SENIORTRUST HUB

Facility record

Bradbury Commons has 68 certified beds in PONCA CITY, Oklahoma. The CMS overall rating is 4 of 5, compared with the Oklahoma average of 2.7. The CMS health inspection rating is 5 of 5, compared with the Oklahoma average of 2.8. The CMS staffing rating is 1 of 5. The latest standard health survey on Jul 3, 2024 lists 0 deficiencies, compared with the Oklahoma average of 4.8. Total nurse staffing is 3.58 hours per resident day in 2025Q3, compared with the Oklahoma average of 3.78.

CMS nursing homes in Oklahoma

CMS nursing home

Bradbury Commons

PONCA CITY, OK

CMS CCN 3755215803707132Listed in the current CMS nursing-home directoryCMS source updated August 1, 2026

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Independent research from official CMS public records. No paid ranking. No Trust Hub quality score.

Research this nursing home using CMS and federal public records. CMS Certification Number 375521.

At a glance

CMS research snapshot

CMS overall rating

4 of 5

CMS health inspection rating

5 of 5

CMS staffing rating

1 of 5

CMS quality-measure rating

3 of 5

CMS ownership-change history

No attached CMS ownership-change event.

These are CMS star ratings, not Trust Hub ratings. Missing evidence is shown as not reported, not as zero.

Quality & care evidence

What CMS reports about quality

  • MDS quality observations are in the CMS extract.
  • PBJ staffing records are in the CMS extract.
  • Inspection evidence is in the CMS extract.
  • Fire-safety evidence is in the CMS extract.

Staffing, inspections, and fire safety are separate CMS evidence families below.

Ownership & management

Who CMS/PECOS connects to this nursing home

Current ownership uses CURRENT OWNED_BY evidence only. UNKNOWN is not a former owner.

Current owners

  • GREEN, KIMIndividual ownerDIRECT OWNERSHIP INTEREST
  • YATES, MICHAELIndividual ownerDIRECT OWNERSHIP INTEREST

Operators

  • GREEN, KIMIndividual owner · CURRENTOPERATIONAL/MANAGERIAL CONTROL
  • PH HEALTHCARE FUND VIII LLCOrganization · CURRENTOPERATIONAL/MANAGERIAL CONTROL
  • REYNOLDS, RYANIndividual owner · CURRENTOPERATIONAL/MANAGERIAL CONTROL
  • SAGE BRADBURY COMMONSOrganization · CURRENTOPERATIONAL/MANAGERIAL CONTROL
  • SAGE INTEGRATED HEALTH LLCOrganization · CURRENTOPERATIONAL/MANAGERIAL CONTROL
  • STACKED STONE PONCA LLCOrganization · CURRENTOPERATIONAL/MANAGERIAL CONTROL
  • YATES, MICHAELIndividual owner · CURRENTOPERATIONAL/MANAGERIAL CONTROL
  • YOUNG, ADAMIndividual owner · CURRENTOPERATIONAL/MANAGERIAL CONTROL
  • ASCENSION HEALTH SENIOR CAREOrganization · UNKNOWNOPERATIONAL/MANAGERIAL CONTROL
  • SPILLARS, RODGERIndividual owner · UNKNOWNOPERATIONAL/MANAGERIAL CONTROL
  • YOUNG, ADAMIndividual owner · UNKNOWNOPERATIONAL/MANAGERIAL CONTROL

Enrollment organizations

  • SAGE BRADBURY COMMONSOrganization · CURRENTMedicare-enrolled legal organization
  • VIA CHRISTI VILLAGE PONCA CITY, INC.Organization · UNKNOWNMedicare-enrolled legal organization
Ownership observations with UNKNOWN status

These relationships were observed in an older snapshot. UNKNOWN does not mean former owner, previous owner, or that ownership ended.

UNKNOWN

  • VIA CHRISTI VILLAGES INCOrganization · UNKNOWN5% OR GREATER DIRECT OWNERSHIP INTEREST100% ownership interest

Ownership change history

CMS ownership-change records

No CMS ownership-change event is currently attached to this profile in the Trust Hub research graph. That is not proof that ownership never changed.

Source freshness

How current each evidence family is

nursing-home-mds-quality-measures
STALE · source as of 2026-08-01
nursing-home-provider-information
STALE · source as of 2026-08-01
skilled-nursing-facility-all-owners
AGING · source as of 2026-08-17
skilled-nursing-facility-change-of-ownership
CURRENT · source as of 2026-08-24

Profile generated 2026-11-04. That timestamp is not CMS evidence freshness.

Methodology

How Trust Hub researches this provider

  • CMS is the source for national nursing-home evidence.
  • Trust Hub does not create the CMS star ratings.
  • Ownership evidence does not measure care quality.
  • CMS CHOW records document reported ownership-change events.
  • Missing evidence is not interpreted as zero.
  • UNKNOWN ownership history is not interpreted as divestiture.
  • Ownership evidence is not a quality measure.
  • Missing evidence is not a zero score.
  • CMS ratings are CMS ratings, not Trust Hub ratings.
  • UNKNOWN ownership does not prove an owner left.
  • CHOW records are CMS transaction records, not Trust Hub judgments or sales.

CMS overview

CMS rating overview

CMS overall

4 of 5

Health inspection

5 of 5

Staffing

1 of 5

Quality measures

3 of 5

No proprietary TrustHub score. These ratings are published separately by CMS. How CMS ratings and facility records are read

CMS certified beds
68
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
5803707132CMS Provider Information

CMS designations

Special Focus and abuse-icon status

This CMS Certification Number appears in the latest CMS Nursing Home Provider Information extract of currently listed nursing homes.

Not currently SFF or candidate

CMS does not currently identify this nursing home as a Special Focus Facility or candidate in the loaded Provider Information extract.

CMS field value: (blank). Observed Aug 1, 2026.

CMS abuse-icon designation

CMS does not currently apply its abuse-icon designation to this facility in the loaded Provider Information extract.

CMS field value: N. Observed Aug 1, 2026.

Enrollment identity

Medicare enrollment organization NPI associated with this CMS Certification Number

These identifiers come from CMS SNF enrollment records linked to this CCN. They are not a substitute for the CMS Certification Number.

  • NPI 1215150297 · enrollment O20080109000540
  • NPI 1780562835 · enrollment O20260219000304

MDS quality measures

Individual CMS quality measures

These MDS quality measures are individual CMS-published scores. They are not the CMS quality-measure star rating.

MDS source release 2026-08-01.

View individual MDS measures
  • Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine (Long Stay): 90.810811
  • Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine (Long Stay): 95.918367
  • Percentage of long-stay residents experiencing one or more falls with major injury (Long Stay): 4.864865 · CMS uses this measure in the quality-measure star rating
  • Percentage of long-stay residents who have depressive symptoms (Long Stay): 9.090909
  • Percentage of long-stay residents who lose too much weight (Long Stay): 9.677419
  • Percentage of long-stay residents who received an antianxiety or hypnotic medication (Long Stay): 11.023622
  • Percentage of long-stay residents who received an antipsychotic medication (Long Stay): 4.587156 · CMS uses this measure in the quality-measure star rating
  • Percentage of long-stay residents who were physically restrained (Long Stay): 0.000000
  • Percentage of long-stay residents whose ability to walk independently worsened (Long Stay): 13.588057 · CMS uses this measure in the quality-measure star rating
  • Percentage of long-stay residents whose need for help with daily activities has increased (Long Stay): 29.032258 · CMS uses this measure in the quality-measure star rating
  • Percentage of long-stay residents with a catheter inserted and left in their bladder (Long Stay): 1.336253 · CMS uses this measure in the quality-measure star rating
  • Percentage of long-stay residents with a urinary tract infection (Long Stay): 2.747253 · CMS uses this measure in the quality-measure star rating
  • Percentage of long-stay residents with new or worsened bowel or bladder incontinence (Long Stay): 33.018483
  • Percentage of long-stay residents with pressure ulcers (Long Stay): 6.702333 · CMS uses this measure in the quality-measure star rating
  • Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine (Short Stay): 72.062663
  • Percentage of short-stay residents who newly received an antipsychotic medication (Short Stay): 2.419355 · CMS uses this measure in the quality-measure star rating
  • Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine (Short Stay): 77.083333

Fire-safety citations

CMS fire-safety citations

These are fire-safety citations, not health deficiencies and not a count of fires.

  • 2024-07-03 · tag 0321 · scope/severity E — Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
  • 2024-07-03 · tag 0374 · scope/severity E — Install smoke barrier doors that can resist smoke for at least 20 minutes.
  • 2024-07-03 · tag 0712 · scope/severity C — Have simulated fire drills held at unexpected times.
  • 2023-05-25 · tag 0222 · scope/severity F — Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
  • 2023-05-25 · tag 0353 · scope/severity F — Inspect, test, and maintain automatic sprinkler systems.
  • 2023-05-25 · tag 0761 · scope/severity F — To conduct inspection, testing and maintenance of fire doors by qualified individuals.
  • 2023-05-25 · tag 0372 · scope/severity E — Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
  • 2023-05-25 · tag 0374 · scope/severity E — Install smoke barrier doors that can resist smoke for at least 20 minutes.
  • 2019-07-11 · tag 0363 · scope/severity E — Install corridor and hallway doors that block smoke.
  • 2019-07-11 · tag 0222 · scope/severity E — Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
  • 2019-07-11 · tag 0321 · scope/severity E — Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

Decision guide

What to review

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

Staffing

CMS publishes a 1-star staffing rating for this facility.

RN staffing was 0.34 hours per resident day in 2025Q3, calculated from CMS PBJ records.

View staffing 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

Who is behind this facility?

SeniorTrustHub found evidence connecting this facility to:

  • CMS reports 12 individual ownership interests

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
23
Organizations shown
11
Individuals shown
12
Latest ownership source update
Aug 17, 2026

CMS-published ownership and control parties

  • PH HEALTHCARE FUND VIII LLC

    Organization · 5% OR GREATER MORTGAGE INTEREST

    Association date reported to CMS: Oct 1, 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
    Aug 1, 2026
    Retrieved
    Aug 26, 2026
    View official CMS source
  • GREEN, KIM

    Individual · ADP OF THE SNF

    Association date reported to CMS: Oct 1, 2025

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Aug 1, 2026
    Retrieved
    Aug 26, 2026
    View official CMS source
  • GT PONCA HOLDCO LLC

    Organization · ADP OF THE SNF

    Association date reported to CMS: Oct 1, 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
    Aug 1, 2026
    Retrieved
    Aug 26, 2026
    View official CMS source
  • PH HEALTHCARE FUND VIII LLC

    Organization · ADP OF THE SNF

    Association date reported to CMS: Oct 1, 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
    Aug 1, 2026
    Retrieved
    Aug 26, 2026
    View official CMS source
  • REYNOLDS, RYAN

    Individual · ADP OF THE SNF

    Association date reported to CMS: Oct 1, 2025

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Aug 1, 2026
    Retrieved
    Aug 26, 2026
    View official CMS source
  • SAGE BRADBURY COMMONS

    Organization · ADP OF THE SNF

    Association date reported to CMS: Oct 13, 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
    Aug 1, 2026
    Retrieved
    Aug 26, 2026
    View official CMS source
  • SAGE INTEGRATED HEALTH LLC

    Organization · ADP OF THE SNF

    Association date reported to CMS: Oct 13, 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
    Aug 1, 2026
    Retrieved
    Aug 26, 2026
    View official CMS source
  • STACKED STONE PONCA LLC

    Organization · ADP OF THE SNF

    Association date reported to CMS: Oct 1, 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
    Aug 1, 2026
    Retrieved
    Aug 26, 2026
    View official CMS source
  • YATES, MICHAEL

    Individual · ADP OF THE SNF

    Association date reported to CMS: Oct 1, 2025

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Aug 1, 2026
    Retrieved
    Aug 26, 2026
    View official CMS source
  • YOUNG, ADAM

    Individual · ADP OF THE SNF

    Association date reported to CMS: Oct 1, 2025

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Aug 1, 2026
    Retrieved
    Aug 26, 2026
    View official CMS source
  • GREEN, KIM

    Individual · CORPORATE OFFICER

    Association date reported to CMS: Oct 1, 2025

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Aug 1, 2026
    Retrieved
    Aug 26, 2026
    View official CMS source
  • YATES, MICHAEL

    Individual · CORPORATE OFFICER

    Association date reported to CMS: Oct 1, 2025

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Aug 1, 2026
    Retrieved
    Aug 26, 2026
    View official CMS source
  • GREEN, KIM

    Individual · DIRECT OWNERSHIP INTEREST

    Association date reported to CMS: Oct 1, 2025

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Aug 1, 2026
    Retrieved
    Aug 26, 2026
    View official CMS source
  • YATES, MICHAEL

    Individual · DIRECT OWNERSHIP INTEREST

    Association date reported to CMS: Oct 1, 2025

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Aug 1, 2026
    Retrieved
    Aug 26, 2026
    View official CMS source
  • GREEN, KIM

    Individual · OPERATIONAL/MANAGERIAL CONTROL

    Association date reported to CMS: Oct 1, 2025

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Aug 1, 2026
    Retrieved
    Aug 26, 2026
    View official CMS source
  • PH HEALTHCARE FUND VIII LLC

    Organization · OPERATIONAL/MANAGERIAL CONTROL

    Association date reported to CMS: Oct 1, 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
    Aug 1, 2026
    Retrieved
    Aug 26, 2026
    View official CMS source
  • REYNOLDS, RYAN

    Individual · OPERATIONAL/MANAGERIAL CONTROL

    Association date reported to CMS: Oct 1, 2025

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Aug 1, 2026
    Retrieved
    Aug 26, 2026
    View official CMS source
  • SAGE BRADBURY COMMONS

    Organization · OPERATIONAL/MANAGERIAL CONTROL

    Association date reported to CMS: Oct 1, 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
    Aug 1, 2026
    Retrieved
    Aug 26, 2026
    View official CMS source
  • SAGE INTEGRATED HEALTH LLC

    Organization · OPERATIONAL/MANAGERIAL CONTROL

    Association date reported to CMS: Oct 1, 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
    Aug 1, 2026
    Retrieved
    Aug 26, 2026
    View official CMS source
  • STACKED STONE PONCA LLC

    Organization · OPERATIONAL/MANAGERIAL CONTROL

    Association date reported to CMS: Oct 1, 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
    Aug 1, 2026
    Retrieved
    Aug 26, 2026
    View official CMS source
  • YATES, MICHAEL

    Individual · OPERATIONAL/MANAGERIAL CONTROL

    Association date reported to CMS: Oct 1, 2025

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Aug 1, 2026
    Retrieved
    Aug 26, 2026
    View official CMS source
  • YOUNG, ADAM

    Individual · OPERATIONAL/MANAGERIAL CONTROL

    Association date reported to CMS: Oct 1, 2025

    View ownership source details
    Source organization
    Centers for Medicare & Medicaid Services (CMS)
    Dataset
    Ownership
    CMS dataset identifier
    y2hd-n93e
    Source updated
    Aug 1, 2026
    Retrieved
    Aug 26, 2026
    View official CMS source
  • SAGE BRADBURY COMMONS

    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
    Aug 17, 2026
    Retrieved
    Aug 26, 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?

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
Jul 3, 2024
Survey type
Fire Safety Standard
Linked findings
0
Highest linked CMS classification
No linked health-deficiency finding in the loaded record
View source details
Dataset
Inspection Dates
CMS dataset ID
svdt-c123
CMS source updated
Aug 1, 2026
CMS provider ID
375521
Source record locator
csv-row:103013:ccn:375521
View official CMS source
Jul 3, 2024 — Fire Safety Standard — 0 linked findings

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

Jul 3, 2024 — Health Standard — 0 linked findings

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

May 25, 2023 — Fire Safety Standard — 0 linked findings

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

May 25, 2023 — Health Standard — 0 linked findings

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

Jul 11, 2019 — Fire Safety Standard — 0 linked findings

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

Jul 11, 2019 — Health Standard — 7 linked findings
  • F0578 — Resident Rights Deficiencies

    Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.

    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 (Aug 13, 2019)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Aug 1, 2026
    CMS provider ID
    375521
    Source record locator
    csv-row:286982:ccn:375521
    View official CMS source
  • F0622 — Resident Rights Deficiencies

    Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.

    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 13, 2019)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Aug 1, 2026
    CMS provider ID
    375521
    Source record locator
    csv-row:286985:ccn:375521
    View official CMS source
  • F0661 — Resident Assessment and Care Planning Deficiencies

    Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.

    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 13, 2019)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Aug 1, 2026
    CMS provider ID
    375521
    Source record locator
    csv-row:286986:ccn:375521
    View official CMS source
  • F0695 — Quality of Life and Care Deficiencies

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

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

    Correction status: Deficient, Provider has date of correction (Aug 13, 2019)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Aug 1, 2026
    CMS provider ID
    375521
    Source record locator
    csv-row:286981:ccn:375521
    View official CMS source
  • F0755 — Pharmacy Service Deficiencies

    Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

    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 (Aug 13, 2019)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Aug 1, 2026
    CMS provider ID
    375521
    Source record locator
    csv-row:286983:ccn:375521
    View official CMS source
  • F0758 — Pharmacy 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 (Aug 13, 2019)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Aug 1, 2026
    CMS provider ID
    375521
    Source record locator
    csv-row:286984:ccn:375521
    View official CMS source
  • F0880 — Infection 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 (Aug 13, 2019)

    View source details
    Dataset
    Health Deficiencies
    CMS dataset ID
    r5ix-sfxw
    CMS source updated
    Aug 1, 2026
    CMS provider ID
    375521
    Source record locator
    csv-row:286987:ccn:375521
    View official CMS source

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.

Facility history

Facility History

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

What changed recently?

  • RN staffing decreasedRN staffing decreased from 0.47 to 0.34 hours per resident day between 2025Q2 and 2025Q3. Staffing declined across those reported periods.

2025

  1. RN staffing decreased

    RN staffing decreased from 0.47 to 0.34 hours per resident day between 2025Q2 and 2025Q3. Staffing declined across those reported periods.

    0.47 → 0.34

    CMS · Reported in a source release · View related evidence

2024

  1. Health inspection completed

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

    CMS · Recorded event date · View related evidence

2023

  1. Health inspection completed

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

    CMS · Recorded event date · View related evidence

2019

  1. Health inspection completed

    7 deficiencies were recorded. That includes 1 higher-severity deficiency.

    CMS · Recorded event date · View related evidence

Staffing

Reported nursing staffing at a glance

CMS staffing rating: 1 of 5 stars. CMS calculates that rating separately using its published methodology. The values below are calculations from daily PBJ records for 2025Q3 (current source quarter).

Inspect a PBJ quarter
Total nursing
3.579
reported hours per resident day
RN categories
0.34
reported hours per resident day
LPN/LVN categories
0.832
reported hours per resident day
CNA
1.738
reported hours per resident day

Weekday and weekend calculations

2025Q3 reported hours per resident day
MeasureMonday–FridaySaturday–Sunday
Total nursing3.7213.219
RN categories0.3790.242

Contract staff accounted for 9.1% of reported nursing hours included in this quarter calculation.

PBJ reports zero combined RN-category hours on 3 days with a positive MDS census in this quarter.

Reported RN-category hours per resident day were 0.126 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
2025Q23.6550.4660.7671.81114.6%91
2025Q33.5790.340.8321.7389.1%92

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
2025Q3
Coverage
Jul 1, 2025–Sep 30, 2025
Days represented
92 (92 with positive MDS census)
CMS source updated
Feb 5, 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 5-star health inspection rating.
  • CMS reports a 1-star staffing rating.
  • CMS reports a 3-star quality-measure rating.

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Provider Information
Source organization
Centers for Medicare & Medicaid Services (CMS)
Dataset identifier
4pq5-n9py
Source updated
Aug 1, 2026
Retrieved
Aug 26, 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
Aug 1, 2026
Retrieved
Aug 26, 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
Aug 1, 2026
Retrieved
Aug 26, 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–Sep 30, 2025
Source updated
Feb 5, 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
Aug 1, 2026
Retrieved
Aug 26, 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
Aug 17, 2026
Retrieved
Aug 26, 2026
Supports
Ownership parties, organization connections, and ownership history
View official CMS source

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