-04
K324 · Smoke Deficiencies
Fire Safety
Provide properly protected cooking facilities.
Corrected 2025-12-22
F · Potential for more than minimal harm
2025-12-04
K345 · Smoke Deficiencies
Fire Safety
Have approved installation, maintenance and testing program for fire alarm systems.
Corrected 2025-12-22
F · Potential for more than minimal harm
2025-12-04
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2025-12-22
F · Potential for more than minimal harm
2025-12-04
K511 · Services Deficiencies
Fire Safety
Have properly installed electrical wiring and gas equipment.
Corrected 2025-12-22
E · Potential for more than minimal harm
2025-12-04
K211 · Egress Deficiencies
Fire Safety
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Corrected 2025-12-22
F · Potential for more than minimal harm
2022-12-27
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 2023-02-20
F · Potential for more than minimal harm
2022-12-27
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2023-02-20
F · Potential for more than minimal harm
2022-12-27
K712 · Miscellaneous Deficiencies
Fire Safety
Have simulated fire drills held at unexpected times.
Corrected 2023-02-20
F · Potential for more than minimal harm
2022-12-27
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 2023-02-20
F · Potential for more than minimal harm
2022-12-27
K918 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2023-02-20
E · Potential for more than minimal harm
2022-12-27
K211 · Egress Deficiencies
Fire Safety
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Corrected 2023-02-20
E · Potential for more than minimal harm
2022-12-27
K912 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have power receptacles that are properly grounded.
Corrected 2023-02-20
F · Potential for more than minimal harm
2020-02-20
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 2020-09-10
F · Potential for more than minimal harm
2020-02-20
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2020-09-10
F · Potential for more than minimal harm
2020-02-20
K712 · Miscellaneous Deficiencies
Fire Safety
Have simulated fire drills held at unexpected times.
Corrected 2020-09-10
F · Potential for more than minimal harm
2020-02-20
K916 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have a battery powered remote alarm panel in a location accessible by operating personnel.
Corrected 2020-09-10
E · Potential for more than minimal harm
2020-02-20
K227 · Egress Deficiencies
Fire Safety
Have ramps, exits, fire escape ladders, steps, and areas of refuge that meet safety requirements.
Corrected 2020-09-10
E · Potential for more than minimal harm
2020-02-20
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 2020-09-10
E · Potential for more than minimal harm
2020-02-20
K347 · Smoke Deficiencies
Fire Safety
Properly provide smoke detection systems in areas open to corridors.
Corrected 2020-09-10
E · Potential for more than minimal harm
2020-02-20
K363 · Smoke Deficiencies
Fire Safety
Install corridor and hallway doors that block smoke.
Corrected 2020-09-10
E · Potential for more than minimal harm
2020-02-20
K511 · Services Deficiencies
Fire Safety
Have properly installed electrical wiring and gas equipment.
Corrected 2020-09-10
E · Potential for more than minimal harm
2020-02-20
K920 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Ensure proper usage of power strips and extension cords.
Corrected 2020-09-10
C · Minimal harm
2020-02-20
E24 · Emergency Preparedness Deficiencies
Fire Safety
Establish policies and procedures for volunteers.
Corrected 2020-03-31
C · Minimal harm
2020-02-20
E26 · Emergency Preparedness Deficiencies
Fire Safety
Establish roles under a Waiver declared by secretary.
Corrected 2020-03-31
Inspection history
Recent health citations
D · Potential for more than minimal harm
2025-12-04
F695 · Quality of Life and Care Deficiencies
Health
Provide safe and appropriate respiratory care for a resident when needed.
Corrected 2025-12-22
J · Immediate jeopardy
2024-10-29
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 2024-11-08
D · Potential for more than minimal harm
2023-07-06
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 2023-08-21
F · Potential for more than minimal harm
2022-12-27
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 2023-02-20
D · Potential for more than minimal harm
2022-12-27
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 2023-02-20
D · Potential for more than minimal harm
2022-12-27
F807 · Nutrition and Dietary Deficiencies
Health
Ensure each resident receives and the facility provides drinks consistent with resident needs and preferences and sufficient to maintain resident hydration.
Corrected 2023-02-20
D · Potential for more than minimal harm
2022-12-27
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2023-02-20
D · Potential for more than minimal harm
2020-02-20
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 2020-03-02
D · Potential for more than minimal harm
2020-02-20
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 2020-03-02
D · Potential for more than minimal harm
2020-02-20
F842 · Resident Assessment and Care Planning Deficiencies
Health
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected 2020-03-02
D · Potential for more than minimal harm
2020-02-20
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2020-03-02
Penalties and ownership
What sits behind the stars
$166,764
2024-10-29
Fine
Fine · fine $166,764
Fine
Ownership
Carlow LLC
5% Or Greater Direct Ownership Interest · Organization
Oneill, John
5% Or Greater Indirect Ownership Interest · Individual
Oneill, Deborah
5% Or Greater Indirect Ownership Interest · Individual
Middleburg Heights Holdings LLC
5% Or Greater Mortgage Interest · Organization
O'neill Management, LLC
Operational/Managerial Control · Organization
Oneill, Deborah
Corporate Officer · Individual
Oneill, John
Corporate Officer · Individual
Verlinger, Elizabeth
W-2 Managing Employee · Individual
Nearby options
Other facilities in reach
#1
Parkside Villa
Middleburg Heights, OH
4-star overall rating with 3-star inspections with 9 recent health deficiencies with 8 fire-safety deficiencies in the latest cycle
#2
Middleburg Heights Health & Rehabilitation Center
Middleburg Heights, OH
3-star overall rating with 2-star inspections with $76,040 in total fines with 15 recent health deficiencies with 13 fire-safety deficiencies in the latest cycle
#3
Aristocrat Berea Healthcare And Rehabilitation
Berea, OH
3-star overall rating with 2-star inspections with 8 recent health deficiencies with 7 fire-safety deficiencies in the latest cycle
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