Cycle 1
Health 2024-08-29 · Fire 2024-08-29
5 health deficiencies
Top issue: Quality of Life and Care (2 deficiencies)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Ocala, FL
Timberridge Nursing & Rehabilitation Center
3-star overall rating with 2-star inspections with $119,636 in total fines with 5 recent health deficiencies
9848 Sw 110th St, Ocala, FL
(352) 854-8200
Overall
3 / 5
CMS overall stars
Health inspections
2 / 5
Survey and complaint cycles
Staffing
3 / 5
RN + nurse staffing
Quality measures
5 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
180
Certified beds
Average residents
161
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
Infinite Care
Operator or chain grouping
Approved since
1991-03-01
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Chain footprint
20 facilities
Chain averages 3 overall / 3 health / 3 staffing / 4 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
0.64
Registered nurse staffing · state 0.73 · national 0.68
LPN hours / resident day
0.87
Licensed practical nurse staffing · state 0.79 · national 0.87
Aide hours / resident day
2.21
Nurse aide staffing · state 2.34 · national 2.35
Total nurse hours
3.72
All reported nurse hours · state 3.86 · national 3.89
Licensed hours
1.51
RN + LPN hours · state 1.52 · national 1.54
Weekend hours
3.37
Weekend nurse staffing · state 3.51 · national 3.43
Weekend RN hours
0.32
Weekend registered nurse coverage · state 0.53 · national 0.47
Physical therapist
0.04
Reported PT staffing · state 0.10 · national 0.07
Adjusted RN hours
0.64
CMS adjusted RN staffing hours
Adjusted total hours
3.77
CMS adjusted total nurse staffing hours
Case-mix index
1.35
Higher values indicate more complex resident acuity
RN turnover
44%
Annual RN turnover · state 46% · national 45%
Total nurse turnover
41%
Annual nurse turnover · state 42% · national 46%
SNF VBP
Value-based purchasing
Program rank
5,907
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
34.63
Composite VBP score used to determine payment impact.
Payment multiplier
0.9885
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
3.36
Baseline 24.76% · Performance 21.77% · Measure score 3.36 · Achievement 0 · Improvement 3.36
Healthcare-associated infections
3.08
Baseline 5.48% · Performance 6.92% · Measure score 3.08 · Achievement 3.08 · Improvement 0
Total nurse turnover
5.04
Baseline 61.63% · Performance 43.09% · Measure score 5.04 · Achievement 5.04 · Improvement 4.54
Adjusted total nurse staffing
2.38
Baseline 3.57 hours · Performance 3.75 hours · Measure score 2.38 · Achievement 2.38 · Improvement 0.32
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 11.33% |
10.72%
0.6 pts worse
|
No Different than the National Rate · Eligible stays 459 · Observed rate 11.11% · Lower 95% interval 9.2% |
| Discharge to community | 45.93% |
50.57%
4.6 pts worse
|
No Different than the National Rate · Eligible stays 457 · Observed rate 41.14% · Lower 95% interval 41.38% |
| Medicare spending per beneficiary | 1.08 |
1.02
0.1 pts worse
|
|
| Drug regimen review with follow-up | 96.3% |
95.27%
1 pts better
|
Numerator 338 · Denominator 351 |
| Falls with major injury | 0.28% |
0.77%
0.5 pts better
|
Numerator 1 · Denominator 351 |
| Discharge self-care score | 67.21% |
53.69%
13.5 pts better
|
Numerator 123 · Denominator 183 |
| Discharge mobility score | 57.92% |
50.94%
7 pts better
|
Numerator 106 · Denominator 183 |
| Pressure ulcers or injuries, new or worsened | 2.56% |
2.29%
0.3 pts worse
|
Numerator 9 · Denominator 351 · Adjusted rate 2.39% |
| Healthcare-associated infections requiring hospitalization | 6.92% |
7.12%
0.2 pts better
|
No Different than the National Rate · Eligible stays 250 · Observed rate 6.4% · Lower 95% interval 4.79% |
| Staff COVID-19 vaccination coverage | 18.28% |
8.2%
10.1 pts better
|
Numerator 83 · Denominator 454 |
| Staff flu vaccination coverage | 24.2% |
42%
17.8 pts worse
|
Numerator 114 · Denominator 471 |
| Discharge function score | 73.77% |
56.45%
17.3 pts better
|
Numerator 135 · Denominator 183 |
| Transfer of health information to provider | 89.92% |
95.95%
6 pts worse
|
Numerator 214 · Denominator 238 |
| Transfer of health information to patient | 80% |
96.28%
16.3 pts worse
|
Numerator 24 · Denominator 30 |
| Resident COVID-19 vaccinations up to date | 0.52% |
25.2%
24.7 pts worse
|
Numerator 1 · Denominator 192 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 1.7 |
2.1
0.4 pts better
|
1.9
0.2 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.7 · Observed 1.4 · Expected 1.5 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 0.8 |
1.2
0.4 pts better
|
1.8
1 pts better
|
Long Stay · 20240701-20250630 · Adjusted 0.8 · Observed 0.7 · Expected 1.4 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 99.8% |
97.8%
2 pts better
|
93.4%
6.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 100.0% · Q3 99.2% · Q4 100.0% · 4Q avg 99.8% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 100.0% |
99.2%
0.8 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 | 0.2% |
2.6%
2.4 pts better
|
3.3%
3.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.8% · Q3 0.0% · Q4 0.0% · 4Q avg 0.2% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 0.8% |
3.7%
2.9 pts better
|
11.4%
10.6 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.6% · Q2 1.8% · Q3 0.0% · Q4 0.0% · 4Q avg 0.8% |
| Percentage of long-stay residents who lose too much weight | 6.8% |
5.9%
0.9 pts worse
|
5.4%
1.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 8.3% · Q2 8.2% · Q3 7.1% · Q4 3.6% · 4Q avg 6.8% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 14.0% |
15.7%
1.7 pts better
|
19.6%
5.6 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 14.5% · Q2 14.4% · Q3 13.7% · Q4 13.3% · 4Q avg 14.0% |
| Percentage of long-stay residents who received an antipsychotic medication | 5.0% |
9.8%
4.8 pts better
|
16.7%
11.7 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 5.0% · Q2 3.4% · Q3 6.5% · Q4 5.1% · 4Q avg 5.0% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.0%
About the same
|
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 | 10.5% |
11.7%
1.2 pts better
|
16.3%
5.8 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 11.4% · Q2 16.0% · Q3 6.3% · Q4 6.5% · 4Q avg 10.5% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 5.7% |
9.8%
4.1 pts better
|
14.9%
9.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 6.0% · Q2 6.7% · Q3 4.1% · Q4 6.1% · 4Q avg 5.7% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.2% |
0.4%
0.2 pts better
|
1.0%
0.8 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.8% · Q4 0.0% · 4Q avg 0.2% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 0.6% |
0.8%
0.2 pts better
|
1.7%
1.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.9% · Q4 1.6% · 4Q avg 0.6% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 8.4% |
12.5%
4.1 pts better
|
19.8%
11.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 9.4% · Q2 11.9% · Q3 7.8% · Q4 4.3% · 4Q avg 8.4% |
| Percentage of long-stay residents with pressure ulcers | 3.0% |
5.1%
2.1 pts better
|
5.1%
2.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 2.6% · Q2 5.4% · Q3 1.6% · Q4 2.3% · 4Q avg 3.0% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 99.0% |
94.3%
4.7 pts better
|
81.7%
17.3 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 98.3% · Q2 98.9% · Q3 99.3% · Q4 99.2% · 4Q avg 99.0% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 10.5% |
9.3%
1.2 pts worse
|
12.0%
1.5 pts better
|
Short Stay · 20240701-20250630 · Adjusted 10.5% · Observed 11.3% · Expected 12.0% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 0.3% |
1.5%
1.2 pts better
|
1.6%
1.3 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.5% · Q4 0.7% · 4Q avg 0.3% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 97.6% |
94.7%
2.9 pts better
|
79.7%
17.9 pts better
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 97.6% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 26.6% |
26.2%
0.4 pts worse
|
23.9%
2.7 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 26.6% · Observed 30.0% · Expected 26.8% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2023-04-27 · Fire 2023-04-27
7 health deficiencies
Top issue: Resident Rights (2 deficiencies)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Cycle 3
Health 2021-12-02 · Fire 2021-12-02
8 health deficiencies
Top issue: Administration (2 deficiencies)
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
2024-08-29
F552 · Resident Rights Deficiencies
Health
Ensure that residents are fully informed and understand their health status, care and treatments.
Corrected 2024-10-03
E · Potential for more than minimal harm
2024-08-29
F684 · Quality of Life and Care Deficiencies
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2024-10-03
D · Potential for more than minimal harm
2024-08-29
F641 · Resident Assessment and Care Planning Deficiencies
Health
Ensure each resident receives an accurate assessment.
Corrected 2024-10-03
D · Potential for more than minimal harm
2024-08-29
F692 · Quality of Life and Care Deficiencies
Health
Provide enough food/fluids to maintain a resident's health.
Corrected 2024-10-03
D · Potential for more than minimal harm
2024-08-29
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 2024-10-03
D · Potential for more than minimal harm
2024-08-29
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2024-10-03
J · Immediate jeopardy
2024-01-19
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected 2024-02-19
J · Immediate jeopardy
2024-01-19
F835 · Administration Deficiencies
Health
Administer the facility in a manner that enables it to use its resources effectively and efficiently.
Corrected 2024-02-19
J · Immediate jeopardy
2024-01-19
F867 · Administration Deficiencies
Health
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Corrected 2024-02-19
D · Potential for more than minimal harm
2023-10-13
F580 · Resident Rights Deficiencies
Health
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Corrected 2023-11-17
D · Potential for more than minimal harm
2023-10-13
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 2023-11-17
D · Potential for more than minimal harm
2023-10-13
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 2023-11-17
E · Potential for more than minimal harm
2023-04-27
F695 · Quality of Life and Care Deficiencies
Health
Provide safe and appropriate respiratory care for a resident when needed.
Corrected 2023-06-09
E · Potential for more than minimal harm
2023-04-27
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 2023-06-09
D · Potential for more than minimal harm
2023-04-27
F625 · Resident Rights Deficiencies
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 2023-06-09
D · Potential for more than minimal harm
2023-04-27
F641 · Resident Assessment and Care Planning Deficiencies
Health
Ensure each resident receives an accurate assessment.
Corrected 2023-06-09
D · Potential for more than minimal harm
2023-04-27
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2023-06-09
C · Minimal harm
2023-04-27
F732 · Nursing and Physician Services Deficiencies
Health
Post nurse staffing information every day.
Corrected 2023-06-09
E · Potential for more than minimal harm
2021-12-02
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 2022-01-03
E · Potential for more than minimal harm
2021-12-02
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2021-12-23
Penalties and ownership
What sits behind the stars
$119,636
2024-01-19
Fine
Fine · fine $119,636
Fine
Ownership
Timberridge Operations Holdings, LLC
5% Or Greater Direct Ownership Interest · Organization
Ch Timberridge Holdings LLC
5% Or Greater Indirect Ownership Interest · Organization
Drebin, Ezriel
5% Or Greater Indirect Ownership Interest · Individual
Ed Florida Holdings LLC
5% Or Greater Indirect Ownership Interest · Organization
Herzka, Yisroel
5% Or Greater Indirect Ownership Interest · Individual
Kf Florida Holdings LLC
5% Or Greater Indirect Ownership Interest · Organization
Klein, Solomon
Corporate Officer · Individual
Schlesinger, Ernest
5% Or Greater Indirect Ownership Interest · Individual
Se Florida Holdings LLC
5% Or Greater Indirect Ownership Interest · Organization
Seam Trust
5% Or Greater Indirect Ownership Interest · Organization
Soehner, Richard
W-2 Managing Employee · Individual
Sylvan Sunshine LLC
5% Or Greater Indirect Ownership Interest · Organization
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