Staffing
CMS publishes a 3-star staffing rating for this facility.
RN staffing was 0.61 hours per resident day in 2026Q1, calculated from CMS PBJ records.
View staffing evidenceFacility record
Bayberry Commons has 110 certified beds in Pascoag, Rhode Island. The CMS overall rating is 2 of 5, compared with the Rhode Island average of 2.9. The CMS health inspection rating is 3 of 5, compared with the Rhode Island average of 2.8. The CMS staffing rating is 3 of 5. The latest standard health survey on Jul 18, 2025 lists 4 deficiencies, compared with the Rhode Island average of 6.1. CMS records a fine of $19,136 dated Feb 20, 2025. CMS records a fine of $24,794 dated Dec 19, 2024. CMS records a fine of $8,018 dated Jul 11, 2024. Total nurse staffing is 3.49 hours per resident day in 2026Q1, compared with the Rhode Island average of 3.72.
Nearby facilities
- Crystal Lake Rehabilitation and Care Center Pascoag
- Overlook Nursing and Rehabilitation Center Pascoag
- AdviniaCare Oakland Grove LLC Woonsocket
- AdviniaCare Orchard, LLC East Providence
- Adviniacare Pawtucket Pleasant Rehab Center, LLC Pawtucket
- Adviniacare Providence Dodge Rehab Center, LLC Providence
- AdviniaCare Summit Commons, LLC Providence
- AdviniaCare Waterview Villas, LLC East Providence
- Berkshire Place Providence
- Bethany Home of Rhode Island Providence
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 415080.
At a glance
CMS research snapshot
CMS overall rating
2 of 5
CMS health inspection rating
3 of 5
CMS staffing rating
3 of 5
CMS quality-measure rating
1 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.
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
- DAVID RYAN FAMILY ASSOCIATES LLCOrganization5% OR GREATER DIRECT OWNERSHIP INTEREST99% ownership interest
- DAVID RYAN FAMILY ASSOCIATES LLCOrganization5% OR GREATER DIRECT OWNERSHIP INTEREST99% ownership interest
Operators
- ARNOLD, KELLYIndividual owner · CURRENTOPERATIONAL/MANAGERIAL CONTROL
- ARNOLD, KELLYIndividual owner · CURRENTOPERATIONAL/MANAGERIAL CONTROL
- DAVID RYAN FAMILY ASSOCIATES LLCOrganization · CURRENTOPERATIONAL/MANAGERIAL CONTROL
- DAVID RYAN FAMILY ASSOCIATES LLCOrganization · CURRENTOPERATIONAL/MANAGERIAL CONTROL
- HEALTH CONCEPTS LTDOrganization · CURRENTOPERATIONAL/MANAGERIAL CONTROL
- HEALTH CONCEPTS LTDOrganization · CURRENTOPERATIONAL/MANAGERIAL CONTROL0% ownership interest
- ARNOLD, KELLYIndividual owner · UNKNOWNOPERATIONAL/MANAGERIAL CONTROL
- ARNOLD, KELLYIndividual owner · UNKNOWNOPERATIONAL/MANAGERIAL CONTROL
- DAVID RYAN FAMILY ASSOCIATES LLCOrganization · UNKNOWNOPERATIONAL/MANAGERIAL CONTROL
- DAVID RYAN FAMILY ASSOCIATES LLCOrganization · UNKNOWNOPERATIONAL/MANAGERIAL CONTROL
- HEALTH CONCEPTS LTDOrganization · UNKNOWNOPERATIONAL/MANAGERIAL CONTROL0% ownership interest
- HEALTH CONCEPTS LTDOrganization · UNKNOWNOPERATIONAL/MANAGERIAL CONTROL
Managers
- ALTONGY-BOUDJOUK, JENNIFERIndividual owner · CURRENTW-2 MANAGING EMPLOYEE
- ALTONGY-BOUDJOUK, JENNIFERIndividual owner · CURRENTW-2 MANAGING EMPLOYEE
- KEENE, DEBRAIndividual owner · CURRENTW-2 MANAGING EMPLOYEE
- KEENE, DEBRAIndividual owner · CURRENTW-2 MANAGING EMPLOYEE
- ALTONGY-BOUDJOUK, JENNIFERIndividual owner · UNKNOWNW-2 MANAGING EMPLOYEE
- ALTONGY-BOUDJOUK, JENNIFERIndividual owner · UNKNOWNW-2 MANAGING EMPLOYEE
- KEENE, DEBRAIndividual owner · UNKNOWNW-2 MANAGING EMPLOYEE
- KEENE, DEBRAIndividual owner · UNKNOWNW-2 MANAGING EMPLOYEE
Enrollment organizations
- BURRILLVILLE HEALTH CENTEROrganization · CURRENTMedicare-enrolled legal organization
- BURRILLVILLE HEALTH CENTEROrganization · 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
- DAVID RYAN FAMILY ASSOCIATES LLCOrganization · UNKNOWN5% OR GREATER DIRECT OWNERSHIP INTEREST99% ownership interest
- DAVID RYAN FAMILY ASSOCIATES LLCOrganization · UNKNOWN5% OR GREATER DIRECT OWNERSHIP INTEREST99% 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 2026-11-03. 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
No proprietary TrustHub score. These ratings are published separately by CMS. How CMS ratings and facility records are read
- CMS certified beds
- 110
- 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
- 4015680600Verified public information · checked Aug 2026
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 1073554812 · enrollment O20071218000347
- NPI 1073554812 · enrollment O20071218000347
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): 78.409091
- Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine (Long Stay): 89.898990
- Percentage of long-stay residents experiencing one or more falls with major injury (Long Stay): 7.954545 · CMS uses this measure in the quality-measure star rating
- Percentage of long-stay residents who have depressive symptoms (Long Stay): 13.084112
- Percentage of long-stay residents who lose too much weight (Long Stay): 7.348243
- Percentage of long-stay residents who received an antianxiety or hypnotic medication (Long Stay): 23.101266
- Percentage of long-stay residents who received an antipsychotic medication (Long Stay): 35.925926 · 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): 15.995710 · 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): 34.397163 · 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): 0.000000 · CMS uses this measure in the quality-measure star rating
- Percentage of long-stay residents with a urinary tract infection (Long Stay): 5.157593 · 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): 22.126739
- Percentage of long-stay residents with pressure ulcers (Long Stay): 3.937377 · CMS uses this measure in the quality-measure star rating
- Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine (Short Stay): 49.180328
- Percentage of short-stay residents who newly received an antipsychotic medication (Short Stay): 2.857143 · 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): 64.406780
Decision guide
What to review
Factual evidence to examine before you decide. These summaries are not a score or recommendation.
Inspections
The latest standard inspection on Jul 18, 2025 cited 4 deficiencies.
View inspection evidenceOwnership
CMS-published records list 17 ownership or control parties.
View ownership evidenceEnforcement record
CMS records show a $19,136 fine 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
- 6Current CMS organization identity
Who is behind this facility?
SeniorTrustHub found evidence connecting this facility to:
- 2 CMS-reported ownership organizations
- CMS reports 10 individual ownership interests
Related facilities
6 currently connected nursing homes share this CMS organization identity with HEALTH CONCEPTS LTD.
- Average CMS overall rating
- 3.3 stars across 6 reporting facilities
- CMS monetary penalties
- 3 of 6 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
- $74,035
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
- 17
- Organizations shown
- 7
- Individuals shown
- 10
- Latest ownership source update
- Aug 17, 2026
CMS-published ownership and control parties
DAVID RYAN FAMILY ASSOCIATES LLC
Organization · 5% OR GREATER DIRECT OWNERSHIP INTEREST
Published ownership percentage: 99%
Association date reported to CMS: Dec 20, 2007
Other facilities connected through this exact CMS organization identity: 0 across RI.
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
CARRAGHER, TERRY
Individual · CORPORATE OFFICER
Association date reported to CMS: Jan 1, 2005
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
RYAN, DAVID
Individual · CORPORATE OFFICER
Association date reported to CMS: Jan 1, 2005
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
ARNOLD, KELLY
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Jan 20, 2017
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
DAVID RYAN FAMILY ASSOCIATES LLC
Organization · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Dec 20, 2007
Other facilities connected through this exact CMS organization identity: 0 across RI.
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
HEALTH CONCEPTS LTD
Organization · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Dec 20, 2007
Other facilities connected through this exact CMS organization identity: 0 across RI.
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
ALTONGY-BOUDJOUK, JENNIFER
Individual · W-2 MANAGING EMPLOYEE
Association date reported to CMS: Sep 13, 2021
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
KEENE, DEBRA
Individual · W-2 MANAGING EMPLOYEE
Association date reported to CMS: Feb 14, 1985
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
DAVID RYAN FAMILY ASSOCIATES LLC
Organization · 5% OR GREATER DIRECT OWNERSHIP INTEREST
Published ownership percentage: 99%
Association date reported to CMS: Dec 20, 2007
Other facilities connected through this exact CMS organization identity: 0 across RI.
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
- Aug 17, 2026
- Retrieved
- Aug 26, 2026
CARRAGHER, TERRY
Individual · CORPORATE OFFICER
Association date reported to CMS: Jan 1, 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
- Aug 17, 2026
- Retrieved
- Aug 26, 2026
RYAN, DAVID
Individual · CORPORATE OFFICER
Association date reported to CMS: Jan 1, 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
- Aug 17, 2026
- Retrieved
- Aug 26, 2026
ARNOLD, KELLY
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Jan 20, 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
- Aug 17, 2026
- Retrieved
- Aug 26, 2026
DAVID RYAN FAMILY ASSOCIATES LLC
Organization · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Dec 20, 2007
Other facilities connected through this exact CMS organization identity: 0 across RI.
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
- Aug 17, 2026
- Retrieved
- Aug 26, 2026
HEALTH CONCEPTS LTD
Organization · OPERATIONAL/MANAGERIAL CONTROL
Published ownership percentage: 0%
Association date reported to CMS: Dec 20, 2007
Other facilities connected through this exact CMS organization identity: 5 across RI.
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
- Aug 17, 2026
- Retrieved
- Aug 26, 2026
ALTONGY-BOUDJOUK, JENNIFER
Individual · W-2 MANAGING EMPLOYEE
Association date reported to CMS: Sep 13, 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
- Aug 17, 2026
- Retrieved
- Aug 26, 2026
KEENE, DEBRA
Individual · W-2 MANAGING EMPLOYEE
Association date reported to CMS: Feb 14, 1985
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
- Aug 17, 2026
- Retrieved
- Aug 26, 2026
BURRILLVILLE HEALTH CENTER
Organization · Medicare-enrolled legal organization
Other facilities connected through this exact CMS organization identity: 0 across RI.
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
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 HEALTH CONCEPTS LTD to 6 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
- Jul 18, 2025
- 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
- 415080
- Source record locator
- csv-row:112664:ccn:415080
Jul 18, 2025 — Fire Safety Standard — 0 linked findings
No health-deficiency rows were deterministically linked to this inspection.
Jul 18, 2025 — Health Standard — 4 linked findings
F0658 — Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
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 17, 2025)
View source details
- Dataset
- Health Deficiencies
- CMS dataset ID
- r5ix-sfxw
- CMS source updated
- Aug 1, 2026
- CMS provider ID
- 415080
- Source record locator
- csv-row:314967:ccn:415080
F0756 — Pharmacy Service Deficiencies
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Aug 17, 2025)
View source details
- Dataset
- Health Deficiencies
- CMS dataset ID
- r5ix-sfxw
- CMS source updated
- Aug 1, 2026
- CMS provider ID
- 415080
- Source record locator
- csv-row:314965:ccn:415080
F0842 — Resident 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 (Aug 17, 2025)
View source details
- Dataset
- Health Deficiencies
- CMS dataset ID
- r5ix-sfxw
- CMS source updated
- Aug 1, 2026
- CMS provider ID
- 415080
- Source record locator
- csv-row:314968:ccn:415080
F0880 — Infection 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 (Aug 17, 2025)
View source details
- Dataset
- Health Deficiencies
- CMS dataset ID
- r5ix-sfxw
- CMS source updated
- Aug 1, 2026
- CMS provider ID
- 415080
- Source record locator
- csv-row:314966:ccn:415080
Jul 3, 2025 — Health Complaint — 1 linked finding
F0657 — Resident 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 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 2, 2025)
View source details
- Dataset
- Health Deficiencies
- CMS dataset ID
- r5ix-sfxw
- CMS source updated
- Aug 1, 2026
- CMS provider ID
- 415080
- Source record locator
- csv-row:314969:ccn:415080
Feb 20, 2025 — Health Complaint — 2 linked findings
F0580 — Resident 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 G: Isolated; Actual harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Mar 22, 2025)
View source details
- Dataset
- Health Deficiencies
- CMS dataset ID
- r5ix-sfxw
- CMS source updated
- Aug 1, 2026
- CMS provider ID
- 415080
- Source record locator
- csv-row:314970:ccn:415080
F0658 — Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
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 22, 2025)
View source details
- Dataset
- Health Deficiencies
- CMS dataset ID
- r5ix-sfxw
- CMS source updated
- Aug 1, 2026
- CMS provider ID
- 415080
- Source record locator
- csv-row:314971:ccn:415080
Dec 19, 2024 — Health Complaint — 1 linked finding
F0600 — Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
CMS scope/severity J: Isolated; Immediate jeopardy to resident health or safety.
Correction status: Deficient, Provider has date of correction (Jan 7, 2025)
View source details
- Dataset
- Health Deficiencies
- CMS dataset ID
- r5ix-sfxw
- CMS source updated
- Aug 1, 2026
- CMS provider ID
- 415080
- Source record locator
- csv-row:314972:ccn:415080
Aug 15, 2024 — Health Complaint — 2 linked findings
F0695 — Quality 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 (Sep 4, 2024)
View source details
- Dataset
- Health Deficiencies
- CMS dataset ID
- r5ix-sfxw
- CMS source updated
- Aug 1, 2026
- CMS provider ID
- 415080
- Source record locator
- csv-row:314973:ccn:415080
F0842 — Resident 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 (Sep 4, 2024)
View source details
- Dataset
- Health Deficiencies
- CMS dataset ID
- r5ix-sfxw
- CMS source updated
- Aug 1, 2026
- CMS provider ID
- 415080
- Source record locator
- csv-row:314974:ccn:415080
Aug 5, 2024 — Health Complaint — 1 linked finding
F0689 — Quality 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 (Sep 4, 2024)
View source details
- Dataset
- Health Deficiencies
- CMS dataset ID
- r5ix-sfxw
- CMS source updated
- Aug 1, 2026
- CMS provider ID
- 415080
- Source record locator
- csv-row:314975:ccn:415080
Jul 11, 2024 — Fire Safety Standard — 0 linked findings
No health-deficiency rows were deterministically linked to this inspection.
Jul 11, 2024 — Health Standard — 6 linked findings
F0604 — Freedom from Abuse, Neglect, and Exploitation Deficiencies
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
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 10, 2024)
View source details
- Dataset
- Health Deficiencies
- CMS dataset ID
- r5ix-sfxw
- CMS source updated
- Aug 1, 2026
- CMS provider ID
- 415080
- Source record locator
- csv-row:314976:ccn:415080
F0636 — Resident 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 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 10, 2024)
View source details
- Dataset
- Health Deficiencies
- CMS dataset ID
- r5ix-sfxw
- CMS source updated
- Aug 1, 2026
- CMS provider ID
- 415080
- Source record locator
- csv-row:314977:ccn:415080
F0641 — Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
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 10, 2024)
View source details
- Dataset
- Health Deficiencies
- CMS dataset ID
- r5ix-sfxw
- CMS source updated
- Aug 1, 2026
- CMS provider ID
- 415080
- Source record locator
- csv-row:314978:ccn:415080
F0684 — Quality 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 (Aug 10, 2024)
View source details
- Dataset
- Health Deficiencies
- CMS dataset ID
- r5ix-sfxw
- CMS source updated
- Aug 1, 2026
- CMS provider ID
- 415080
- Source record locator
- csv-row:314980:ccn:415080
F0805 — Nutrition and Dietary Deficiencies
Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
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 10, 2024)
View source details
- Dataset
- Health Deficiencies
- CMS dataset ID
- r5ix-sfxw
- CMS source updated
- Aug 1, 2026
- CMS provider ID
- 415080
- Source record locator
- csv-row:314981:ccn:415080
F0880 — Infection 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 (Aug 10, 2024)
View source details
- Dataset
- Health Deficiencies
- CMS dataset ID
- r5ix-sfxw
- CMS source updated
- Aug 1, 2026
- CMS provider ID
- 415080
- Source record locator
- csv-row:314979:ccn:415080
Jun 22, 2023 — Fire Safety Standard — 0 linked findings
No health-deficiency rows were deterministically linked to this inspection.
Jun 22, 2023 — Health Standard — 3 linked findings
F0686 — Quality 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 22, 2023)
View source details
- Dataset
- Health Deficiencies
- CMS dataset ID
- r5ix-sfxw
- CMS source updated
- Aug 1, 2026
- CMS provider ID
- 415080
- Source record locator
- csv-row:314982:ccn:415080
F0760 — Pharmacy 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 (Jul 22, 2023)
View source details
- Dataset
- Health Deficiencies
- CMS dataset ID
- r5ix-sfxw
- CMS source updated
- Aug 1, 2026
- CMS provider ID
- 415080
- Source record locator
- csv-row:314983:ccn:415080
F0761 — Pharmacy Service Deficiencies
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jul 22, 2023)
View source details
- Dataset
- Health Deficiencies
- CMS dataset ID
- r5ix-sfxw
- CMS source updated
- Aug 1, 2026
- CMS provider ID
- 415080
- Source record locator
- csv-row:314984:ccn:415080
Tags appearing across inspections
- F0658 appears in 2 linked inspections.
- F0842 appears in 2 linked inspections.
- F0880 appears in 2 linked inspections.
Penalties & enforcement
CMS penalty records in the loaded three-year dataset
Fine — Feb 20, 2025
Published fine amount: $19,136.00
View source details
- Dataset
- Penalties
- CMS dataset ID
- g6vv-u9sr
- CMS source updated
- Aug 1, 2026
- CMS provider ID
- 415080
- Source record locator
- csv-row:11435:ccn:415080
Fine — Dec 19, 2024
Published fine amount: $24,794.00
View source details
- Dataset
- Penalties
- CMS dataset ID
- g6vv-u9sr
- CMS source updated
- Aug 1, 2026
- CMS provider ID
- 415080
- Source record locator
- csv-row:11436:ccn:415080
Fine — Jul 11, 2024
Published fine amount: $8,018.00
View source details
- Dataset
- Penalties
- CMS dataset ID
- g6vv-u9sr
- CMS source updated
- Aug 1, 2026
- CMS provider ID
- 415080
- Source record locator
- csv-row:11434:ccn:415080
Questions to ask
Questions generated from the evidence above
- CMS records show F0658 in 2 inspections in the available record. What changes has the facility made to address this issue?
- CMS records show F0842 in 2 inspections in the available record. What changes has the facility made to address this issue?
- CMS records show F0880 in 2 inspections in the available record. What changes has the facility made to address this issue?
- CMS records show a monetary penalty dated Feb 20, 2025. What changes were made after that enforcement action?
Facility history
Facility History
11 historical events available. Dates and values come from published CMS and official state regulator evidence, not a score.
What changed recently?
- Health inspection completed4 deficiencies were recorded.
2025
- Health inspection completed
4 deficiencies were recorded.
CMS · Recorded event date · View related evidence
- Complaint inspection recorded
1 deficiency was recorded.
CMS · Recorded event date · View related evidence
- Complaint inspection recorded
2 deficiencies were recorded. That includes 1 higher-severity deficiency.
CMS · Recorded event date · View related evidence
- Civil monetary penalty recorded
CMS recorded a $19,136 civil monetary penalty.
CMS · Recorded event date · View related evidence
2024
- Complaint inspection recorded
1 deficiencies were recorded. That includes 1 higher-severity deficiency.
CMS · Recorded event date · View related evidence
- Civil monetary penalty recorded
CMS recorded a $24,794 civil monetary penalty.
CMS · Recorded event date · View related evidence
- Complaint inspection recorded
2 deficiencies were recorded.
CMS · Recorded event date · View related evidence
- Complaint inspection recorded
1 deficiencies were recorded. That includes 1 higher-severity deficiency.
CMS · Recorded event date · View related evidence
- Civil monetary penalty recorded
CMS recorded a $8,018 civil monetary penalty.
CMS · Recorded event date · View related evidence
- Health inspection completed
6 deficiencies were recorded.
CMS · Recorded event date · View related evidence
2023
- Health inspection completed
3 deficiencies were 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).
- Total nursing
- 3.489 reported hours per resident day
- RN categories
- 0.608 reported hours per resident day
- LPN/LVN categories
- 0.456 reported hours per resident day
- CNA
- 2.142 reported hours per resident day
Weekday and weekend calculations
| Measure | Monday–Friday | Saturday–Sunday |
|---|---|---|
| Total nursing | 3.663 | 3.062 |
| RN categories | 0.647 | 0.512 |
Contract staff accounted for 13.3% of reported nursing hours included in this quarter calculation.
Reported RN-category hours per resident day were 0.053 higher than the prior loaded quarter.
Staffing over time
Solid bar: Total nursing · Outlined bar: RN categories
| Quarter | Total nursing | RN categories | LPN/LVN | CNA | Contract share | Days |
|---|---|---|---|---|---|---|
| 2025Q2 | 3.462 | 0.642 | 0.436 | 1.989 | 10.2% | 91 |
| 2025Q3 | 3.575 | 0.567 | 0.545 | 2.052 | 7.8% | 92 |
| 2025Q4 | 3.513 | 0.555 | 0.496 | 2.16 | 6.2% | 92 |
| 2026Q1 | 3.489 | 0.608 | 0.456 | 2.142 | 13.3% | 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, 2026–Mar 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 sourceWhat 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 3-star health inspection rating.
- CMS reports a 3-star staffing rating.
- CMS reports a 1-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
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
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
Penalties
- Source organization
- Centers for Medicare & Medicaid Services (CMS)
- Dataset identifier
- g6vv-u9sr
- Source updated
- Aug 1, 2026
- Retrieved
- Aug 26, 2026
- Supports
- Penalties, enforcement, and facility history
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
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
Skilled Nursing Facility All Owners
- Source organization
- Centers for Medicare & Medicaid Services (CMS)
- Dataset identifier
- afe44b85-cc6d-40d7-b5df-00ae8910d1d2
- Source updated
- Aug 17, 2026
- Retrieved
- Aug 26, 2026
- Supports
- Ownership parties, organization connections, and ownership history
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
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.
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