Staffing
CMS publishes a 2-star staffing rating for this facility.
RN staffing was 0.51 hours per resident day in 2026Q1, calculated from CMS PBJ records.
View staffing evidenceAsk Trust Hub Network
Also known publicly as Firesteel Healthcare
MITCHELL, SD
CMS overview
No proprietary TrustHub score. These ratings are published separately by CMS.
Facility information
CMS remains the primary federal record. Public website and additional contact details appear only when independently verified.
Decision guide
Factual evidence to examine before you decide. These summaries are not a score or recommendation.
CMS publishes a 2-star staffing rating for this facility.
RN staffing was 0.51 hours per resident day in 2026Q1, calculated from CMS PBJ records.
View staffing evidenceThe latest standard inspection on Apr 25, 2025 cited 5 deficiencies.
View inspection evidenceCMS-published records list 72 ownership or control parties.
CMS records show an ownership change effective August 2023.
View ownership evidenceCMS groups this facility with a chain covering 44 facilities across 6 states or territories.
View chain evidenceCMS records show a $42,510 fine in the loaded enforcement dataset.
View enforcement evidence →Ownership & operation
Operator, licensee, owner, manager, and chain stay separate. A connected organization is not automatically the party that runs daily operations.
SeniorTrustHub found evidence connecting this facility to:
24 currently connected nursing homes share this CMS organization identity with CH PACIFIC NORTHWEST HOLDINGS LLC.
These figures summarize currently connected CMS-certified nursing homes. Some facilities have incomplete measures; missing values are omitted, not treated as zero. Ownership structures can change. State operator or licensee evidence may differ from CMS ownership disclosures.
Ownership
These are CMS-published ownership disclosures. Medicare enrollment ownership and managerial-control information is reported by enrolled providers through CMS forms; it is not an independent determination of beneficial ownership.
Organization · 5% OR GREATER DIRECT OWNERSHIP INTEREST
Published ownership percentage: 100%
Association date reported to CMS: Aug 31, 2023
Other facilities connected through this exact CMS organization identity: 0 across SD.
Individual · ADP OF THE SNF
Association date reported to CMS: Aug 31, 2023
Organization · ADP OF THE SNF
Association date reported to CMS: Aug 31, 2023
Other facilities connected through this exact CMS organization identity: 0 across SD.
Organization · ADP OF THE SNF
Association date reported to CMS: Mar 7, 2025
Other facilities connected through this exact CMS organization identity: 0 across SD.
Organization · ADP OF THE SNF
Association date reported to CMS: Mar 12, 2025
Other facilities connected through this exact CMS organization identity: 0 across SD.
Organization · ADP OF THE SNF
Association date reported to CMS: Jul 31, 2025
Other facilities connected through this exact CMS organization identity: 0 across SD.
Organization · ADP OF THE SNF
Association date reported to CMS: May 13, 2025
Other facilities connected through this exact CMS organization identity: 0 across SD.
Individual · ADP OF THE SNF
Association date reported to CMS: Aug 31, 2023
Individual · ADP OF THE SNF
Association date reported to CMS: Aug 31, 2023
Individual · ADP OF THE SNF
Association date reported to CMS: Aug 31, 2023
Organization · ADP OF THE SNF
Association date reported to CMS: Mar 7, 2025
Other facilities connected through this exact CMS organization identity: 0 across SD.
Individual · ADP OF THE SNF
Association date reported to CMS: Aug 31, 2023
Organization · ADP OF THE SNF
Association date reported to CMS: Mar 12, 2025
Other facilities connected through this exact CMS organization identity: 0 across SD.
Individual · ADP OF THE SNF
Association date reported to CMS: Aug 31, 2023
Organization · ADP OF THE SNF
Association date reported to CMS: Aug 31, 2023
Other facilities connected through this exact CMS organization identity: 0 across SD.
Individual · ADP OF THE SNF
Association date reported to CMS: Aug 31, 2023
Individual · CORPORATE OFFICER
Association date reported to CMS: Aug 31, 2023
Individual · CORPORATE OFFICER
Association date reported to CMS: Aug 31, 2023
Individual · MANAGING CONTROL - GOVERNING BODY
Association date reported to CMS: Aug 31, 2023
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Aug 31, 2023
Organization · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Aug 31, 2023
Other facilities connected through this exact CMS organization identity: 0 across SD.
Organization · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Aug 31, 2023
Other facilities connected through this exact CMS organization identity: 0 across SD.
Organization · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Aug 31, 2023
Other facilities connected through this exact CMS organization identity: 0 across SD.
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Aug 31, 2023
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Aug 31, 2023
Organization · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Aug 31, 2023
Other facilities connected through this exact CMS organization identity: 0 across SD.
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Aug 31, 2023
Organization · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Aug 31, 2023
Other facilities connected through this exact CMS organization identity: 0 across SD.
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Aug 31, 2023
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Aug 31, 2023
Organization · 5% OR GREATER DIRECT OWNERSHIP INTEREST
Published ownership percentage: 100%
Association date reported to CMS: Aug 31, 2023
CMS classifications: Parent company
Other facilities connected through this exact CMS organization identity: 5 across SD.
Organization · 5% OR GREATER INDIRECT OWNERSHIP INTEREST
Published ownership percentage: 66.5%
Association date reported to CMS: Aug 31, 2023
CMS classifications: Holding company
Other facilities connected through this exact CMS organization identity: 23 across MT, NV, OR, SD, WA.
Individual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST
Published ownership percentage: 66.5%
Association date reported to CMS: Aug 31, 2023
Organization · 5% OR GREATER INDIRECT OWNERSHIP INTEREST
Published ownership percentage: 100%
Association date reported to CMS: Aug 31, 2023
Other facilities connected through this exact CMS organization identity: 21 across MT, NV, OR, SD, WA.
Organization · 5% OR GREATER INDIRECT OWNERSHIP INTEREST
Published ownership percentage: 25%
Association date reported to CMS: Aug 31, 2023
Other facilities connected through this exact CMS organization identity: 23 across MT, NV, OR, SD, WA.
Individual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST
Published ownership percentage: 25%
Association date reported to CMS: Aug 31, 2023
Individual · ADP OF THE SNF
Association date reported to CMS: Aug 31, 2023
Organization · ADP OF THE SNF
Association date reported to CMS: Aug 31, 2023
CMS classifications: Holding company
Other facilities connected through this exact CMS organization identity: 23 across MT, NV, OR, SD, WA.
Organization · ADP OF THE SNF
Association date reported to CMS: Mar 7, 2025
CMS classifications: Chain / home office, Management services company
Other facilities connected through this exact CMS organization identity: 34 across MT, NV, OR, SD, WA, WY.
Organization · ADP OF THE SNF
Association date reported to CMS: Mar 12, 2025
CMS classifications: Management services company
Other facilities connected through this exact CMS organization identity: 39 across CA, MT, NV, OR, SD, WA, WY.
Organization · ADP OF THE SNF
Association date reported to CMS: Jul 31, 2025
Other facilities connected through this exact CMS organization identity: 0 across SD.
Organization · ADP OF THE SNF
Association date reported to CMS: May 13, 2025
Other facilities connected through this exact CMS organization identity: 0 across SD.
Individual · ADP OF THE SNF
Association date reported to CMS: Aug 31, 2023
Individual · ADP OF THE SNF
Association date reported to CMS: Aug 31, 2023
Individual · ADP OF THE SNF
Association date reported to CMS: Aug 31, 2023
Organization · ADP OF THE SNF
Association date reported to CMS: Mar 7, 2025
CMS classifications: Management services company
Other facilities connected through this exact CMS organization identity: 24 across MT, NV, OR, SD, WA, WY.
Individual · ADP OF THE SNF
Association date reported to CMS: Aug 31, 2023
Organization · ADP OF THE SNF
Association date reported to CMS: Mar 12, 2025
Other facilities connected through this exact CMS organization identity: 5 across SD.
Individual · ADP OF THE SNF
Association date reported to CMS: Aug 31, 2023
Organization · ADP OF THE SNF
Association date reported to CMS: Aug 31, 2023
Other facilities connected through this exact CMS organization identity: 23 across MT, NV, OR, SD, WA.
Individual · ADP OF THE SNF
Association date reported to CMS: Aug 31, 2023
Individual · CORPORATE OFFICER
Association date reported to CMS: Aug 31, 2023
Individual · CORPORATE OFFICER
Association date reported to CMS: Aug 31, 2023
Organization · INDIRECT OWNERSHIP INTEREST
Published ownership percentage: 2.25%
Association date reported to CMS: Aug 31, 2023
Other facilities connected through this exact CMS organization identity: 0 across SD.
Organization · INDIRECT OWNERSHIP INTEREST
Published ownership percentage: 2.25%
Association date reported to CMS: Aug 31, 2023
Other facilities connected through this exact CMS organization identity: 0 across SD.
Individual · INDIRECT OWNERSHIP INTEREST
Published ownership percentage: 3%
Association date reported to CMS: Aug 31, 2023
Organization · INDIRECT OWNERSHIP INTEREST
Published ownership percentage: 1%
Association date reported to CMS: Aug 31, 2023
CMS classifications: Private equity company
Other facilities connected through this exact CMS organization identity: 0 across SD.
Individual · INDIRECT OWNERSHIP INTEREST
Published ownership percentage: 1%
Association date reported to CMS: Aug 31, 2025
Organization · INDIRECT OWNERSHIP INTEREST
Published ownership percentage: 3%
Association date reported to CMS: Aug 31, 2023
CMS classifications: Holding company
Other facilities connected through this exact CMS organization identity: 0 across SD.
Individual · MANAGING CONTROL - GOVERNING BODY
Association date reported to CMS: Aug 31, 2023
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Aug 31, 2023
Organization · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Aug 31, 2023
CMS classifications: Chain / home office, Management services company
Other facilities connected through this exact CMS organization identity: 34 across MT, NV, OR, SD, WA, WY.
Organization · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Aug 31, 2023
CMS classifications: Management services company
Other facilities connected through this exact CMS organization identity: 39 across CA, MT, NV, OR, SD, WA, WY.
Organization · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Aug 31, 2023
Other facilities connected through this exact CMS organization identity: 0 across SD.
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Aug 31, 2023
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Aug 31, 2023
Organization · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Aug 31, 2023
CMS classifications: Management services company
Other facilities connected through this exact CMS organization identity: 24 across MT, NV, OR, SD, WA, WY.
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Aug 31, 2023
Organization · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Aug 31, 2023
Other facilities connected through this exact CMS organization identity: 5 across SD.
Individual · OPERATIONAL/MANAGERIAL CONTROL
Association date reported to CMS: Aug 31, 2023
Individual · OPERATIONAL/MANAGERIAL CONTROL
Published ownership percentage: 100%
Association date reported to CMS: Aug 31, 2023
Organization · Medicare-enrolled legal organization
Other facilities connected through this exact CMS organization identity: 0 across SD.
Roles are shown as CMS publishes them. Different CMS sources can describe different enrollment, ownership, and control concepts, so TrustHub keeps each source-specific disclosure distinct.
Chain context
Chain-level values describe this CMS-defined group, not any one facility. CMS Chain ID 846 is a grouping identifier, not a legal organization.
| Month | Facilities | Overall rating | Staffing rating |
|---|---|---|---|
| Wed Jul | 44 | 2.5 | 3.3 |
| Mon Jun | 43 | 2.4 | 3.3 |
| Fri May | 43 | 2.4 | 3.3 |
| Wed Apr | 43 | 2.4 | 3.3 |
| Sun Mar | 41 | 2.3 | 3.1 |
Nursing Home Chain Performance Measures, fixed version da2db00a-0f3d-40a9-a535-588ff1220c55. Membership comes separately from CMS Skilled Nursing Facility Enrollments.
View official CMS sourceInspections & deficiencies
Scope and severity terms below are CMS classifications. They are not a TrustHub score.
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has plan of correction (May 28, 2026)
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
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 plan of correction (Jun 1, 2026)
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
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 plan of correction (May 28, 2026)
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 (Dec 22, 2025)
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 (Jan 9, 2026)
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
CMS scope/severity G: Isolated; Actual harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Dec 22, 2025)
No health-deficiency rows were deterministically linked to this inspection.
No health-deficiency rows were deterministically linked to this inspection.
Allow residents to self-administer drugs if determined clinically appropriate.
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 20, 2025)
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
CMS scope/severity 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 20, 2025)
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
CMS scope/severity F: Widespread; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (May 20, 2025)
Inform resident or representatives choice to enter into binding arbitration agreement and right to refuse.
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 20, 2025)
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
CMS scope/severity G: Isolated; Actual harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (May 20, 2025)
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: Past Non-Compliance (Jan 21, 2025)
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 (Feb 14, 2025)
Keep residents' personal and medical records private and confidential.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Past Non-Compliance (Dec 18, 2024)
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 (Jan 30, 2025)
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 (Jan 30, 2025)
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Jan 30, 2025)
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
CMS scope/severity G: Isolated; Actual harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Dec 27, 2024)
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: Past Non-Compliance (Oct 4, 2024)
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
CMS scope/severity G: Isolated; Actual harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Oct 12, 2024)
Ensure that residents are free from significant medication errors.
CMS scope/severity G: Isolated; Actual harm that is not immediate jeopardy.
Correction status: Past Non-Compliance (Jan 25, 2024)
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 (May 30, 2024)
No health-deficiency rows were deterministically linked to this inspection.
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
CMS scope/severity D: Isolated; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Feb 10, 2024)
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
CMS scope/severity E: Pattern; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Feb 10, 2024)
Provide and implement an infection prevention and control program.
CMS scope/severity F: Widespread; No actual harm with potential for more than minimal harm that is not immediate jeopardy.
Correction status: Deficient, Provider has date of correction (Feb 10, 2024)
No health-deficiency rows were deterministically linked to this inspection.
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 9, 2023)
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 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 9, 2023)
Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
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 9, 2023)
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 (Mar 9, 2023)
Penalties & enforcement
Published fine amount: $42,510.00
Published fine amount: $46,137.00
Published fine amount: $34,320.00
Published fine amount: $6,788.00
Published fine amount: $15,041.00
Published fine amount: $8,512.00
Questions to ask
Facility history
21 historical events available. Dates and values come from published CMS and official state regulator evidence, not a score.
3 deficiencies were recorded.
CMS · Recorded event date · View related evidence
CMS recorded a $42,510 civil monetary penalty.
CMS · Recorded event date · View related evidence
3 deficiencies were recorded. That includes 2 higher-severity deficiencies.
CMS · Recorded event date · View related evidence
Total nurse staffing increased from 3.13 to 3.45 hours per resident day between 2025Q2 and 2025Q3. Staffing improved across those reported periods.
3.13 → 3.45
CMS · Reported in a source release · View related evidence
CMS recorded a $46,137 civil monetary penalty.
CMS · Recorded event date · View related evidence
5 deficiencies were recorded. That includes 1 higher-severity deficiency.
CMS · Recorded event date · View related evidence
No linked health-deficiency findings were recorded for this survey.
CMS · Recorded event date · View related evidence
2 deficiencies were recorded.
CMS · Recorded event date · View related evidence
4 deficiencies were recorded.
CMS · Recorded event date · View related evidence
CMS recorded a $34,320 civil monetary penalty.
CMS · Recorded event date · View related evidence
1 deficiencies were recorded. That includes 1 higher-severity deficiency.
CMS · Recorded event date · View related evidence
1 deficiencies were recorded. That includes 1 higher-severity deficiency.
CMS · Recorded event date · View related evidence
Staffing
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).
| Measure | Monday–Friday | Saturday–Sunday |
|---|---|---|
| Total nursing | 3.688 | 2.941 |
| RN categories | 0.647 | 0.168 |
Contract staff accounted for 27.9% of reported nursing hours included in this quarter calculation.
PBJ reports zero combined RN-category hours on 1 day with a positive MDS census in this quarter.
Reported RN-category hours per resident day were 0.049 higher than the prior loaded quarter.
Solid bar: Total nursing · Outlined bar: RN categories
| Quarter | Total nursing | RN categories | LPN/LVN | CNA | Contract share | Days |
|---|---|---|---|---|---|---|
| 2025Q2 | 3.134 | 0.357 | 0.477 | 1.552 | 13.5% | 91 |
| 2025Q3 | 3.454 | 0.399 | 0.567 | 1.824 | 28.7% | 92 |
| 2025Q4 | 3.558 | 0.459 | 0.59 | 1.819 | 37.6% | 92 |
| 2026Q1 | 3.473 | 0.509 | 0.561 | 1.75 | 27.9% | 90 |
Hours-per-resident-day values are calculated by this platform from CMS-published daily PBJ hours and MDS census. For each displayed period, included hours are summed and divided by the summed census for days with a positive census. They are not CMS case-mix-adjusted staffing measures or a staffing rating.
View official CMS PBJ sourceWhat we can verify today
These measures come from the current successfully ingested CMS Nursing Home Provider Information release.
Planned evidence layers
These areas require separate authoritative CMS datasets. No findings are shown until those sources are ingested and reviewed.
Trust participation
Claims, corrections, and factual context are free. Submissions never replace CMS evidence or affect ranking.
Source register
No paid placements. Facilities cannot pay to rank higher. We cite. You decide.