Staffing
CMS publishes a 3-star staffing rating for this facility.
RN staffing was 0.44 hours per resident day in 2026Q1, calculated from CMS PBJ records.
View staffing evidenceAsk Trust Hub Network
CMS overview
No proprietary TrustHub score. These ratings are published separately by CMS.
Facility information
CMS remains the primary federal record. Public website and additional contact details appear only when independently verified.
Decision guide
Factual evidence to examine before you decide. These summaries are not a score or recommendation.
CMS publishes a 3-star staffing rating for this facility.
RN staffing was 0.44 hours per resident day in 2026Q1, calculated from CMS PBJ records.
View staffing evidenceThe latest standard inspection on Apr 28, 2025 cited 12 deficiencies.
View inspection evidenceCMS-published records list 43 ownership or control parties.
CMS records show an ownership change effective April 2023.
View ownership evidenceCMS groups this facility with a chain covering 68 facilities across 5 states or territories.
View chain evidenceCMS records show a $19,971 fine in the loaded enforcement dataset.
View enforcement evidence →Ownership & operation
Operator, licensee, owner, manager, and chain stay separate. A connected organization is not automatically the party that runs daily operations.
SeniorTrustHub found evidence connecting this facility to:
22 currently connected nursing homes share this CMS organization identity with FIRST SWEETZER HOLDINGS LLC.
These figures summarize currently connected CMS-certified nursing homes. Some facilities have incomplete measures; missing values are omitted, not treated as zero. Ownership structures can change. State operator or licensee evidence may differ from CMS ownership disclosures.
Ownership
These are CMS-published ownership disclosures. Medicare enrollment ownership and managerial-control information is reported by enrolled providers through CMS forms; it is not an independent determination of beneficial ownership.
Organization · ADP OF THE SNF
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 0 across NM.
Organization · ADP OF THE SNF
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 0 across NM.
Organization · ADP OF THE SNF
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 0 across NM.
Organization · ADP OF THE SNF
Association date reported to CMS: Apr 1, 2024
Other facilities connected through this exact CMS organization identity: 0 across NM.
Organization · ADP OF THE SNF
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 0 across NM.
Organization · ADP OF THE SNF
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 0 across NM.
Individual · ADP OF THE SNF
Association date reported to CMS: Mar 7, 2024
Organization · ADP OF THE SNF
Association date reported to CMS: Apr 1, 2024
Other facilities connected through this exact CMS organization identity: 0 across NM.
Individual · ADP OF THE SNF
Association date reported to CMS: Mar 1, 2023
Organization · ADP OF THE SNF
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 0 across NM.
Individual · CORPORATE OFFICER
Association date reported to CMS: Mar 1, 2023
Organization · DIRECT OWNERSHIP INTEREST
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 0 across NM.
Organization · INDIRECT OWNERSHIP INTEREST
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 0 across NM.
Organization · INDIRECT OWNERSHIP INTEREST
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 0 across NM.
Organization · INDIRECT OWNERSHIP INTEREST
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 0 across NM.
Individual · INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF
Association date reported to CMS: Jul 17, 2025
Individual · INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF
Association date reported to CMS: Jul 17, 2025
Individual · INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF
Association date reported to CMS: Jul 17, 2025
Individual · INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF
Association date reported to CMS: Jul 17, 2025
Individual · INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF
Association date reported to CMS: Jul 17, 2025
Individual · INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF
Association date reported to CMS: Apr 1, 2025
Individual · INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF
Association date reported to CMS: Jul 17, 2025
Individual · INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF
Association date reported to CMS: Apr 1, 2025
Organization · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Apr 1, 2023
Other facilities connected through this exact CMS organization identity: 0 across NM.
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Mar 1, 2023
Organization · ADP OF THE SNF
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 0 across NM.
Organization · ADP OF THE SNF
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 18 across NM, TX.
Organization · ADP OF THE SNF
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 7 across NM.
Organization · ADP OF THE SNF
Association date reported to CMS: Apr 1, 2024
Other facilities connected through this exact CMS organization identity: 26 across CA, NM, OR, TX, WA.
Organization · ADP OF THE SNF
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 23 across IN, MO, NM, TX.
Organization · ADP OF THE SNF
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 16 across NM.
Individual · ADP OF THE SNF
Association date reported to CMS: Mar 7, 2024
Organization · ADP OF THE SNF
Association date reported to CMS: Apr 1, 2024
Other facilities connected through this exact CMS organization identity: 18 across MD, NM, VA.
Individual · ADP OF THE SNF
Association date reported to CMS: Mar 1, 2023
Organization · ADP OF THE SNF
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 5 across NM.
Individual · CORPORATE OFFICER
Published ownership percentage: 0%
Association date reported to CMS: Mar 1, 2023
Organization · DIRECT OWNERSHIP INTEREST
Published ownership percentage: 100%
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 5 across NM.
Organization · INDIRECT OWNERSHIP INTEREST
Published ownership percentage: 97%
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 12 across MO, NM, TX.
Organization · INDIRECT OWNERSHIP INTEREST
Published ownership percentage: 2%
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 21 across MO, NM, TX.
Organization · INDIRECT OWNERSHIP INTEREST
Published ownership percentage: 1%
Association date reported to CMS: Mar 1, 2023
Other facilities connected through this exact CMS organization identity: 12 across MO, NM.
Organization · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Apr 1, 2023
Other facilities connected through this exact CMS organization identity: 5 across NM.
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Mar 1, 2023
Organization · Medicare-enrolled legal organization
Other facilities connected through this exact CMS organization identity: 0 across NM.
Roles are shown as CMS publishes them. Different CMS sources can describe different enrollment, ownership, and control concepts, so TrustHub keeps each source-specific disclosure distinct.
Chain context
Chain-level values describe this CMS-defined group, not any one facility. CMS Chain ID 773 is a grouping identifier, not a legal organization.
| Month | Facilities | Overall rating | Staffing rating |
|---|---|---|---|
| Wed Jul | 68 | 2.2 | 1.7 |
| Mon Jun | 66 | 2.3 | 1.8 |
| Fri May | 64 | 2.4 | 1.8 |
| Wed Apr | 62 | 2.3 | 1.7 |
| Sun Mar | 52 | 2.4 | 1.8 |
| Sun Feb | 47 | 2.3 | 1.8 |
Nursing Home Chain Performance Measures, fixed version da2db00a-0f3d-40a9-a535-588ff1220c55. Membership comes separately from CMS Skilled Nursing Facility Enrollments.
View official CMS sourceInspections & deficiencies
Scope and severity terms below are CMS classifications. They are not a TrustHub score.
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Dec 19, 2025)
Assess the resident when there is a significant change in condition
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Dec 19, 2025)
Assure that each resident’s assessment is updated at least once every 3 months.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Dec 19, 2025)
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Sep 16, 2025)
No health-deficiency rows were deterministically linked to this inspection.
Ensure that residents are fully informed and understand their health status, care and treatments.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jun 16, 2025)
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jun 16, 2025)
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jun 16, 2025)
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.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jun 16, 2025)
Ensure each resident receives an accurate assessment.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jun 16, 2025)
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jun 16, 2025)
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jun 16, 2025)
Ensure services provided by the nursing facility meet professional standards of quality.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jun 16, 2025)
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jun 16, 2025)
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.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jun 16, 2025)
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
CMS scope/severity F: Widespread; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jun 16, 2025)
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jun 16, 2025)
Protect each resident from the wrongful use of the resident's belongings or money.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Past Non-Compliance (Oct 28, 2024)
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Aug 8, 2024)
No health-deficiency rows were deterministically linked to this inspection.
No health-deficiency rows were deterministically linked to this inspection.
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 6, 2024)
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 6, 2024)
Protect each resident from separation (from other residents, his/her room, or confinement to his/her room).
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 6, 2024)
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 6, 2024)
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.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 6, 2024)
Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 6, 2024)
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 6, 2024)
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 6, 2024)
Provide enough food/fluids to maintain a resident's health.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 6, 2024)
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
CMS scope/severity F: Widespread; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 6, 2024)
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.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 6, 2024)
Provide or obtain dental services for each resident.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 6, 2024)
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
CMS scope/severity F: Widespread; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 6, 2024)
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 6, 2024)
Develop and implement policies and procedures for flu and pneumonia vaccinations.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 6, 2024)
No health-deficiency rows were deterministically linked to this inspection.
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Dec 9, 2022)
Allow residents to easily view the nursing home's survey results and communicate with advocate agencies.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Dec 9, 2022)
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Dec 9, 2022)
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.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Dec 9, 2022)
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Dec 9, 2022)
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Dec 9, 2022)
Penalties & enforcement
Published fine amount: $19,971.00
Questions to ask
Facility history
11 historical events available. Dates and values come from published CMS and official state regulator evidence, not a score.
3 deficiencies were recorded.
CMS · Recorded event date · View related evidence
Total nurse staffing decreased from 3.34 to 3.07 hours per resident day between 2025Q2 and 2025Q3. Staffing declined across those reported periods.
3.34 → 3.07
CMS · Reported in a source release · View related evidence
1 deficiency was recorded.
CMS · Recorded event date · View related evidence
12 deficiencies were recorded.
CMS · Recorded event date · View related evidence
1 deficiency was recorded.
CMS · Recorded event date · View related evidence
1 deficiency was recorded.
CMS · Recorded event date · View related evidence
CMS recorded a $19,971 civil monetary penalty.
CMS · Recorded event date · View related evidence
No linked health-deficiency findings were recorded for this survey.
CMS · Recorded event date · View related evidence
15 deficiencies were recorded.
CMS · Recorded event date · View related evidence
An ownership change was recorded. New organization: PALOMA SPRINGS HEALTHCARE LLC.
SIERRA HEALTH CARE INC. → PALOMA SPRINGS HEALTHCARE LLC
CMS · Recorded event date · View related evidence
6 deficiencies were recorded.
CMS · Recorded event date · View related evidence
Staffing
CMS staffing rating: 3 of 5 stars. CMS calculates that rating separately using its published methodology. The values below are calculations from daily PBJ records for 2026Q1 (current source quarter).
| Measure | Monday–Friday | Saturday–Sunday |
|---|---|---|
| Total nursing | 3.228 | 2.807 |
| RN categories | 0.552 | 0.179 |
Contract staff accounted for 0% of reported nursing hours included in this quarter calculation.
Reported RN-category hours per resident day were 0.024 lower than the prior loaded quarter.
Solid bar: Total nursing · Outlined bar: RN categories
| Quarter | Total nursing | RN categories | LPN/LVN | CNA | Contract share | Days |
|---|---|---|---|---|---|---|
| 2025Q2 | 3.337 | 0.484 | 0.534 | 1.851 | 0% | 91 |
| 2025Q3 | 3.073 | 0.49 | 0.507 | 1.65 | 0% | 92 |
| 2025Q4 | 3.15 | 0.468 | 0.495 | 1.812 | 0% | 92 |
| 2026Q1 | 3.106 | 0.444 | 0.502 | 1.792 | 0% | 90 |
Hours-per-resident-day values are calculated by this platform from CMS-published daily PBJ hours and MDS census. For each displayed period, included hours are summed and divided by the summed census for days with a positive census. They are not CMS case-mix-adjusted staffing measures or a staffing rating.
View official CMS PBJ sourceWhat we can verify today
These measures come from the current successfully ingested CMS Nursing Home Provider Information release.
Planned evidence layers
These areas require separate authoritative CMS datasets. No findings are shown until those sources are ingested and reviewed.
Trust participation
Claims, corrections, and factual context are free. Submissions never replace CMS evidence or affect ranking.
Source register
No paid placements. Facilities cannot pay to rank higher. We cite. You decide.