Lansing, MI

Regency at Lansing West

4-star overall rating with 4-star inspections with $11,788 in total fines with 2 fire-safety deficiencies in the latest cycle

12200 Broadbent, Lansing, MI

(517) 731-6200

Compare this facility

Overall

4 / 5

CMS overall stars

Health inspections

4 / 5

Survey and complaint cycles

Staffing

3 / 5

RN + nurse staffing

Quality measures

4 / 5

Resident outcomes and process measures

Quick facts

Facility snapshot

Beds

120

Certified beds

Average residents

112

Average occupied residents

Ownership

For-Profit

Publicly displayed owner type

Chain

Ciena Healthcare/Laurel Health Care

Operator or chain grouping

Approved since

2015-09-02

CMS approved date

Coverage

Medicare + Medicaid

Participation flags

Chain footprint

84 facilities

Chain averages 3 overall / 3 health / 3 staffing / 4 quality stars

Changed ownership

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

1.01

Registered nurse staffing · state 0.77 · national 0.68

LPN hours / resident day

0.70

Licensed practical nurse staffing · state 0.88 · national 0.87

Aide hours / resident day

2.05

Nurse aide staffing · state 2.38 · national 2.35

Total nurse hours

3.77

All reported nurse hours · state 4.03 · national 3.89

Licensed hours

1.71

RN + LPN hours · state 1.65 · national 1.54

Weekend hours

3.26

Weekend nurse staffing · state 3.52 · national 3.43

Weekend RN hours

0.51

Weekend registered nurse coverage · state 0.49 · national 0.47

Physical therapist

0.13

Reported PT staffing · state 0.07 · national 0.07

Adjusted RN hours

0.94

CMS adjusted RN staffing hours

Adjusted total hours

3.49

CMS adjusted total nurse staffing hours

Case-mix index

1.48

Higher values indicate more complex resident acuity

RN turnover

29%

Annual RN turnover · state 41% · national 45%

Total nurse turnover

51%

Annual nurse turnover · state 44% · national 46%

SNF VBP

Value-based purchasing

Program rank

8,089

Lower is better among SNFs in the FY 2026 VBP program.

Performance score

27.85

Composite VBP score used to determine payment impact.

Payment multiplier

0.9847

Above 1.000 increases Medicare payment; below 1.000 reduces it.

Program components

How the VBP score is built

Readmission

3.41

Baseline 18.96% · Performance 19.85% · Measure score 3.41 · Achievement 3.41 · Improvement 0

Healthcare-associated infections

2.80

Baseline 6.46% · Performance 7.00% · Measure score 2.80 · Achievement 2.80 · Improvement 0

Total nurse turnover

2.17

Baseline 67.41% · Performance 56.06% · Measure score 2.17 · Achievement 1.86 · Improvement 2.17

Adjusted total nurse staffing

2.77

Baseline 3.81 hours · Performance 3.87 hours · Measure score 2.77 · Achievement 2.77 · Improvement 0

SNF QRP

Medicare quality reporting measures

Measure	Facility	National	Note
Potentially preventable 30-day readmission	12.95%	10.72% 2.2 pts worse	No Different than the National Rate · Eligible stays 209 · Observed rate 14.83% · Lower 95% interval 9.54%
Discharge to community	56.45%	50.57% 5.9 pts better	No Different than the National Rate · Eligible stays 199 · Observed rate 52.26% · Lower 95% interval 50.2%
Medicare spending per beneficiary	1.05	1.02 About the same
Drug regimen review with follow-up	95.2%	95.27% 0.1 pts worse	Numerator 119 · Denominator 125
Falls with major injury	2.4%	0.77% 1.6 pts worse	Numerator 3 · Denominator 125
Discharge self-care score	52.58%	53.69% 1.1 pts worse	Numerator 51 · Denominator 97
Discharge mobility score	50.52%	50.94% 0.4 pts worse	Numerator 49 · Denominator 97
Pressure ulcers or injuries, new or worsened	0%	2.29% 2.3 pts better	Numerator 0 · Denominator 125 · Adjusted rate 0%
Healthcare-associated infections requiring hospitalization	7%	7.12% 0.1 pts better	No Different than the National Rate · Eligible stays 128 · Observed rate 6.25% · Lower 95% interval 3.5%
Staff COVID-19 vaccination coverage	18.24%	8.2% 10 pts better	Numerator 31 · Denominator 170
Staff flu vaccination coverage	32.61%	42% 9.4 pts worse	Numerator 60 · Denominator 184
Discharge function score	52.58%	56.45% 3.9 pts worse	Numerator 51 · Denominator 97
Transfer of health information to provider	100%	95.95% 4 pts better	Numerator 24 · Denominator 24
Transfer of health information to patient	100%	96.28% 3.7 pts better	Numerator 83 · Denominator 83
Resident COVID-19 vaccinations up to date	43.55%	25.2% 18.3 pts better	Numerator 27 · Denominator 62

Quality measures

Resident outcomes and process scores

Measure	Facility	State	National	Note
Number of hospitalizations per 1000 long-stay resident days	1.7	1.7 About the same	1.9 0.2 pts better	Long Stay · 20240701-20250630 · Adjusted 1.7 · Observed 2.0 · Expected 2.3 · Used in QM five-star
Number of outpatient emergency department visits per 1000 long-stay resident days	1.3	1.5 0.2 pts better	1.8 0.5 pts better	Long Stay · 20240701-20250630 · Adjusted 1.3 · Observed 1.4 · Expected 1.7 · Used in QM five-star
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine	98.9%	95.0% 3.9 pts better	93.4% 5.5 pts better	Long Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 100.0% · Q3 98.6% · Q4 97.2% · 4Q avg 98.9%
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine	100.0%	95.0% 5 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	5.1%	3.1% 2 pts worse	3.3% 1.8 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 7.4% · Q2 7.6% · Q3 2.9% · Q4 2.8% · 4Q avg 5.1% · Used in QM five-star
Percentage of long-stay residents who have depressive symptoms	6.0%	4.1% 1.9 pts worse	11.4% 5.4 pts better	Long Stay · 2024Q4-2025Q3 · Q1 8.5% · Q2 5.2% · Q3 6.1% · Q4 4.3% · 4Q avg 6.0%
Percentage of long-stay residents who lose too much weight	2.6%	5.5% 2.9 pts better	5.4% 2.8 pts better	Long Stay · 2024Q4-2025Q3 · Q1 3.6% · Q2 1.9% · Q3 0.0% · Q4 5.0% · 4Q avg 2.6%
Percentage of long-stay residents who received an antianxiety or hypnotic medication	15.6%	19.6% 4 pts better	19.6% 4 pts better	Long Stay · 2024Q4-2025Q3 · Q1 24.6% · Q2 12.5% · Q3 13.1% · Q4 12.7% · 4Q avg 15.6%
Percentage of long-stay residents who received an antipsychotic medication	9.9%	16.5% 6.6 pts better	16.7% 6.8 pts better	Long Stay · 2024Q4-2025Q3 · Q1 11.6% · Q2 14.0% · Q3 7.8% · Q4 7.4% · 4Q avg 9.9% · 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	19.2%	13.9% 5.3 pts worse	16.3% 2.9 pts worse	Long Stay · 2024Q4-2025Q3 · Q2 46.4% · Q3 11.3% · Q4 3.3% · 4Q avg 19.2% · Used in QM five-star
Percentage of long-stay residents whose need for help with daily activities has increased	15.4%	11.7% 3.7 pts worse	14.9% 0.5 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 17.0% · Q2 14.3% · Q3 16.7% · Q4 13.6% · 4Q avg 15.4% · Used in QM five-star
Percentage of long-stay residents with a catheter inserted and left in their bladder	3.0%	0.9% 2.1 pts worse	1.0% 2 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 3.5% · Q3 3.4% · Q4 5.0% · 4Q avg 3.0% · Used in QM five-star
Percentage of long-stay residents with a urinary tract infection	1.1%	1.7% 0.6 pts better	1.7% 0.6 pts better	Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 1.6% · Q3 1.4% · Q4 1.4% · 4Q avg 1.1% · Used in QM five-star
Percentage of long-stay residents with new or worsened bowel or bladder incontinence	27.1%	20.4% 6.7 pts worse	19.8% 7.3 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 24.7% · Q2 17.4% · Q3 27.4% · Q4 38.4% · 4Q avg 27.1%
Percentage of long-stay residents with pressure ulcers	8.0%	5.6% 2.4 pts worse	5.1% 2.9 pts worse	Long Stay · 2024Q4-2025Q3 · Q1 7.2% · Q2 11.5% · Q3 8.0% · Q4 5.5% · 4Q avg 8.0% · Used in QM five-star
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine	94.3%	82.8% 11.5 pts better	81.7% 12.6 pts better	Short Stay · 2024Q4-2025Q3 · Q1 96.6% · Q2 95.4% · Q3 93.3% · Q4 91.3% · 4Q avg 94.3%
Percentage of short-stay residents who had an outpatient emergency department visit	8.4%	11.5% 3.1 pts better	12.0% 3.6 pts better	Short Stay · 20240701-20250630 · Adjusted 8.4% · Observed 8.7% · Expected 11.6% · Used in QM five-star
Percentage of short-stay residents who newly received an antipsychotic medication	1.3%	1.3% About the same	1.6% 0.3 pts better	Short Stay · 2024Q4-2025Q3 · Q1 0.5% · Q2 2.4% · Q3 1.4% · Q4 0.6% · 4Q avg 1.3% · Used in QM five-star
Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine	86.0%	79.5% 6.5 pts better	79.7% 6.3 pts better	Short Stay · 2024Q3-2025Q2 · 4Q avg 86.0%
Percentage of short-stay residents who were rehospitalized after a nursing home admission	26.3%	24.2% 2.1 pts worse	23.9% 2.4 pts worse	Short Stay · 20240701-20250630 · Adjusted 26.3% · Observed 27.5% · Expected 25.0% · Used in QM five-star

Survey summary

Recent inspection cycles

Cycle 1 Health 2025-08-13 · Fire 2025-08-13

0 health deficiencies

No concentrated health issue counts in this cycle.

2 fire-safety deficiencies

Top issue: Gas and Vacuum and Electrical Systems (1 deficiency)

Cycle 2 Health 2024-07-26 · Fire 2024-07-26

6 health deficiencies

Top issue: Quality of Life and Care (3 deficiencies)

0 fire-safety deficiencies

No concentrated fire-safety issue counts in this cycle.

Cycle 3 Health 2023-05-15 · Fire 2023-05-15

16 health deficiencies

Top issue: Quality of Life and Care (4 deficiencies)

5 fire-safety deficiencies

Top issue: Gas and Vacuum and Electrical Systems (2 deficiencies)

Fire safety

Fire-safety citations

E · Potential for more than minimal harm 2025-08-13

K372 · Smoke Deficiencies

Fire Safety

Ensure smoke barriers are constructed to a 1 hour fire resistance rating.

Corrected 2025-09-02

E · Potential for more than minimal harm 2025-08-13

K920 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Ensure proper usage of power strips and extension cords.

Corrected 2025-09-02

F · Potential for more than minimal harm 2023-05-15

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 2023-06-07

F · Potential for more than minimal harm 2023-05-15

K918 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Have generator or other power source capable of supplying service within 10 seconds.

Corrected 2023-06-07

F · Potential for more than minimal harm 2023-05-15

K920 · Gas, Vacuum, and Electrical Systems Deficiencies

Fire Safety

Ensure proper usage of power strips and extension cords.

Corrected 2023-06-07

E · Potential for more than minimal harm 2023-05-15

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 2023-06-07

E · Potential for more than minimal harm 2023-05-15

K511 · Services Deficiencies

Fire Safety

Have properly installed electrical wiring and gas equipment.

Corrected 2023-06-07

Inspection history

Recent health citations

G · Actual harm 2025-02-20

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 2025-03-13

D · Potential for more than minimal harm 2025-01-03

F609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies

Health

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Corrected 2025-02-04

D · Potential for more than minimal harm 2024-07-26

F582 · Resident Rights Deficiencies

Health

Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.

Corrected 2024-08-30

D · Potential for more than minimal harm 2024-07-26

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 2024-08-30

D · Potential for more than minimal harm 2024-07-26

F692 · Quality of Life and Care Deficiencies

Health

Provide enough food/fluids to maintain a resident's health.

Corrected 2024-08-30

D · Potential for more than minimal harm 2024-07-26

F770 · Administration Deficiencies

Health

Provide timely, quality laboratory services/tests to meet the needs of residents.

Corrected 2024-08-30

D · Potential for more than minimal harm 2023-10-31

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 2023-12-05

D · Potential for more than minimal harm 2023-10-11

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 2023-09-22

G · Actual harm 2023-05-15

F686 · Quality of Life and Care Deficiencies

Health

Provide appropriate pressure ulcer care and prevent new ulcers from developing.

Corrected 2023-06-07

F · Potential for more than minimal harm 2023-05-15

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 2023-06-07

F · Potential for more than minimal harm 2023-05-15

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 2023-06-07

E · Potential for more than minimal harm 2023-05-15

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 2023-06-07

E · Potential for more than minimal harm 2023-05-15

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 2023-06-16