Average — CMS composite of the measures below.
A standard survey is most likely before around December 2026
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Madison Grove Post Acute during CMS and state inspections, most recent first.
The facility failed to maintain a clean, pest-free environment in a shared room and bathroom for two residents, both with tracheostomies and significant neurologic or motor impairments. A CNA and an LVN observed and confirmed approximately 50 dead gnats on the shower floor in the shared bathroom. In the adjoining bedroom, an LVN and the Maintenance Supervisor identified a cracked vinyl flooring plank near a sliding door with a missing section and visible evidence of termites. The DON, referencing the facility’s pest control and maintenance policies, acknowledged that resident rooms are expected to be free of gnats and termites and that the building should be kept in good repair and free from hazards.
Surveyors found that eight of nine shower beds in three shower rooms were missing required locking pins on their side rails, and staff had been using plastic bags to support the rails while continuing to use the beds. A CNA reported the pins had been missing for about two weeks, and the Maintenance Director confirmed the missing pins during inspections. The DON reviewed the PVC equipment owner’s manual, which warns that improper use and failure to ensure proper assembly may result in death or injury, and acknowledged that the shower beds were used before repairs, contrary to the manufacturer’s instructions and the facility’s maintenance policy assigning responsibility to the Maintenance Director to keep equipment safe and operable.
A resident’s nebulizer tubing and mask had conflicting dates and were not kept on the same weekly change schedule, while another resident on EBP had an RNA keep gloves on, reach into a pocket, and use a walkie talkie during care instead of removing gloves and performing hand hygiene. Two other residents on oxygen had tubing or a nasal cannula that was unlabeled, undated, or overdue for the weekly change ordered by the facility. The DON and IP stated staff were expected to follow infection control policies and respiratory equipment labeling and change procedures.
State agency complaint information was not posted in an accessible, understandable location on the first floor. A resident with ESRD and amputations, a resident with DM, dysphagia, hemiplegia, and hemiparesis, and a resident with Guillain-Barre syndrome, DM, and quadriplegia, along with a representative, stated they could not locate the information without staff help. The LTC Ombudsman posting was in the dining room, but the required State agency posting was on the second floor away from the elevator and not visible from the entrance area.
Expired medical supplies were found in two medication storage rooms. In Unit 400, six Covid-19 rapid tests and nine Eswab collection and transport systems were past expiration, and an LVN stated they posed a risk for residents. In Unit 100, 171 safety pen needles were expired, and an RN stated they posed an infection risk. The DON could not provide a policy for expired supplies and stated none was in place for medication supply or supply storage.
A CNA stood while feeding a resident who required 1:1 meal assistance under the Red Napkin Program. The resident had dysphagia, HTN, and mobility issues, and the meal ticket indicated feeding assistance was needed. The CNA stated she was supposed to sit while feeding to show respect, and the DON confirmed staff are expected to sit unless the resident has a preference.
Failure to Develop Antibiotic Care Plans: Two residents had antibiotic orders for UTI treatment, but the RN UM could not find care plans for either resident during record review. One resident had a Cephalexin order via G-tube and the other had a Cefoxitin IV order; both residents also had IV sites observed. The DON reviewed the IDT care planning policy and stated the care plan is a living document to guide care, and that the policy was not followed.
A resident with HF, dementia, and dysphagia was served lunch that included 4 oz of whole milk even though the meal ticket specified 8 oz. The LVN UM confirmed the resident should have received the full amount, and the DON stated the tray was missed and the Food and Nutrition Services policy was not followed.
A resident with dysphagia and type 2 DM had orders for Gabapentin and Valproic acid to be given via PEG tube, but an LVN administered both meds by mouth during a med pass observation. The surveyor stopped the oral administration, and the LVN stated the resident preferred oral meds and that she had been giving them that way for the past three days without documented evidence of a changed order. The DON confirmed that giving medication by a route other than ordered is an error.
Medication Error Rate Exceeded Allowed Threshold: The facility had a 7.41% medication error rate after two errors were found in 27 opportunities. An LPN administered a resident’s gabapentin and valproic acid by mouth even though both meds were ordered via PEG. The LPN said the resident preferred oral meds and believed the route had been changed, but no documented order was provided. The DON confirmed that giving meds by a route other than ordered is an error.
The facility failed to maintain a safe and sanitary environment when a rain gutter above the smoking area door was not maintained and caused a constant drip onto the resident walkway. A resident with Guillain-Barre syndrome, DM, and quadriplegia reported the leak, and staff observed saturated towels and a yellow caution sign near the doorway. The DOM stated no work order had been issued, identified the source as a gutter connected to the station three bridge, noted an unknown black substance on the gutter, and said there was no maintenance policy in place.
A resident who was dependent on staff for all ADLs and required a two-person assist for bed mobility was left with only one CNA during repositioning and a brief change. Despite the care plan and facility policy mandating two-person assistance, the CNA proceeded alone, resulting in the resident falling from bed and sustaining a displaced intertrochanteric fracture of the left hip. Staff interviews confirmed the expectation of two-person assistance, and the DON acknowledged the protocol was not followed.
A resident with quadriplegia, contractures, and total dependence on staff for care and repositioning was found with left leg pain and later diagnosed with a fracture after being sent to the hospital. Despite care plans requiring two staff for repositioning and regular passive range of motion, there was no documentation explaining how the injury occurred, indicating a failure to provide adequate supervision and accident prevention.
A resident with multiple health conditions developed a stage 3 pressure ulcer on the right trochanter due to the facility's failure to prevent it. Despite efforts to reposition the resident and use an air loss mattress, the resident's noncompliance and preference for the right side contributed to the ulcer's development. The care plan did not address the resident's refusal to reposition, and there was no documentation of an interdisciplinary team meeting to address the issue.
A resident in distress, with chronic health conditions, experienced verbal abuse from a respiratory therapist (RT) who clapped loudly and used foul language. The RT's behavior was witnessed by staff, including an LVN who intervened. After leaving the resident's room, the RT damaged facility property in a fit of anger. The facility's abuse prevention policy was not followed, as acknowledged by the ADON.
A resident with multiple health conditions, including knee contractures, sustained an acute distal femur shaft fracture due to inadequate supervision. Despite a care plan to prevent injuries, staff were unaware of how the injury occurred, and no incidents were reported. The facility's policy on safety and supervision was not effectively implemented.
Failure to Maintain Pest-Free, Hazard-Free Resident Room and Bathroom
Penalty
Summary
The facility failed to maintain a safe, clean, and sanitary environment for two residents sharing a room and bathroom. One resident had diagnoses including tracheostomy status, hemiplegia, and hemiparesis affecting the right dominant side, and the other had diagnoses including encephalopathy and tracheostomy status. During an observation with a CNA in the shared bathroom, approximately 50 dead gnats were found on the shower floor and verified by the CNA. A subsequent observation with an LVN in the same bathroom confirmed the presence of approximately 50 dead gnats on the shower floor. Further observation with the LVN and the Maintenance Supervisor in the residents’ shared room revealed evidence of termites on the vinyl flooring near the sliding door. The Maintenance Supervisor identified a cracked vinyl flooring plank with a missing section measuring approximately 2 inches wide and 8 inches long, and stated there was evidence of termites in that area, describing the situation as unacceptable and something that should have been addressed promptly. Review of the facility’s pest control policy indicated the facility maintains an ongoing pest control program to keep the building free of insects and rodents, and the DON acknowledged that residents’ rooms should be free from gnats and termites and that the building should be in good condition and free from hazards, as also reflected in the facility’s maintenance policy.
Failure to Maintain Shower Beds in Safe Working Condition
Penalty
Summary
The facility failed to maintain eight of nine shower beds in safe working condition when surveyors observed that the side rails on these beds were missing required locking pins. During an observation in one shower room, a CNA reported that several locking pins had been missing for approximately two weeks and that plastic bags were being used to support the side rails while awaiting repairs. The CNA confirmed that the shower beds continued to be used in this condition. Subsequent inspections by the Maintenance Director in three separate shower rooms confirmed that a total of eight shower beds had missing locking pins on their side rails. During a telephone interview and record review, the DON reviewed the manufacturer’s owner’s manual for the PVC healthcare equipment, which stated that improper use of the equipment or failure to follow directions and warnings may result in death or injury, and that equipment must be properly assembled before use and after any adjustments, repairs, or service. The DON acknowledged that the shower beds had been used prior to repair, contrary to the manual’s instructions. The facility’s maintenance policy indicated that the building must be maintained in compliance with applicable laws and guidelines and that the Maintenance Director is responsible for maintaining a schedule of maintenance services to ensure the building and equipment are maintained in a safe and operable manner.
Infection Control Lapses With Respiratory Equipment and Hand Hygiene
Penalty
Summary
Infection prevention and control practices were not maintained for multiple residents involving respiratory equipment and hand hygiene. Resident 40, who was admitted with shortness of breath, wheezing, and muscle weakness, had nebulizer equipment that was not dated consistently: the nebulizer tubing was dated September 1, 2025, while the mask was dated September 8, 2025. The LVN/UM stated the tubing and mask were part of the same kit and should reflect the same date, and that the equipment was required to be changed weekly for infection control purposes. The infection prevention nurse also reviewed the facility’s respiratory equipment change schedule and stated the policy was not followed and the date should match. Resident 48 was on Enhanced Barrier Precautions, with signage outside the room directing staff to wear gloves and gown for high-contact care activities. While RNA 1 was providing care in the room, she reached into her pocket, removed a walkie talkie, and made a call while still wearing gloves, then returned the device to her pocket. RNA 1 stated she would wash her hands and wipe the walkie talkie, and later stated she would never do it again. The LVN unit manager stated staff are expected to remove gloves and use hand hygiene after any resident care, and the DON stated staff are expected to follow infection control policies and procedures. Resident 154, who had COPD, emphysema, and shortness of breath, was observed on oxygen with tubing that was unlabeled and undated, even though the RN supervisor stated oxygen tubing is changed every Sunday and should have been labeled and dated. Resident 216, who had emphysema, severe persistent asthma, hypertension, and shortness of breath, was observed with a nasal cannula dated September 1, 2025, and the RN stated it should have been changed every week as ordered. The infection prevention nurse reviewed the facility’s respiratory policies and procedures and stated disposable equipment must be labeled with the resident’s name and date, and that the policies were not followed.
State Agency Complaint Information Not Accessible on First Floor
Penalty
Summary
The facility failed to ensure resident rights were respected for three sampled residents when contact information for pertinent State agencies was not posted in a manner that was accessible and understandable to residents and resident representatives on the first floor. The report states that the required State agency information was located on the second floor away from the elevator, was not posted on the first floor, and was not visible from the entrance or elevator area because there were two hallways between the entrance and the elevator. The Long-Term Care Ombudsman Program information was posted in the dining room on the first floor, but the pertinent State agency information was not located there. Resident 19, who was admitted with ESRD, difficulty walking, absence of the right leg below the knee, and absence of the left leg above the knee, had a BIMS score of 15 and stated he was not aware of where to find State agency information and would need staff assistance to locate it. Resident 53, admitted with type 2 DM, dysphagia, hemiplegia, and hemiparesis, had a BIMS score of 2, and the resident's representative stated they were not aware of the location of the State agency information. Resident 54, admitted with Guillain-Barre syndrome, type 2 DM, and quadriplegia, had a BIMS score of 15 and stated he was not aware of the location of the State agency information and could not locate it without staff involvement.
Expired Medical Supplies Found in Medication Storage Rooms
Penalty
Summary
The facility failed to ensure that two medication storage rooms were free of expired medical supplies. During a concurrent observation and interview in the Medication Storage Room in Unit 400, six Covid-19 rapid tests and nine Eswab collection and transport systems were found with expired dates, and LVN 1 stated the supplies were past expiration and posed a risk for residents. During a separate observation and interview in the Medication Storage Room in Unit 100, 171 safety pen needles were found with an expired date, and RN 4 stated the supplies were expired and posed an infection risk for residents. During interview, the DON was unable to provide a policy regarding expired supplies and stated there was no policy in place regarding medication supply or supply storage.
Failure to Maintain Dignity During Feeding Assistance
Penalty
Summary
The facility failed to maintain dignity for one of three sampled residents when a CNA stood while assisting the resident with breakfast. Resident 10 was admitted with diagnoses including dysphagia, hypertension, and other abnormalities of gait and mobility. The resident had physician orders dated June 8, 2025 for the Red Napkin Program with meals and 1:1 assist, and diet orders dated September 8, 2025 for a fortified CCHO NAS diet, regular texture, regular/thin consistency, no spicy food, lactose intolerant, and Red Napkin Program. On September 15, 2025, Resident 10 was observed sleeping in bed with a breakfast tray on the bedside table, and the meal ticket indicated the resident required feeding assistance. During a later observation, CNA 1 was seen standing at the bedside while feeding Resident 10 for the duration of breakfast. When asked about the expectation for feeding residents, CNA 1 stated she was supposed to sit down while feeding to show respect. The DON reviewed the facility policy stating residents shall receive meal assistance in a manner that meets individual needs and that residents who cannot feed themselves will be fed with attention to safety, comfort, and dignity, and stated staff are expected to sit while feeding residents unless the resident has a preference.
Failure to Develop Antibiotic Care Plans
Penalty
Summary
The facility failed to ensure care plans were developed for antibiotic therapy for two sampled residents. Resident 4 was admitted with diagnoses including cerebral infarction, candidal sepsis, and shortness of breath. On September 13, 2025, Resident 4 had a physician order for Cephalexin oral suspension 250 mg/5 ml, to give 10 ml via G-tube every 12 hours for a UTI for 5 days. During observation on September 14, 2025, Resident 4 was lying in bed asleep and had an IV site on the right wrist. During a concurrent interview and record review on September 17, 2025, the RN UM reviewed Resident 4's care plan and stated she could not see a care plan for the Cephalexin antibiotic for UTI, and stated there should have been a care plan because it guides the plan of care. Resident 15 was admitted with diagnoses including hemiplegia and hemiparesis following cerebral infarction, elevated white blood cell count, and pneumonia. During observation on September 14, 2025, Resident 15 was lying in bed awake and staring at the wall and had an IV site on the right wrist. The Order Summary Report dated September 16, 2025, showed a physician order for Cefoxitin sodium 1 gram IV every 8 hours for UTI for 7 days. During a concurrent interview and record review on September 17, 2025, the RN UM reviewed Resident 15's care plan and stated she could not see a care plan for the cefoxitin antibiotic for UTI, and stated there should have been a care plan for Resident 15's antibiotic. The DON reviewed the facility's policy on interdisciplinary care planning and stated the care plan is a living document to guide care, and that the policy was not followed.
Incorrect Milk Portion Served With Resident Meal
Penalty
Summary
The facility failed to ensure that Resident 37 received food preferences as indicated on the meal ticket. Resident 37 was admitted with diagnoses including hypertensive heart disease with heart failure, unspecified dementia, and dysphagia. The resident’s diet order, dated September 5, 2025, specified a fortified diet with minced and moist texture and regular/thin consistency. During a concurrent observation and interview on September 14, 2025, at 12:28 PM, Resident 37 was observed sitting up in bed with lunch on the bedside table. The meal included minced meat, vegetables, rice, mashed potatoes, 4 oz of whole milk, and 8 oz of water. Resident 37’s meal ticket indicated 8 fl oz of whole milk. At 1:04 PM, the LVN UM reviewed the meal and meal ticket and stated Resident 37 should have been served 8 oz of whole milk instead of 4 oz, and that staff were expected to verify the correct amount was provided. The DON later reviewed the facility’s Food and Nutrition Services policy, which stated residents are to receive nourishing, palatable, well-balanced diets and that food and nutrition staff will inspect trays to ensure the correct meal is provided; the DON stated Resident 37’s tray was missed and the policy was not followed.
Medication Route Error During Administration
Penalty
Summary
The facility failed to ensure medications were administered without errors for one of 11 residents observed during medication pass. Resident 247 was admitted with diagnoses including dysphagia and type 2 diabetes mellitus. The resident had physician orders for Gabapentin 800 mg, one tablet by PEG tube every eight hours for neuropathy, and Valproic acid oral solution 250 mg/5 mL, 20 mL via PEG tube every eight hours for seizure disorder. During a medication administration observation, LVN 3 prepared Resident 247's Gabapentin tablet and Valproic acid oral solution and administered both medications by mouth instead of by the ordered PEG-tube route. The surveyor intervened and stopped the oral administration. During interview, LVN 3 stated the resident preferred medications by mouth and said she had administered the medications by mouth for the past three days, but she was unable to provide documented evidence that the physician orders had been changed to oral administration. The DON reviewed the facility policy and stated that medication given by a route other than ordered is considered an error and that LVN 3 should have followed the order.
Medication Error Rate Exceeded Allowed Threshold
Penalty
Summary
The facility failed to ensure the medication error rate remained below 5 percent. During observation, interview, and record review, two medication errors were identified out of 27 opportunities for error, resulting in an overall medication error rate of 7.41 percent. The error involved Resident 247, who was admitted with diagnoses including dysphagia and type 2 diabetes mellitus. Resident 247 had physician orders for gabapentin 800 mg to be given via PEG every eight hours for neuropathy and valproic acid oral solution 250 mg/5 mL, 20 mL via PEG every eight hours for seizure disorder. During medication administration observation, LVN 3 prepared both medications and administered them by mouth instead of by PEG. When interviewed, LVN 3 stated the resident preferred medications by mouth and said she had given the medications by mouth for the past three days, believing the order had been changed to oral route, but she could not provide documented evidence of any such order. The DON reviewed the facility policy on administering medication, which requires checking the right route, and stated that giving medication by a route other than ordered is an error.
Unsafe Smoking Area Walkway Due to Leaking Gutter
Penalty
Summary
The facility failed to maintain a safe and sanitary environment for one of 10 residents reviewed for smoking when the rain gutter above the door of the smoking area was not maintained and caused a constant leak onto the walkway. Resident 54 was admitted with Guillain-Barre syndrome, type 2 diabetes mellitus, and quadriplegia. During observation and interview with Resident 54 in the smoking area, the resident stated there was a constant drip of water located directly next to the door of the smoking area. Multiple saturated towels and a yellow caution sign were observed next to the towels. During a later observation and interview with the Director of Maintenance, the DOM stated there had been no work order issued for the drip and identified the source as a gutter connected to the station three bridge. The DOM also stated there was an unknown black substance on the gutter, that the drip was in the walkway of residents, and that there was no maintenance policy in place.
Failure to Provide Required Two-Person Assist Results in Resident Fall and Hip Fracture
Penalty
Summary
A deficiency occurred when a resident, who was dependent on staff for all activities of daily living and required a two-person assist for bed mobility and personal care, was left unsupervised by only one Certified Nursing Assistant (CNA) during repositioning and a brief change. The resident, who had significant medical conditions including type 2 diabetes, hypertension, dependence on a respirator, confusion, limited mobility, and contractures, was unable to assist in their own care. Despite the care plan and facility policy requiring two staff members for such assistance, the CNA proceeded alone, resulting in the resident sliding from the bed, striking their head, and sustaining a displaced intertrochanteric fracture of the left hip. Interviews with staff confirmed that the standard practice in the subacute unit was to use a two-person assist for residents with similar needs, and a buddy system was in place to ensure adequate supervision. The CNA involved admitted to providing care alone and not waiting for assistance, even though the resident was known to be a two-person assist. The Director of Nursing acknowledged that the CNA did not follow protocol, and the facility's policy emphasized the need for interventions based on residents' specific risks to prevent falls. The failure to provide adequate supervision and follow established protocols directly led to the resident's fall and injury.
Failure to Prevent Avoidable Accident Resulting in Resident Fracture
Penalty
Summary
The facility failed to provide adequate supervision and prevent avoidable accidents for a resident with quadriplegia and contractures, who was totally dependent on staff for all activities of daily living and repositioning. The resident, who was nonverbal and assessed for pain through facial grimacing, was found to have pain in the left lower leg and was subsequently diagnosed with a fracture of the proximal left tibia and a possible fibular neck fracture after being transferred to the hospital. Staff interviews indicated that the resident required two staff members for repositioning every two hours, and passive range of motion was to be performed three times a week as tolerated. Record reviews showed that the resident's care plan identified total dependence for repositioning and turning in bed, but there was no documentation or explanation regarding how the injury occurred. The facility's policy stated a commitment to maintaining an environment free from accident hazards and providing supervision to prevent accidents. Despite these policies and care plans, the resident sustained a significant injury resulting in hospitalization, indicating a failure to ensure adequate supervision and accident prevention for a clinically compromised, nonverbal resident.
Failure to Prevent Pressure Ulcer Development
Penalty
Summary
The facility failed to prevent the development of a stage 3 pressure ulcer on the right trochanter of a resident, who was clinically compromised with conditions including esophageal cancer, a tracheostomy, diabetes type II, and hypertension. Upon admission, the resident had a stage 4 pressure ulcer on the right knee. Despite the facility's efforts to reposition the resident and use an air loss mattress, the resident developed a stage 3 pressure ulcer on the right trochanter. The resident was noted to be noncompliant and favored the right side, which contributed to the development of the ulcer. The facility's care plan for the resident, initiated in August, did not address the resident's refusal to reposition, and there was no documentation of an interdisciplinary team meeting in June to address the wound and repositioning refusals. The facility's policy on wound care and prevention of pressure ulcers was reviewed, indicating procedures for care, services, and documentation related to pressure and non-pressure related wounds. However, the lack of a care plan addressing the resident's specific needs and refusals contributed to the deficiency.
Verbal Abuse Incident by Respiratory Therapist
Penalty
Summary
The facility failed to protect a resident's right to be free from verbal abuse, as evidenced by an incident involving a respiratory therapist (RT 1) who was verbally abusive towards a resident in distress. The resident, who had been admitted with diagnoses including hypertensive heart disease, chronic kidney disease, and chronic respiratory failure, was experiencing a medical emergency when the incident occurred. During this time, RT 1 was observed clapping loudly in the resident's face and using foul language, threatening to "beat" and "fuck up" the resident. This behavior was witnessed by other staff members, including a licensed vocational nurse (LVN 1), who intervened and instructed RT 1 to stop. Following the incident in the resident's room, RT 1 exhibited further aggressive behavior outside the room. RT 1 was seen in the charting room, where he expressed frustration and anger, stating he was "done with this shit" and "going to lose my job." He proceeded to physically damage facility property by kicking a chair into a desktop computer, breaking the computer over his knee, and throwing it against the wall. RT 1 continued his destructive behavior by kicking a wall, creating a hole, and tearing a kiosk off the wall before leaving the facility in a vehicle. The facility's policy on abuse, neglect, exploitation, and misappropriation prevention was not followed, as acknowledged by the Assistant Director of Nursing (ADON). The policy clearly states that residents have the right to be free from all forms of abuse, including verbal abuse, and that the facility is committed to protecting residents from such incidents. Despite this policy, the actions of RT 1 violated the resident's rights and demonstrated a failure in the facility's commitment to preventing abuse.
Inadequate Supervision Leads to Resident's Fracture
Penalty
Summary
The facility failed to provide adequate supervision to prevent avoidable accidents, resulting in a resident sustaining an acute distal femur shaft fracture. The resident, who had a history of traumatic brain injury, respiratory failure, asthma, seizures, hypertension, and gastrostomy status, was observed with swelling of the left thigh and knee. The care plan indicated the resident had bilateral knee contractures, with a goal to remain free of injuries related to these contractures. However, during a physical assessment, staff noted abnormal movement and swelling in the resident's left thigh and knee, with a popping sensation felt around the joint. Despite the facility's policy emphasizing resident safety and supervision, staff were unsure of how the injury occurred, and no incidents or accidents were reported. The Registered Nurse Supervisor stated that staff are expected to check on residents every two hours and as needed, but the lack of documentation or awareness of the incident suggests a lapse in supervision. The radiology report confirmed the fracture, highlighting the failure to prevent the accident and ensure the resident's safety.
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What surveyors actually found near you
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
Illustrative
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Illustrative
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Nursing homes near Redlands
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Redlands Healthcare Center | 0.1 mi | ★★★★★ | 6 | 0 |
| Redlands Comm Hosp D/p Snf | 0.1 mi | ★★★★★ | 8 | 0 |
| Brookside Healthcare Center | 0.7 mi | ★★★★★ | 0 | 0 |
| Plymouth Village | 1.8 mi | ★★★★★ | 1 | 0 |
| Asistencia Villa Healthcare Center | 1.9 mi | ★★★★★ | 18 | 0 |
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