OTTERBEIN PORTAGE VALLEY

PEMBERVILLE, OH

CMS provider ID 365571CMS source updated July 29, 2026

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CMS overview

CMS rating overview

CMS overall

4 of 5 CMS stars

Health inspection

3 of 5 CMS stars

Staffing

3 of 5 CMS stars

Quality-measure

5 of 5 CMS stars

No proprietary TrustHub score. These ratings are published separately by CMS.

How CMS describes these ratings
CMS overall rating
The CMS overall rating summarizes health inspections, staffing, and quality measures within Medicare's Five-Star system.
Health inspection rating
The CMS health inspection rating reflects findings from standard and complaint inspections used in Medicare's Five-Star system.
Staffing rating
The CMS staffing rating reflects staffing levels and related measures used in Medicare's Five-Star system.
Quality-measure rating
The CMS quality-measure rating summarizes selected resident assessment and claims-based measures used in Medicare's Five-Star system.
CMS certified beds
50
Ownership descriptor
Non profit - Corporation
Medicare participation
Yes
Medicaid participation
Yes

Facility information

Contact

CMS remains the primary federal record. Public website and additional contact details appear only when independently verified.

Phone
4198337000CMS Provider Information

Decision guide

What to review

Factual evidence to examine before you decide. These summaries are not a score or recommendation.

Staffing

CMS publishes a 3-star staffing rating for this facility.

RN staffing was 0.89 hours per resident day in 2026Q1, calculated from CMS PBJ records.

View staffing evidence

Chain context

CMS groups this facility with a chain covering 19 facilities across 2 states or territories.

View chain evidence

Ownership & operation

Ownership & Operation

Operator, licensee, owner, manager, and chain stay separate. A connected organization is not automatically the party that runs daily operations.

Ownership type
Non profit - CorporationCMS
Chain
OTTERBEIN SENIORLIFECMS identifies this facility as part of the OTTERBEIN SENIORLIFE chain.
Related facilities
18Current CMS organization identity

Explore ownership network →

Who is behind this facility?

SeniorTrustHub found evidence connecting this facility to:

  • 4 CMS-reported ownership organizations
  • CMS reports 63 individual ownership interests
  • a CMS chain / common-control group

Related facilities

18 currently connected nursing homes share this CMS organization identity with OTTERBEIN HOME.

Average CMS overall rating
2.9 stars across 18 reporting facilities
CMS monetary penalties
5 of 18 facilities had a recorded monetary penalty in the available CMS period.
Recent CMS penalties
2 facilities had a CMS penalty in the last 18 months.
Recent high-value CMS enforcement
1 facilities had a high-value CMS fine or payment denial in the last 18 months.
Recent CMS complaint inspections
14 facilities had a CMS complaint inspection in the last 18 months.
Total recorded CMS fines
$114,494

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

Who CMS records show is connected to this facility

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.

Reported party records
98
Organizations shown
12
Individuals shown
63
Latest ownership source update
Jul 27, 2026

CMS-published ownership and control parties

  • OTTERBEIN LSC, LLC

    Organization · 5% OR GREATER DIRECT OWNERSHIP INTEREST

    Published ownership percentage: 100%

    Association date reported to CMS: Jan 1, 2016

    Other facilities connected through this exact CMS organization identity: 0 across OH.

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • OTTERBEIN HOME

    Organization · 5% OR GREATER INDIRECT OWNERSHIP INTEREST

    Published ownership percentage: 100%

    Association date reported to CMS: Dec 1, 2021

    Other facilities connected through this exact CMS organization identity: 0 across OH.

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • FUNCTIONAL PATHWAYS OF TENNESSEE LLC

    Organization · ADP OF THE SNF

    Association date reported to CMS: Apr 4, 2025

    Other facilities connected through this exact CMS organization identity: 0 across OH.

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • KIRKENDALL, JESSICA

    Individual · ADP OF THE SNF

    Association date reported to CMS: Jan 3, 2023

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • OTTERBEIN HOME

    Organization · ADP OF THE SNF

    Association date reported to CMS: Dec 1, 2021

    Other facilities connected through this exact CMS organization identity: 0 across OH.

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • PIERCE, JOHN

    Individual · ADP OF THE SNF

    Association date reported to CMS: Dec 1, 2021

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • POLARIS PHARMACY SERVICES OF OHIO LLC

    Organization · ADP OF THE SNF

    Association date reported to CMS: Dec 1, 2018

    Other facilities connected through this exact CMS organization identity: 0 across OH.

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • POWELL, ANGIE

    Individual · CORPORATE DIRECTOR

    Association date reported to CMS: Nov 24, 2014

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • STEPHENSON, JOHN

    Individual · CORPORATE DIRECTOR

    Association date reported to CMS: Aug 9, 1982

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • GREEN, JAMES

    Individual · CORPORATE OFFICER

    Association date reported to CMS: Nov 21, 2005

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • HAWKINS, RITA

    Individual · CORPORATE OFFICER

    Association date reported to CMS: Jan 16, 2006

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • MILLER, JASON

    Individual · CORPORATE OFFICER

    Association date reported to CMS: Aug 4, 2014

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • WILSON, JILL

    Individual · CORPORATE OFFICER

    Association date reported to CMS: May 1, 2009

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • BAKER, STEVE

    Individual · INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF

    Association date reported to CMS: Apr 4, 2025

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • GALBUT, ABRAHAM

    Individual · INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF

    Association date reported to CMS: Apr 4, 2025

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • GALBUT, DANIEL

    Individual · INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF

    Association date reported to CMS: Apr 6, 2025

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • GALBUT, DAVID

    Individual · INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF

    Association date reported to CMS: Apr 4, 2025

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • GALBUT, ERIC

    Individual · INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF

    Association date reported to CMS: Apr 6, 2025

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • GALBUT, ROBERT

    Individual · INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF

    Association date reported to CMS: Apr 4, 2025

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • PARITZKY, JONATHAN

    Individual · INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF

    Association date reported to CMS: Apr 4, 2025

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • ROMBRO, DAVID

    Individual · INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF

    Association date reported to CMS: Apr 4, 2025

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • ZISEK, TODD

    Individual · INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF

    Association date reported to CMS: Apr 4, 2025

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • BARBEE, DANIEL

    Individual · MANAGING CONTROL - GOVERNING BODY

    Association date reported to CMS: Dec 1, 2021

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • BENEDICT, JUDY

    Individual · MANAGING CONTROL - GOVERNING BODY

    Association date reported to CMS: Jan 1, 2024

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • BOWLUS, MARILYN

    Individual · MANAGING CONTROL - GOVERNING BODY

    Association date reported to CMS: Jan 1, 2014

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • GODFREY, MIKE

    Individual · MANAGING CONTROL - GOVERNING BODY

    Association date reported to CMS: Jan 1, 2024

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • HINDS, NORRIS

    Individual · MANAGING CONTROL - GOVERNING BODY

    Association date reported to CMS: Apr 1, 2021

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • KYLLO, THOMAS

    Individual · MANAGING CONTROL - GOVERNING BODY

    Association date reported to CMS: Jan 1, 2015

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • LOAR, TARA

    Individual · MANAGING CONTROL - GOVERNING BODY

    Association date reported to CMS: Jan 1, 2025

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • MCKIBBIN, KATIE

    Individual · MANAGING CONTROL - GOVERNING BODY

    Association date reported to CMS: Jan 1, 2023

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • APP, LYNN

    Individual · OPERATIONAL/MANAGERIAL CONTROL

    Association date reported to CMS: Dec 1, 2021

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • BARTLETT, VICTORIA

    Individual · OPERATIONAL/MANAGERIAL CONTROL

    Association date reported to CMS: Dec 1, 2021

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • BAYLIFF, BECKY

    Individual · OPERATIONAL/MANAGERIAL CONTROL

    Association date reported to CMS: Dec 1, 2021

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • BROWNSON, WILLIAM

    Individual · OPERATIONAL/MANAGERIAL CONTROL

    Association date reported to CMS: Dec 1, 2021

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • BURKE, DANIEL

    Individual · OPERATIONAL/MANAGERIAL CONTROL

    Association date reported to CMS: Dec 1, 2021

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • COLEMAN, ROBERT

    Individual · OPERATIONAL/MANAGERIAL CONTROL

    Association date reported to CMS: Dec 1, 2021

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • FRALEY, RALPH

    Individual · OPERATIONAL/MANAGERIAL CONTROL

    Association date reported to CMS: Dec 1, 2021

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • FUNCTIONAL PATHWAYS OF TENNESSEE LLC

    Organization · OPERATIONAL/MANAGERIAL CONTROL

    Association date reported to CMS: Dec 1, 2018

    Other facilities connected through this exact CMS organization identity: 0 across OH.

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • GLOSSER, HEIDI

    Individual · OPERATIONAL/MANAGERIAL CONTROL

    Association date reported to CMS: Dec 1, 2021

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • GREEN, JAMES

    Individual · OPERATIONAL/MANAGERIAL CONTROL

    Association date reported to CMS: Dec 1, 2021

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • HAZELBAKER, TOMAS

    Individual · OPERATIONAL/MANAGERIAL CONTROL

    Association date reported to CMS: Dec 1, 2021

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • KIRKENDALL, JESSICA

    Individual · OPERATIONAL/MANAGERIAL CONTROL

    Association date reported to CMS: Jan 3, 2023

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • OTTERBEIN HOME

    Organization · OPERATIONAL/MANAGERIAL CONTROL

    Association date reported to CMS: Dec 1, 2021

    Other facilities connected through this exact CMS organization identity: 0 across OH.

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • PIERCE, JOHN

    Individual · OPERATIONAL/MANAGERIAL CONTROL

    Association date reported to CMS: Dec 1, 2021

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • VONDERHAAR, STEVE

    Individual · OPERATIONAL/MANAGERIAL CONTROL

    Association date reported to CMS: Dec 1, 2021

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • BARBEE, DANIEL

    Individual · TRUSTEE OF THE SNF

    Association date reported to CMS: Dec 1, 2021

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • BENEDICT, JUDY

    Individual · TRUSTEE OF THE SNF

    Association date reported to CMS: Jan 1, 2024

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • BOWLUS, MARILYN

    Individual · TRUSTEE OF THE SNF

    Association date reported to CMS: Jan 1, 2014

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • GODFREY, MIKE

    Individual · TRUSTEE OF THE SNF

    Association date reported to CMS: Jan 1, 2024

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • HINDS, NORRIS

    Individual · TRUSTEE OF THE SNF

    Association date reported to CMS: Apr 1, 2021

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • KYLLO, THOMAS

    Individual · TRUSTEE OF THE SNF

    Association date reported to CMS: Jan 1, 2015

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • LOAR, TARA

    Individual · TRUSTEE OF THE SNF

    Association date reported to CMS: Jan 1, 2025

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • MCKIBBIN, KATIE

    Individual · TRUSTEE OF THE SNF

    Association date reported to CMS: Jan 1, 2023

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • OTTERBEIN LSC, LLC

    Organization · 5% OR GREATER DIRECT OWNERSHIP INTEREST

    Published ownership percentage: 100%

    Association date reported to CMS: Jan 1, 2016

    Other facilities connected through this exact CMS organization identity: 7 across IN, OH.

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Skilled Nursing Facility All Owners
    CMS dataset identifier
    afe44b85-cc6d-40d7-b5df-00ae8910d1d2
    Source updated
    Jul 27, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • OTTERBEIN HOME

    Organization · 5% OR GREATER INDIRECT OWNERSHIP INTEREST

    Published ownership percentage: 100%

    Association date reported to CMS: Dec 1, 2021

    CMS classifications: Parent company, Chain / home office

    Other facilities connected through this exact CMS organization identity: 17 across IN, OH.

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Skilled Nursing Facility All Owners
    CMS dataset identifier
    afe44b85-cc6d-40d7-b5df-00ae8910d1d2
    Source updated
    Jul 27, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • FUNCTIONAL PATHWAYS OF TENNESSEE LLC

    Organization · ADP OF THE SNF

    Association date reported to CMS: Apr 4, 2025

    Other facilities connected through this exact CMS organization identity: 24 across IA, IL, IN, NC, OH, PA, RI, SC, TN, VA.

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Skilled Nursing Facility All Owners
    CMS dataset identifier
    afe44b85-cc6d-40d7-b5df-00ae8910d1d2
    Source updated
    Jul 27, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • KIRKENDALL, JESSICA

    Individual · ADP OF THE SNF

    Association date reported to CMS: Jan 3, 2023

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Skilled Nursing Facility All Owners
    CMS dataset identifier
    afe44b85-cc6d-40d7-b5df-00ae8910d1d2
    Source updated
    Jul 27, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • OTTERBEIN HOME

    Organization · ADP OF THE SNF

    Association date reported to CMS: Dec 1, 2021

    CMS classifications: Chain / home office

    Other facilities connected through this exact CMS organization identity: 17 across IN, OH.

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Skilled Nursing Facility All Owners
    CMS dataset identifier
    afe44b85-cc6d-40d7-b5df-00ae8910d1d2
    Source updated
    Jul 27, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • PIERCE, JOHN

    Individual · ADP OF THE SNF

    Association date reported to CMS: Dec 1, 2021

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Skilled Nursing Facility All Owners
    CMS dataset identifier
    afe44b85-cc6d-40d7-b5df-00ae8910d1d2
    Source updated
    Jul 27, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • POLARIS PHARMACY SERVICES OF OHIO LLC

    Organization · ADP OF THE SNF

    Association date reported to CMS: Dec 1, 2018

    Other facilities connected through this exact CMS organization identity: 14 across IN, OH.

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Skilled Nursing Facility All Owners
    CMS dataset identifier
    afe44b85-cc6d-40d7-b5df-00ae8910d1d2
    Source updated
    Jul 27, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • POWELL, ANGIE

    Individual · CORPORATE DIRECTOR

    Association date reported to CMS: Nov 24, 2014

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Skilled Nursing Facility All Owners
    CMS dataset identifier
    afe44b85-cc6d-40d7-b5df-00ae8910d1d2
    Source updated
    Jul 27, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • STEPHENSON, JOHN

    Individual · CORPORATE DIRECTOR

    Association date reported to CMS: Aug 9, 1982

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Skilled Nursing Facility All Owners
    CMS dataset identifier
    afe44b85-cc6d-40d7-b5df-00ae8910d1d2
    Source updated
    Jul 27, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • GREEN, JAMES

    Individual · CORPORATE OFFICER

    Association date reported to CMS: Nov 21, 2005

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Skilled Nursing Facility All Owners
    CMS dataset identifier
    afe44b85-cc6d-40d7-b5df-00ae8910d1d2
    Source updated
    Jul 27, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • HAWKINS, RITA

    Individual · CORPORATE OFFICER

    Association date reported to CMS: Jan 16, 2006

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Skilled Nursing Facility All Owners
    CMS dataset identifier
    afe44b85-cc6d-40d7-b5df-00ae8910d1d2
    Source updated
    Jul 27, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • MILLER, JASON

    Individual · CORPORATE OFFICER

    Association date reported to CMS: Aug 4, 2014

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Skilled Nursing Facility All Owners
    CMS dataset identifier
    afe44b85-cc6d-40d7-b5df-00ae8910d1d2
    Source updated
    Jul 27, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • WILSON, JILL

    Individual · CORPORATE OFFICER

    Association date reported to CMS: May 1, 2009

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Skilled Nursing Facility All Owners
    CMS dataset identifier
    afe44b85-cc6d-40d7-b5df-00ae8910d1d2
    Source updated
    Jul 27, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • BARBEE, DANIEL

    Individual · MANAGING CONTROL - GOVERNING BODY

    Association date reported to CMS: Dec 1, 2021

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Skilled Nursing Facility All Owners
    CMS dataset identifier
    afe44b85-cc6d-40d7-b5df-00ae8910d1d2
    Source updated
    Jul 27, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • BENEDICT, JUDY

    Individual · MANAGING CONTROL - GOVERNING BODY

    Association date reported to CMS: Jan 1, 2024

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Skilled Nursing Facility All Owners
    CMS dataset identifier
    afe44b85-cc6d-40d7-b5df-00ae8910d1d2
    Source updated
    Jul 27, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • BOWLUS, MARILYN

    Individual · MANAGING CONTROL - GOVERNING BODY

    Association date reported to CMS: Jan 1, 2014

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Skilled Nursing Facility All Owners
    CMS dataset identifier
    afe44b85-cc6d-40d7-b5df-00ae8910d1d2
    Source updated
    Jul 27, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • GODFREY, MIKE

    Individual · MANAGING CONTROL - GOVERNING BODY

    Association date reported to CMS: Jan 1, 2024

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Skilled Nursing Facility All Owners
    CMS dataset identifier
    afe44b85-cc6d-40d7-b5df-00ae8910d1d2
    Source updated
    Jul 27, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • HINDS, NORRIS

    Individual · MANAGING CONTROL - GOVERNING BODY

    Association date reported to CMS: Apr 1, 2021

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Skilled Nursing Facility All Owners
    CMS dataset identifier
    afe44b85-cc6d-40d7-b5df-00ae8910d1d2
    Source updated
    Jul 27, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • KYLLO, THOMAS

    Individual · MANAGING CONTROL - GOVERNING BODY

    Association date reported to CMS: Jan 1, 2015

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Skilled Nursing Facility All Owners
    CMS dataset identifier
    afe44b85-cc6d-40d7-b5df-00ae8910d1d2
    Source updated
    Jul 27, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • LOAR, TARA

    Individual · MANAGING CONTROL - GOVERNING BODY

    Association date reported to CMS: Jan 1, 2025

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Skilled Nursing Facility All Owners
    CMS dataset identifier
    afe44b85-cc6d-40d7-b5df-00ae8910d1d2
    Source updated
    Jul 27, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • MCKIBBIN, KATIE

    Individual · MANAGING CONTROL - GOVERNING BODY

    Association date reported to CMS: Jan 1, 2023

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Skilled Nursing Facility All Owners
    CMS dataset identifier
    afe44b85-cc6d-40d7-b5df-00ae8910d1d2
    Source updated
    Jul 27, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source
  • APP, LYNN

    Individual · OPERATIONAL/MANAGERIAL CONTROL

    Association date reported to CMS: Dec 1, 2021

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Skilled Nursing Facility All Owners
    CMS dataset identifier
    afe44b85-cc6d-40d7-b5df-00ae8910d1d2
    Source updated
    Jul 27, 2026
    Retrieved
    Aug 15, 2026
    View official CMS source

What this means

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.

Questions to ask

  • CMS records list several organizations with ownership or control roles. Which entity is responsible for day-to-day operations at this facility?
  • CMS records connect OTTERBEIN LSC, LLC to 8 facilities. Which policies and staffing decisions are managed centrally versus locally?

Chain context

CMS groups this facility with OTTERBEIN SENIORLIFE

Chain-level values describe this CMS-defined group, not any one facility. CMS Chain ID 389 is a grouping identifier, not a legal organization.

Facilities
19
States and territories
2
Average overall rating
3
Average staffing rating
2.9
Average total nurse HPRD
4.1
Total fines
7
Review CMS chain evidence

CMS-published history

Monthly chain measures
MonthFacilitiesOverall ratingStaffing rating
Wed Jul1932.9
Mon Jun193.13.2
Fri May192.92.9
Wed Apr193.13.3
Sun Mar192.83.2
Sun Feb192.93.4

Questions to ask

  • CMS groups facilities in 2 states or territories under this chain. Which operational policies are set at the chain level?
  • CMS reports 7 fines across the chain in this dataset. What compliance functions are managed centrally?
CMS chain source and methodology

Nursing Home Chain Performance Measures, fixed version da2db00a-0f3d-40a9-a535-588ff1220c55. Membership comes separately from CMS Skilled Nursing Facility Enrollments.

View official CMS source

Inspections & deficiencies

What CMS inspection records show

Scope and severity terms below are CMS classifications. They are not a TrustHub score.

Latest recorded inspection

Date
Apr 15, 2026
Survey type
Health Complaint
Linked findings
2
Highest linked CMS classification
D — Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy
View source details
Dataset
Inspection Dates
CMS dataset ID
svdt-c123
CMS source updated
Jul 1, 2026
CMS provider ID
365571
Source record locator
csv-row:93904:ccn:365571
View official CMS source
Apr 15, 2026Health Complaint 2 linked findings
  • F0580Resident Rights Deficiencies

    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 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 (Apr 21, 2026)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    365571
    Source record locator
    csv-row:261528:ccn:365571
    View official CMS source
  • F0812Nutrition and Dietary Deficiencies

    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with 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 (Apr 21, 2026)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    365571
    Source record locator
    csv-row:261529:ccn:365571
    View official CMS source
Jun 18, 2025Fire Safety Standard 0 linked findings

No health-deficiency rows were deterministically linked to this inspection.

Jun 18, 2025Health Complaint 0 linked findings

No health-deficiency rows were deterministically linked to this inspection.

Jun 18, 2025Health Standard 3 linked findings
  • F0686Quality of Life and Care Deficiencies

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

    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 (Jul 11, 2025)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    365571
    Source record locator
    csv-row:261530:ccn:365571
    View official CMS source
  • F0695Quality of Life and Care Deficiencies

    Provide safe and appropriate respiratory care for a resident when needed.

    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 (Jul 11, 2025)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    365571
    Source record locator
    csv-row:261531:ccn:365571
    View official CMS source
  • F0880Infection Control Deficiencies

    Provide and implement an infection prevention and control program.

    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 (Jul 11, 2025)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    365571
    Source record locator
    csv-row:261534:ccn:365571
    View official CMS source
Mar 4, 2025Health Complaint 3 linked findings
  • F0684Quality of Life and Care Deficiencies

    Provide appropriate treatment and care according to orders, resident’s preferences and goals.

    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 21, 2025)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    365571
    Source record locator
    csv-row:261535:ccn:365571
    View official CMS source
  • F0689Quality of Life and Care Deficiencies

    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

    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 21, 2025)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    365571
    Source record locator
    csv-row:261536:ccn:365571
    View official CMS source
  • F0842Resident Assessment and Care Planning Deficiencies

    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 (Mar 21, 2025)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    365571
    Source record locator
    csv-row:261537:ccn:365571
    View official CMS source
Jan 23, 2025Health Complaint 1 linked finding
  • F0551Resident Rights Deficiencies

    Give the resident's representative the ability to exercise the resident's 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 (Feb 3, 2025)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    365571
    Source record locator
    csv-row:261538:ccn:365571
    View official CMS source
Sep 10, 2024Health Complaint 2 linked findings
  • F0550Resident Rights Deficiencies

    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 (Sep 23, 2024)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    365571
    Source record locator
    csv-row:261539:ccn:365571
    View official CMS source
  • F0607Freedom from Abuse, Neglect, and Exploitation Deficiencies

    Develop and implement policies and procedures to prevent abuse, neglect, and theft.

    CMS scope/severity C: Widespread; No actual harm with potential for minimal harm.

    Correction status: Deficient, Provider has plan of correction (Sep 23, 2024)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    365571
    Source record locator
    csv-row:261540:ccn:365571
    View official CMS source
Jul 23, 2024Health Complaint 1 linked finding
  • F0677Quality of Life and Care Deficiencies

    Provide care and assistance to perform activities of daily living for any resident who is unable.

    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 4, 2024)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    365571
    Source record locator
    csv-row:261541:ccn:365571
    View official CMS source
May 30, 2024Health Complaint 2 linked findings
  • F0759Pharmacy Service Deficiencies

    Ensure medication error rates are not 5 percent or greater.

    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 10, 2024)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    365571
    Source record locator
    csv-row:261550:ccn:365571
    View official CMS source
  • F0760Pharmacy Service Deficiencies

    Ensure that residents are free from significant medication errors.

    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 10, 2024)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    365571
    Source record locator
    csv-row:261551:ccn:365571
    View official CMS source
Aug 7, 2023Health Complaint 1 linked finding
  • F0760Pharmacy Service Deficiencies

    Ensure that residents are free from significant medication errors.

    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 25, 2023)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    365571
    Source record locator
    csv-row:261552:ccn:365571
    View official CMS source
Nov 28, 2022Fire Safety Standard 0 linked findings

No health-deficiency rows were deterministically linked to this inspection.

Nov 28, 2022Health Standard 8 linked findings
  • F0558Resident Rights Deficiencies

    Reasonably accommodate the needs and preferences of each resident.

    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 22, 2022)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    365571
    Source record locator
    csv-row:261544:ccn:365571
    View official CMS source
  • F0561Resident Rights Deficiencies

    Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.

    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 22, 2022)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    365571
    Source record locator
    csv-row:261545:ccn:365571
    View official CMS source
  • F0582Resident Rights Deficiencies

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

    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 22, 2022)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    365571
    Source record locator
    csv-row:261546:ccn:365571
    View official CMS source
  • F0677Quality of Life and Care Deficiencies

    Provide care and assistance to perform activities of daily living for any resident who is unable.

    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 22, 2022)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    365571
    Source record locator
    csv-row:261547:ccn:365571
    View official CMS source
  • F0684Quality of Life and Care Deficiencies

    Provide appropriate treatment and care according to orders, resident’s preferences and goals.

    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 22, 2022)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    365571
    Source record locator
    csv-row:261548:ccn:365571
    View official CMS source
  • F0686Quality of Life and Care Deficiencies

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

    CMS scope/severity G: Isolated; Actual harm that is not immediate jeopardy.

    Correction status: Deficient, Provider has date of correction (Dec 22, 2022)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    365571
    Source record locator
    csv-row:261542:ccn:365571
    View official CMS source
  • F0883Infection Control Deficiencies

    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 (Dec 22, 2022)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    365571
    Source record locator
    csv-row:261549:ccn:365571
    View official CMS source
  • F0919Environmental Deficiencies

    Make sure that a working call system is available in each resident's bathroom and bathing area.

    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 22, 2022)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    365571
    Source record locator
    csv-row:261543:ccn:365571
    View official CMS source
Jan 4, 2020Fire Safety Standard 0 linked findings

No health-deficiency rows were deterministically linked to this inspection.

Jan 4, 2020Health Standard 2 linked findings
  • F0686Quality of Life and Care Deficiencies

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

    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 (Jan 31, 2020)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    365571
    Source record locator
    csv-row:261553:ccn:365571
    View official CMS source
  • F0698Quality of Life and Care Deficiencies

    Provide safe, appropriate dialysis care/services for a resident who requires such services.

    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 (Jan 31, 2020)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    365571
    Source record locator
    csv-row:261554:ccn:365571
    View official CMS source

Tags appearing across inspections

  • F0686 appears in 3 linked inspections.
  • F0677 appears in 2 linked inspections.
  • F0684 appears in 2 linked inspections.
  • F0760 appears in 2 linked inspections.

Penalties & enforcement

CMS penalty records in the loaded three-year dataset

No penalty records were found for this provider in the currently loaded CMS Penalties dataset.

Questions to ask

Questions generated from the evidence above

  • CMS records show F0686 in 3 inspections in the available record. What changes has the facility made to address this issue?
  • CMS records show F0677 in 2 inspections in the available record. What changes has the facility made to address this issue?
  • CMS records show F0684 in 2 inspections in the available record. What changes has the facility made to address this issue?
  • CMS records show F0760 in 2 inspections in the available record. What changes has the facility made to address this issue?

Facility history

Facility History

14 historical events available. Dates and values come from published CMS and official state regulator evidence, not a score.

What changed recently?

  • Complaint inspection recorded2 deficiencies were recorded.
  • Total nurse staffing decreasedTotal nurse staffing decreased from 4.41 to 3.46 hours per resident day between 2025Q4 and 2026Q1. Staffing declined across those reported periods.

2026

  1. Complaint inspection recorded

    2 deficiencies were recorded.

    CMS · Recorded event date · View related evidence

  2. Total nurse staffing decreased

    Total nurse staffing decreased from 4.41 to 3.46 hours per resident day between 2025Q4 and 2026Q1. Staffing declined across those reported periods.

    4.413.46

    CMS · Reported in a source release · View related evidence

2025

  1. RN staffing increased

    RN staffing increased from 0.61 to 0.91 hours per resident day between 2025Q3 and 2025Q4. Staffing improved across those reported periods.

    0.610.91

    CMS · Reported in a source release · View related evidence

  2. Total nurse staffing increased

    Total nurse staffing increased from 3.58 to 4.41 hours per resident day between 2025Q3 and 2025Q4. Staffing improved across those reported periods.

    3.584.41

    CMS · Reported in a source release · View related evidence

  3. Complaint inspection recorded

    No linked health-deficiency findings were recorded for this survey.

    CMS · Recorded event date · View related evidence

  4. Health inspection completed

    3 deficiencies were recorded.

    CMS · Recorded event date · View related evidence

  5. Complaint inspection recorded

    3 deficiencies were recorded.

    CMS · Recorded event date · View related evidence

  6. Complaint inspection recorded

    1 deficiency was recorded.

    CMS · Recorded event date · View related evidence

2024

  1. Complaint inspection recorded

    2 deficiencies were recorded.

    CMS · Recorded event date · View related evidence

  2. Complaint inspection recorded

    1 deficiency was recorded.

    CMS · Recorded event date · View related evidence

  3. Complaint inspection recorded

    2 deficiencies were recorded.

    CMS · Recorded event date · View related evidence

2023

  1. Complaint inspection recorded

    1 deficiency was recorded.

    CMS · Recorded event date · View related evidence

Staffing

Reported nursing staffing at a glance

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).

Inspect a PBJ quarter
Total nursing
3.456
reported hours per resident day
RN categories
0.889
reported hours per resident day
LPN/LVN categories
0.528
reported hours per resident day
CNA
2.039
reported hours per resident day

Weekday and weekend calculations

2026Q1 reported hours per resident day
MeasureMonday–FridaySaturday–Sunday
Total nursing3.6033.089
RN categories10.611

Contract staff accounted for 0% of reported nursing hours included in this quarter calculation.

Reported RN-category hours per resident day were 0.020 lower than the prior loaded quarter.

Staffing over time

Solid bar: Total nursing · Outlined bar: RN categories

Calculated reported hours per resident day by PBJ quarter
QuarterTotal nursingRN categoriesLPN/LVNCNAContract shareDays
2025Q23.7110.6290.9932.0890%91
2025Q33.5840.6150.8882.0820%92
2025Q44.4070.9091.3662.1320%92
2026Q13.4560.8890.5282.0390%90

Questions to ask

  • PBJ records show lower calculated RN-category hours per resident day on weekends this quarter. How does the facility plan RN coverage on Saturdays and Sundays?
Staffing source and calculation details
Source
Centers for Medicare & Medicaid Services (CMS)
Dataset
Payroll Based Journal Daily Nurse Staffing
CMS dataset ID
7e0d53ba-8f02-4c66-98a5-14a1c997c50d
Quarter
2026Q1
Coverage
Jan 1, 2026Mar 31, 2026
Days represented
90 (90 with positive MDS census)
CMS source updated
Jul 29, 2026
Calculation version
pbj-quarter-ratio-of-sums-v1

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 source

What we can verify today

Current Provider Information facts

These measures come from the current successfully ingested CMS Nursing Home Provider Information release.

  • CMS reports a 4-star overall rating.
  • CMS reports a 3-star health inspection rating.
  • CMS reports a 3-star staffing rating.
  • CMS reports a 5-star quality-measure rating.

Planned evidence layers

Additional public-source research

These areas require separate authoritative CMS datasets. No findings are shown until those sources are ingested and reviewed.

    Trust participation

    See something that needs correction?

    Claims, corrections, and factual context are free. Submissions never replace CMS evidence or affect ranking.

    How corrections work

    Source register

    See where this record came from

    Provider Information
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset identifier
    4pq5-n9py
    Source updated
    Jul 29, 2026
    Retrieved
    Aug 14, 2026
    Supports
    Overview, facility facts, and CMS ratings
    View official CMS source
    Inspection Dates
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset identifier
    svdt-c123
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 14, 2026
    Supports
    Inspections and facility history
    View official CMS source
    Health Deficiencies
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset identifier
    r5ix-sfxw
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 14, 2026
    Supports
    Health deficiencies and facility history
    View official CMS source
    Payroll Based Journal Daily Nurse Staffing
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset identifier
    7e0d53ba-8f02-4c66-98a5-14a1c997c50d
    Coverage
    Apr 1, 2025–Mar 31, 2026
    Source updated
    Jul 29, 2026
    Retrieved
    Aug 15, 2026
    Supports
    PBJ staffing cards, history, and transparent calculations
    View official CMS source
    Ownership
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset identifier
    y2hd-n93e
    Source updated
    Jul 1, 2026
    Retrieved
    Aug 15, 2026
    Supports
    Ownership parties, organization connections, and ownership history
    View official CMS source
    Skilled Nursing Facility All Owners
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset identifier
    afe44b85-cc6d-40d7-b5df-00ae8910d1d2
    Source updated
    Jul 27, 2026
    Retrieved
    Aug 15, 2026
    Supports
    Ownership parties, organization connections, and ownership history
    View official CMS source
    Nursing Home Chain Performance Measures
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset identifier
    97ecfad1-d3f1-4d42-b774-d74661d830bc
    Coverage
    Wed Jul
    Source updated
    Aug 12, 2026
    Retrieved
    Aug 16, 2026
    Supports
    CMS chain context, performance, and monthly history
    View official CMS source
    Skilled Nursing Facility Enrollments
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset identifier
    5f2c306f-3b1c-42cd-b037-187b2ce22126
    Source updated
    Jul 27, 2026
    Retrieved
    Aug 15, 2026
    Supports
    Exact CMS chain affiliation
    View official CMS source

    No paid placements. Facilities cannot pay to rank higher. We cite. You decide.