Hillcrest Manor Nursing Center

Blackwell, OK

CMS provider ID 375402CMS source updated July 29, 2026

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CMS overview

CMS rating overview

CMS overall

2 of 5 CMS stars

Health inspection

2 of 5 CMS stars

Staffing

2 of 5 CMS stars

Quality-measure

2 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
137
Ownership descriptor
For profit - Limited Liability company
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
5803633244Verified public information · checked Aug 2026

Decision guide

What to review

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

Staffing

CMS publishes a 2-star staffing rating for this facility.

RN staffing was 0.36 hours per resident day in 2026Q1, calculated from CMS PBJ records.

View staffing evidence
Enforcement record

CMS records show a 36-day payment denial in the loaded enforcement dataset.

View enforcement 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
For profit - Limited Liability companyCMS
Related facilities
4Current 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 24 individual ownership interests

Related facilities

4 currently connected nursing homes share this CMS organization identity with JEFFREY W YOUNG REVOCABLE TRUST DATED JULY 27, 2017.

Average CMS overall rating
2 stars across 4 reporting facilities
CMS monetary penalties
2 of 4 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
2 facilities had a high-value CMS fine or payment denial in the last 18 months.
Recent CMS complaint inspections
3 facilities had a CMS complaint inspection in the last 18 months.
Total recorded CMS fines
$68,726

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
41
Organizations shown
17
Individuals shown
24
Latest ownership source update
Jul 27, 2026

CMS-published ownership and control parties

  • GRANT RHODES REVOCABLE TRUST

    Organization · 5% OR GREATER DIRECT OWNERSHIP INTEREST

    Published ownership percentage: 50%

    Association date reported to CMS: Jan 1, 2017

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

    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
  • JEFFREY W YOUNG REVOCABLE TRUST DATED JULY 27, 2017

    Organization · 5% OR GREATER DIRECT OWNERSHIP INTEREST

    Published ownership percentage: 50%

    Association date reported to CMS: Jan 1, 2017

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

    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
  • RHODES, JONATHAN

    Individual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST

    Published ownership percentage: 50%

    Association date reported to CMS: Jan 1, 2017

    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
  • YOUNG, JEFFREY

    Individual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST

    Published ownership percentage: 50%

    Association date reported to CMS: Jan 1, 2017

    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
  • BEDLAM PROPERTIES HO LLC

    Organization · ADP OF THE SNF

    Association date reported to CMS: Jan 6, 2025

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

    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
  • BLACK DIAMOND INVESTMENTS

    Organization · ADP OF THE SNF

    Association date reported to CMS: Dec 27, 2024

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

    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
  • CARSON, JONATHAN

    Individual · ADP OF THE SNF

    Association date reported to CMS: Dec 27, 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
  • GRANT RHODES REVOCABLE TRUST

    Organization · ADP OF THE SNF

    Association date reported to CMS: Jan 6, 2025

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

    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
  • JEFFREY W YOUNG REVOCABLE TRUST DATED JULY 27, 2017

    Organization · ADP OF THE SNF

    Association date reported to CMS: Jan 6, 2025

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

    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
  • LIETZKE, MARK

    Individual · ADP OF THE SNF

    Association date reported to CMS: Jan 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
  • MATRIX PROVIDER SOLUTIONS LLC

    Organization · ADP OF THE SNF

    Association date reported to CMS: Jan 6, 2025

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

    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
  • RHODES, JONATHAN

    Individual · ADP OF THE SNF

    Association date reported to CMS: Jan 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
  • SNOW, LARRY

    Individual · ADP OF THE SNF

    Association date reported to CMS: Jan 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
  • SPILLARS, RODGER

    Individual · ADP OF THE SNF

    Association date reported to CMS: Jan 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
  • YOUNG, JEFFREY

    Individual · ADP OF THE SNF

    Association date reported to CMS: Jan 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
  • SNOW, LARRY

    Individual · CORPORATE OFFICER

    Association date reported to CMS: Mar 1, 2020

    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
  • BEDLAM PROPERTIES HO LLC

    Organization · OPERATIONAL/MANAGERIAL CONTROL

    Association date reported to CMS: Dec 27, 2024

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

    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
  • LIETZKE, MARK

    Individual · OPERATIONAL/MANAGERIAL CONTROL

    Association date reported to CMS: Dec 27, 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
  • SNOW, LARRY

    Individual · OPERATIONAL/MANAGERIAL CONTROL

    Association date reported to CMS: Jan 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
  • GRANT RHODES REVOCABLE TRUST

    Organization · 5% OR GREATER DIRECT OWNERSHIP INTEREST

    Published ownership percentage: 50%

    Association date reported to CMS: Jan 1, 2017

    Other facilities connected through this exact CMS organization identity: 1 across OK.

    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
  • JEFFREY W YOUNG REVOCABLE TRUST DATED JULY 27, 2017

    Organization · 5% OR GREATER DIRECT OWNERSHIP INTEREST

    Published ownership percentage: 50%

    Association date reported to CMS: Jan 1, 2017

    Other facilities connected through this exact CMS organization identity: 3 across OK.

    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
  • RHODES, JONATHAN

    Individual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST

    Published ownership percentage: 50%

    Association date reported to CMS: Jan 1, 2017

    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
  • YOUNG, JEFFREY

    Individual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST

    Published ownership percentage: 50%

    Association date reported to CMS: Jan 1, 2017

    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
  • BEDLAM PROPERTIES HO LLC

    Organization · ADP OF THE SNF

    Association date reported to CMS: Jan 6, 2025

    Other facilities connected through this exact CMS organization identity: 3 across OK.

    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
  • BLACK DIAMOND INVESTMENTS

    Organization · ADP OF THE SNF

    Association date reported to CMS: Dec 27, 2024

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

    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
  • CARSON, JONATHAN

    Individual · ADP OF THE SNF

    Association date reported to CMS: Dec 27, 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
  • GRANT RHODES REVOCABLE TRUST

    Organization · ADP OF THE SNF

    Association date reported to CMS: Jan 6, 2025

    Other facilities connected through this exact CMS organization identity: 1 across OK.

    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
  • Individual name not published by CMS

    Individual · ADP OF THE SNF

    Association date reported to CMS: Dec 27, 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
  • JEFFREY W YOUNG REVOCABLE TRUST DATED JULY 27, 2017

    Organization · ADP OF THE SNF

    Association date reported to CMS: Jan 6, 2025

    Other facilities connected through this exact CMS organization identity: 3 across OK.

    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
  • LIETZKE, MARK

    Individual · ADP OF THE SNF

    Association date reported to CMS: Jan 6, 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
  • MATRIX PROVIDER SOLUTIONS LLC

    Organization · ADP OF THE SNF

    Association date reported to CMS: Jan 6, 2025

    Other facilities connected through this exact CMS organization identity: 3 across OK.

    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
  • RHODES, JONATHAN

    Individual · ADP OF THE SNF

    Association date reported to CMS: Jan 6, 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
  • SNOW, LARRY

    Individual · ADP OF THE SNF

    Association date reported to CMS: Jan 6, 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
  • SPILLARS, RODGER

    Individual · ADP OF THE SNF

    Association date reported to CMS: Jan 6, 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
  • YOUNG, JEFFREY

    Individual · ADP OF THE SNF

    Association date reported to CMS: Jan 6, 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
  • SNOW, LARRY

    Individual · CORPORATE OFFICER

    Published ownership percentage: 100%

    Association date reported to CMS: Mar 1, 2020

    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
  • Individual name not published by CMS

    Individual · INDIRECT OWNERSHIP INTEREST

    Published ownership percentage: 0%

    Association date reported to CMS: Jan 1, 2017

    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
  • BEDLAM PROPERTIES HO LLC

    Organization · OPERATIONAL/MANAGERIAL CONTROL

    Association date reported to CMS: Dec 27, 2024

    Other facilities connected through this exact CMS organization identity: 3 across OK.

    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
  • LIETZKE, MARK

    Individual · OPERATIONAL/MANAGERIAL CONTROL

    Association date reported to CMS: Dec 27, 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
  • SNOW, LARRY

    Individual · OPERATIONAL/MANAGERIAL CONTROL

    Association date reported to CMS: Jan 6, 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
  • BEDLAM PROPERTIES, LLC

    Organization · Medicare-enrolled legal organization

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

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Skilled Nursing Facility Enrollments
    CMS dataset identifier
    5f2c306f-3b1c-42cd-b037-187b2ce22126
    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 GRANT RHODES REVOCABLE TRUST to 2 facilities. Which policies and staffing decisions are managed centrally versus locally?

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
May 19, 2025
Survey type
Health Complaint
Linked findings
1
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
375402
Source record locator
csv-row:102105:ccn:375402
View official CMS source
May 19, 2025Health Complaint 1 linked finding
  • 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 (Jun 13, 2025)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    375402
    Source record locator
    csv-row:284638:ccn:375402
    View official CMS source
Apr 4, 2025Fire Safety Standard 0 linked findings

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

Apr 4, 2025Health Complaint 0 linked findings

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

Apr 4, 2025Health Standard 7 linked findings
  • F0636Resident Assessment and Care Planning Deficiencies

    Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 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 (May 6, 2025)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    375402
    Source record locator
    csv-row:284633:ccn:375402
    View official CMS source
  • F0640Resident Assessment and Care Planning Deficiencies

    Encode each resident’s assessment data and transmit these data to the State within 7 days of 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 (May 6, 2025)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    375402
    Source record locator
    csv-row:284634:ccn:375402
    View official CMS source
  • F0657Resident Assessment and Care Planning Deficiencies

    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 G: Isolated; Actual harm that is not immediate jeopardy.

    Correction status: Deficient, Provider has date of correction (May 1, 2025)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    375402
    Source record locator
    csv-row:284628:ccn:375402
    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 (May 6, 2025)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    375402
    Source record locator
    csv-row:284635:ccn:375402
    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 G: Isolated; Actual harm that is not immediate jeopardy.

    Correction status: Deficient, Provider has date of correction (Apr 30, 2025)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    375402
    Source record locator
    csv-row:284629:ccn:375402
    View official CMS source
  • F0758Pharmacy Service Deficiencies

    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 (May 6, 2025)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    375402
    Source record locator
    csv-row:284632:ccn:375402
    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 (May 6, 2025)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    375402
    Source record locator
    csv-row:284637:ccn:375402
    View official CMS source
Aug 29, 2024Health Complaint 1 linked finding
  • 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 (Sep 30, 2024)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    375402
    Source record locator
    csv-row:284639:ccn:375402
    View official CMS source
Dec 14, 2023Fire Safety Standard 0 linked findings

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

Dec 14, 2023Health Standard 5 linked findings
  • F0567Resident Rights Deficiencies

    Honor the resident's right to manage his or her financial affairs.

    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 (Feb 13, 2024)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    375402
    Source record locator
    csv-row:284640:ccn:375402
    View official CMS source
  • F0568Resident Rights Deficiencies

    Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.

    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 (Feb 13, 2024)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    375402
    Source record locator
    csv-row:284641:ccn:375402
    View official CMS source
  • F0570Resident Rights Deficiencies

    Assure the security of all personal funds of residents deposited with the facility.

    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 (Feb 13, 2024)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    375402
    Source record locator
    csv-row:284642:ccn:375402
    View official CMS source
  • F0760Pharmacy Service Deficiencies

    Ensure that residents are free from significant medication errors.

    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 (Feb 13, 2024)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    375402
    Source record locator
    csv-row:284643:ccn:375402
    View official CMS source
  • F0880Infection Control Deficiencies

    Provide and implement an infection prevention and control program.

    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 (Feb 13, 2024)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    375402
    Source record locator
    csv-row:284644:ccn:375402
    View official CMS source
Nov 30, 2022Fire Safety Standard 0 linked findings

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

Nov 30, 2022Health Standard 7 linked findings
  • F0582Resident Rights Deficiencies

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

    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 (Jan 16, 2023)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    375402
    Source record locator
    csv-row:284645:ccn:375402
    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 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 (Jan 16, 2023)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    375402
    Source record locator
    csv-row:284646:ccn:375402
    View official CMS source
  • F0686Quality of Life and Care Deficiencies

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

    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 (Jan 16, 2023)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    375402
    Source record locator
    csv-row:284647:ccn:375402
    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 (Jan 16, 2023)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    375402
    Source record locator
    csv-row:284650:ccn:375402
    View official CMS source
  • F0851Administration Deficiencies

    Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.

    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 (Jan 16, 2023)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    375402
    Source record locator
    csv-row:284648:ccn:375402
    View official CMS source
  • F0880Infection Control Deficiencies

    Provide and implement an infection prevention and control program.

    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 (Jan 16, 2023)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    375402
    Source record locator
    csv-row:284649:ccn:375402
    View official CMS source
  • F0888Infection Control Deficiencies

    Ensure staff are vaccinated for COVID-19

    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 16, 2023)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    375402
    Source record locator
    csv-row:284651:ccn:375402
    View official CMS source

Tags appearing across inspections

  • F0689 appears in 3 linked inspections.
  • F0880 appears in 3 linked inspections.
  • F0677 appears in 2 linked inspections.

Penalties & enforcement

CMS penalty records in the loaded three-year dataset

  • Payment DenialApr 4, 2025

    Payment denial length: 36 days

    View source details
    Dataset
    Penalties
    CMS dataset ID
    g6vv-u9sr
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    375402
    Source record locator
    csv-row:10822:ccn:375402
    View official CMS source
  • FineApr 4, 2025

    Published fine amount: $46,898.00

    View source details
    Dataset
    Penalties
    CMS dataset ID
    g6vv-u9sr
    CMS source updated
    Jul 1, 2026
    CMS provider ID
    375402
    Source record locator
    csv-row:10821:ccn:375402
    View official CMS source

Questions to ask

Questions generated from the evidence above

  • CMS records show F0689 in 3 inspections in the available record. What changes has the facility made to address this issue?
  • CMS records show F0880 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 a monetary penalty dated Apr 4, 2025. What changes were made after that enforcement action?

Facility history

Facility History

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

What changed recently?

  • Complaint inspection recorded1 deficiency was recorded.
  • Medicare payment denial recordedCMS recorded a Medicare payment denial lasting 36 days.

2025

  1. Complaint inspection recorded

    1 deficiency was recorded.

    CMS · Recorded event date · View related evidence

  2. Medicare payment denial recorded

    CMS recorded a Medicare payment denial lasting 36 days.

    CMS · Recorded event date · View related evidence

  3. Health inspection completed

    7 deficiencies were recorded. That includes 2 higher-severity deficiencies.

    CMS · Recorded event date · View related evidence

  4. Civil monetary penalty recorded

    CMS recorded a $46,898 civil monetary penalty.

    CMS · Recorded event date · View related evidence

  5. Complaint inspection recorded

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

    CMS · Recorded event date · View related evidence

2024

  1. Complaint inspection recorded

    1 deficiency was recorded.

    CMS · Recorded event date · View related evidence

2023

  1. Health inspection completed

    5 deficiencies were recorded.

    CMS · Recorded event date · View related evidence

2022

  1. Health inspection completed

    7 deficiencies were recorded.

    CMS · Recorded event date · View related evidence

Staffing

Reported nursing staffing at a glance

CMS staffing rating: 2 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
2.958
reported hours per resident day
RN categories
0.364
reported hours per resident day
LPN/LVN categories
0.574
reported hours per resident day
CNA
1.181
reported hours per resident day

Weekday and weekend calculations

2026Q1 reported hours per resident day
MeasureMonday–FridaySaturday–Sunday
Total nursing3.0482.738
RN categories0.4030.268

Contract staff accounted for 14.7% of reported nursing hours included in this quarter calculation.

Reported RN-category hours per resident day were 0.129 higher 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
2025Q32.970.2350.511.26516%92
2026Q12.9580.3640.5741.18114.7%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?
  • PBJ records show that some reported nursing hours were contract hours. How does the facility orient and integrate contract staff?
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 2-star overall rating.
  • CMS reports a 2-star health inspection rating.
  • CMS reports a 2-star staffing rating.
  • CMS reports a 2-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.

  • Chain / portfolio intelligence

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
Penalties
Source organization
Centers for Medicare & Medicaid Services (CMS)
Dataset identifier
g6vv-u9sr
Source updated
Jul 1, 2026
Retrieved
Aug 14, 2026
Supports
Penalties, enforcement, 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
Jul 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
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
Ownership parties, organization connections, and ownership history
View official CMS source
Verified public facility information
Source organization
Public facility listing
Dataset identifier
commercial-corroboration:public-listing
Source updated
Aug 18, 2026
Retrieved
Aug 18, 2026
Supports
Independently verified public website, phone, or publicly used name. Not a CMS rating or regulatory status.
How sources work

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