Above average — CMS composite of the measures below.
A standard survey is most likely before around August 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 Rivergate Health Care Center during CMS and state inspections, most recent first.
A resident with severe dementia and a BIMS score of 0/15 was physically harmed by a resident representative who was reported to have smacked the resident, grabbed the resident’s jaw/chin, and later grabbed the resident’s arm. Staff members witnessed or were told about the incidents, but the NHA said it was not abuse, told staff not to document it because it could alert the state, and no investigation was initiated. Staff also gave inconsistent information about supervised visitation and dining room arrangements, and the resident’s care plan did not address prevention of further physical harm.
Failure to investigate and document alleged abuse by a resident representative. Staff reported that a resident with severe cognitive impairment was smacked and had the jaw/chin grabbed while being fed, and later the same resident was observed being grabbed by the arm and pulled away from others. An LPN reported the incident to the NHA, but the NHA said it was not abuse and told staff not to document it in the EMR; no investigation was initiated and the resident was not immediately assessed for injury.
Failure to Report Alleged Abuse and Physical Harm: A resident with severe cognitive impairment and multiple diagnoses was involved in incidents where a resident representative was reported to have slapped, grabbed the resident’s jaw/face, and later grabbed the resident’s arm. Staff interviews confirmed the events, but the NHA determined it was not abuse, no investigation was initiated, and the incidents were not reported to the State Agency or documented in the medical record.
Failure to Investigate and Document Alleged Abuse: Staff reported that a resident representative smacked a resident and grabbed the resident's jaw while feeding, then later grabbed the resident's arm and pulled the resident away from others. An LPN said the NHA told her not to document the incident in the EMR, the SW said no investigation was initiated, and the NHA stated she did not consider it abuse. The resident had severe cognitive impairment with a BIMS of 0/15 and diagnoses including dementia and Alzheimer's disease.
Surveyors found loose pills and suppositories scattered in three medication carts, with staff unable to identify some of the medications and inconsistent understanding of cleaning responsibilities. Facility policy requires medications to be stored in original containers and for those with missing labels to be destroyed, but these procedures were not followed.
A resident with severe cognitive impairment and a known risk for elopement was able to leave a secured unit and exit the building unsupervised by following visitors onto an elevator and out the front door while the front desk was left unattended. The resident was found outside by a CNA and escorted back inside. Staff interviews and policy review confirmed that the front desk should not have been left without coverage, and the lack of supervision directly led to the resident's elopement.
A resident with multiple health conditions experienced a fall and later tested positive for COVID-19. The facility failed to notify the resident's representative about the fall in a timely manner and did not document notification of the positive COVID-19 test, contrary to facility policy.
A resident with a history of a left femur fracture and other conditions fell during a shower transfer when a CNA did not follow the care plan requiring a two-person assist. The resident was lowered to the floor after their leg gave out, resulting in bruising. The DON confirmed the care plan was not followed, violating the facility's fall management policy.
The facility's kitchen operations were found deficient due to unsanitary conditions and improper sanitization practices, potentially affecting 172 residents. Non-food contact surfaces were observed with visible debris, and the sanitizer concentration was found to be zero, despite logs indicating otherwise. The Dietary Manager acknowledged the issues, indicating a lack of understanding and adherence to cleaning protocols.
The facility was found to have environmental deficiencies, including debris in laundry room dryers and dust accumulation in clean linen storage closets. The Environmental Services Manager acknowledged these issues during a survey and indicated that they would be addressed.
The facility failed to maintain an effective pest control program, as evidenced by live flies and ants observed under a hand washing sink in the kitchenette. The Dietary Manager and Maintenance Director were unaware of pest issues, and the pest control service record was indecipherable. This non-compliance with the 2017 U.S. Public Health Service Food Code increased the risk of contamination and foodborne illness.
A resident was found with medications left at their bedside without an assessment or physician's order for self-administration. The resident, who has COPD and intact cognition, reported that nurses leave medications if they are sleeping. Interviews with an LPN and the interim DON confirmed that medications should not be left at the bedside without proper assessment and orders. Facility policy mandates safe and appropriate medication administration per physician order.
A facility failed to complete a PASARR Level II evaluation for a resident with multiple mental health diagnoses, as required by their Level I screening. The Social Service Designee noted the absence of the evaluation in the resident's medical record, attributing it to the physician's delay in completing the necessary form.
A CNA used profane language in front of a resident with dementia who became combative during care. The incident was reported by another CNA, and the offending CNA was terminated for violating company policies.
The facility failed to develop and implement a care plan for a resident prescribed Seroquel for a mood disorder and did not obtain consent for the use of the psychotropic drug. The resident, diagnosed with dementia and impaired cognition, had no documented interventions to monitor the medication's side effects, and the Medication Informed Consent form was incomplete. The DON confirmed these deficiencies.
The facility failed to maintain accurate documentation in the EHR for a resident with paraplegia, leading to incomplete medical records and inadequate care. The resident required substantial assistance with ADLs and had severe impaired cognition. An RN documented wound care on two dates, but later admitted that care was not performed on one of those dates. The NHA confirmed the need for accurate and timely documentation.
Failure to Identify Resident Representative Physical Harm as Abuse
Penalty
Summary
The facility failed to accurately identify incidents of physical harm as abuse by a resident representative involving one resident with severe cognitive impairment. The resident was admitted with diagnoses including atrial fibrillation, Alzheimer’s disease with late onset, hypertension, COPD, anemia, dementia, and adjustment disorder, and had a BIMS score of 0/15. Staff reported that the resident representative became frustrated while feeding the resident and smacked the resident and grabbed the resident’s jaw or chin, but the incident was not documented in the EMR and the nursing home administrator told staff not to document it because it could alert the state. The administrator later stated the event was not abuse and did not complete an investigation. Multiple staff members described witnessing or being told about the resident representative grabbing the resident’s face or jaw with force. An LPN reported seeing another LPN run down the hall yelling that the resident representative hit the resident, and said she was told not to document it. Another LPN stated the resident representative grabbed the resident’s jaw to force the resident to eat and that the administrator determined it was not abuse, which is why she did not document it. A social worker reported being told that the resident representative could not go into the resident’s room because the resident representative slapped the resident, and stated the administrator, who was the abuse coordinator, did not initiate an investigation. Physical harm continued when a dietary aide observed the resident representative grabbing the resident’s arm, and another dietary aide described the resident representative as controlling and aggressive, including forcefully pushing drinks toward the resident and grabbing the resident’s arm to pull the resident away from other residents. Staff gave inconsistent and incomplete explanations about supervised visitation and dining room arrangements, and several staff members were unaware of any incident or the purpose of the change. The resident’s care plan addressed cognitive impairment and meal assistance, and later included an intervention for the resident representative to eat meals with the resident in the dining room, but the facility did not provide care plan interventions related to preventing further physical harm.
Failure to Investigate and Document Alleged Resident Representative Abuse
Penalty
Summary
The facility failed to thoroughly implement its abuse policy after allegations that a resident representative physically harmed a resident with severe cognitive impairment. The resident, admitted with atrial fibrillation, Alzheimer's disease with late onset, hypertension, obstructive pulmonary disease, anemia, dementia, and adjustment disorder, had a BIMS score of 0/15. Staff reported that the resident representative became frustrated while feeding the resident and smacked the resident and grabbed the resident's jaw or chin to force the resident to eat. A licensed practical nurse witnessed the event and reported it by telephone to the nursing home administrator, who told staff not to document the incident in the EMR because it could alert the state. The clinical record did not contain documentation of the incident, and the licensed practical nurse did not assess the resident for bruising or injury immediately after the event. Additional interviews described continued physical contact by the resident representative after the initial incident. A dietary aide reported observing the resident representative grab the resident's arm with force and pull the resident away from other residents in the dining room, describing the behavior as aggressive and controlling. Another dietary aide reported that staff immediately relayed the arm-grabbing incident to multiple staff at the nurse's desk. The social worker stated she was told the resident representative could not go into the resident's room because the resident had been slapped, and she confirmed she had not been informed of any investigation. The nursing home administrator stated she did not initiate an investigation because she did not consider the event to be abuse and acknowledged telling staff that the resident representative was not trying to hurt the resident.
Failure to Report Alleged Abuse and Physical Harm
Penalty
Summary
The facility failed to report suspected abuse and incidents of physical harm involving a resident with severe cognitive impairment. R501 was admitted with diagnoses including atrial fibrillation, Alzheimer’s disease with late onset, hypertension, obstructive pulmonary disease, anemia, dementia, and adjustment disorder, and had a BIMS score of 0/15. The State Agency received an anonymous complaint alleging that the resident was abused by a resident representative while being fed, including being smacked and having the jaw grabbed when the resident would not eat. Staff interviews confirmed that LPN C witnessed the resident representative grab R501’s jaw/face with force in an attempt to make the resident eat, and LPN A reported seeing LPN C upset after the incident and hearing that the resident representative had slapped and grabbed R501’s face. The clinical record did not show documentation of the incident or an immediate assessment for bruising or injury. Additional interviews described a second incident in which the resident representative was observed grabbing R501’s arm and pulling the resident away from other residents in the dining room. Dietary staff described the resident representative as controlling and aggressive, and one dietary aide stated the incident was immediately reported to staff at the nurse’s desk. The NHA stated that the event was not abuse and reported that no investigation or report was completed because she did not consider it abuse. Social work staff stated they were not informed of an investigation, and the facility did not provide further documentation related to abuse identification. The deficiency was cited because the facility did not report the alleged abuse and related physical harm incidents to the State Agency as required.
Failure to Investigate and Document Alleged Resident Representative Abuse
Penalty
Summary
The facility failed to thoroughly conduct and document an investigation of alleged physical abuse involving a resident with severe cognitive impairment. The resident was admitted with diagnoses including atrial fibrillation, Alzheimer's disease with late onset, hypertension, COPD, anemia, dementia, and adjustment disorder, and had a BIMS score of 0/15. Staff reported that a resident representative became frustrated while feeding the resident and smacked the resident and grabbed the resident's jaw or chin to force eating. LPN C reported witnessing the resident representative grab the resident's jaw with force and stated she immediately called the NHA, who told her not to document the incident in the EMR because it could alert the state. The clinical record did not contain documentation of the incident, and LPN C did not assess the resident for bruising or injury immediately afterward. Additional staff interviews described continued physical contact by the resident representative, including grabbing the resident's arm and pulling the resident away from other residents in the dining room. Dietary staff described the resident representative as controlling and aggressive, and one dietary aide stated the incident was immediately reported to staff at the nurse's desk. The SW stated she was informed that the resident representative could not go into the resident's room because the resident representative slapped the resident, and she confirmed that the NHA, who served as abuse coordinator, did not initiate an investigation. The NHA stated she did not do an investigation or report the incident because she did not consider it abuse and acknowledged telling staff that the resident representative was not trying to hurt the resident.
Improper Disposal and Storage of Loose Medications in Medication Carts
Penalty
Summary
Surveyors observed that the facility failed to ensure proper disposal and storage of loose medications in three out of four medication carts inspected. On multiple units, loose pills and suppositories were found scattered in the drawers of medication carts. Staff members, including LPNs, were unable to identify some of the loose medications and acknowledged that these should have been either properly stored or discarded. The facility's policy requires medications to be stored in their original containers and for medications with missing labels to be destroyed and reordered. Interviews with staff revealed inconsistent understanding and implementation of responsibilities for cleaning and maintaining medication carts. Some LPNs stated that all nurses were responsible for cleaning the carts, while another indicated that pharmacy staff cleaned the carts several times a month. The DON clarified that midnight shift nurses were responsible for cleaning, and each nurse was expected to maintain their own cart. Despite these expectations, the presence of loose and unidentified medications in multiple carts indicated a failure to adhere to the facility's medication storage and disposal policies.
Failure to Prevent Elopement Due to Inadequate Supervision and Unattended Front Desk
Penalty
Summary
A resident with severe cognitive impairment, diagnosed with Alzheimer's Disease, dementia, anxiety, and major depression, and under legal guardianship, was assessed and care planned as being at risk for elopement. The resident's care plan included monitoring for exit-seeking behaviors, such as following visitors and pacing near exit doors and elevators. Despite these interventions, the resident was able to leave a secured unit on the second floor by following a visitor onto an elevator that required a passcode, and subsequently exited the building through the front door by following another visitor. At the time of the incident, the front desk, which controlled the security release for the front doors, was left unattended by the receptionist, who stepped away for 5-10 minutes without arranging for coverage. This allowed the resident to exit the building unsupervised. The resident was later found outside near the back of the facility by a CNA, who was returning from a break. The resident stated they were looking for their car and did not recall how they got outside. The incident was not immediately known to staff, and the resident was outside for approximately 10 minutes before being escorted back inside. Interviews with staff and review of facility policies revealed that it was against facility policy to leave the front desk unattended, and that receptionists were expected to have coverage when stepping away. The facility's elopement policy defined elopement as a resident leaving a safe area without authorization or necessary supervision. The failure to provide adequate supervision and monitoring, as well as leaving the front desk unattended, directly led to the resident's unsupervised exit from the building.
Removal Plan
- A schedule has been established to monitor the involved R600 every 15 minutes.
- R600's elopement care plan was reviewed and updated to reflect activities of interest including model care that he can design, music, bingo, purposeful wandering.
- Notification sent to families/representatives on not letting self out of the building, which is a breach of our security systems.
- Residents identified at risk for exit seeking were assessed to reduce opportunity to exit facility; their care plans were reviewed, photos updated if necessary, Medical Director and responsible parties notified to be aware of surroundings when on elevator.
- Committee will continue to monitor and perform analysis for any potential root cause to variation in updated systematic process.
- Signage has been placed by and in the elevator to remind visitors to be aware of anyone on the elevator without a badge/nametag may be an indication of an unaccompanied resident and to notify a staff member immediately.
- All current residents' elopement risk evaluations were reviewed and updated with care plans reviewed and updated as needed.
- Front door push button relocated and a protective cover placed over it so visitors cannot reach over the counter and push the button.
- Staff educated on elopement, front desk to be attended during business hours.
- Education on proper visitor sign in/out process.
- Elopement policies were reviewed.
- Elopement risk list updated.
- Elopement investigation procedure and documentation process were reviewed.
- Elopement drill was completed multiple shifts.
- Elopement audits completed.
Failure to Notify Resident Representative of Change in Condition
Penalty
Summary
The facility failed to notify the resident representative of a change in condition for one resident, resulting in missed opportunities for participation in medical decisions. The resident, who had diagnoses including protein-calorie malnutrition, dysphagia, epilepsy, anxiety disorder, and depression, experienced a fall from bed. The event note documented that the resident was found on the floor, assisted back to bed, and received medical attention including a STAT X-ray and pain medication. However, the notification to the resident's representative about the fall was delayed by 24 hours, and no explanation for this delay was provided by the Director of Nursing (DON). Additionally, the facility did not document the notification of the resident's representative regarding a positive COVID-19 test result. The resident tested positive for COVID-19, and medication was ordered by the medical doctor, but there was no evidence that the family was informed. The facility's policy requires immediate notification of the resident, physician, and resident representative in cases of accidents or significant changes in treatment, which was not adhered to in this instance.
Failure to Follow Transfer Assistance Plan Leads to Resident Fall
Penalty
Summary
The facility failed to ensure that staff followed the care plan for transfer assistance, resulting in a fall for a resident. The resident, who had a history of a left femur fracture, multiple sclerosis, muscle weakness, and hemiplegia affecting the left side, was observed with bruising on both arms and reported falling in the shower with a CNA. The resident's care plan required a two-person assist for transfers, which was not followed during the incident. The incident report indicated that the CNA was transferring the resident from a shower chair to a wheelchair when the resident's left leg gave out, leading to the resident being lowered to the floor. The Director of Nursing confirmed that the CNA did not adhere to the two-person assist requirement as outlined in the resident's care plan and Kardex. The facility's policy on fall management emphasizes the need for adequate supervision and adherence to care plans to prevent accidents.
Sanitation Deficiencies in Kitchen Operations
Penalty
Summary
The facility failed to maintain sanitary conditions in the kitchen, which increased the potential for cross-contamination of food and foodborne illness, potentially affecting all 172 residents receiving meal services. During an inspection, several non-food contact surfaces, including ventilation filters above the fryer, grates of the flat top grill, sides of the oven, and the oven's stainless steel backsplash, were observed to be soiled with visible debris. The Dietary Manager acknowledged the lack of timely and sufficient cleaning, noting that debris from a previous day's meal was still present. Additionally, the can opener's cutting blade at the cook prep station was found with visible debris, and the flooring in the walk-in freezer had an accumulation of dust and debris. The facility did not provide a cleaning schedule to verify the completion of daily cleaning tasks. Furthermore, the facility's process for cleaning and sanitizing work surfaces was found to be inadequate. The Dietary Manager explained the use of red and green buckets for soapy water and sanitizer, respectively. However, upon testing, the sanitizer concentration was found to be zero, despite a log indicating a concentration of 200 ppm earlier that morning. The Dietary Manager admitted that the staff might not have fully understood the procedure. This failure to maintain proper sanitizer concentration is a violation of the 2017 U.S. Public Health Service Food Code, which requires chemical sanitizers to meet specific criteria for food-contact surfaces.
Environmental Deficiencies in Laundry and Linen Storage Areas
Penalty
Summary
The facility failed to maintain a safe, functional, and sanitary environment for its 172 residents and staff, as observed during an environmental tour. The surveyor noted that all dryers in the laundry room contained a variety of melted and baked-on debris inside their drums. When questioned, the Environmental Services Manager, Staff C, acknowledged the issue and mentioned that such debris should be caught during sorting. Additionally, an accumulation of dust and debris was found on the flooring of the clean linen storage closets on both the first and second floors. Staff C responded that these areas would be vacuumed and monitored more closely during the day.
Failure to Maintain Effective Pest Control Program
Penalty
Summary
The facility failed to maintain an effective pest control program, resulting in the presence of live flies and ants underneath the designated hand washing sink in the first floor's kitchenette. This deficiency was observed by a surveyor on 5/30/24 at 11:43 AM. When questioned, the Dietary Manager, identified as staff A, was unaware of any pest issues and indicated that maintenance would handle such concerns. The Maintenance Director, identified as staff B, also stated they were unaware of any pest concerns, noting that the pest control technician typically arrives before their workday begins and that the service is considered preventative maintenance. A review of the facility's pest control service record dated 5/29/24 showed treatment around the foundation's perimeter using bait boxes. However, additional information in the service record was indecipherable by both the surveyor and staff B. The 2017 U.S. Public Health Service Food Code, Chapter 6-501.111, requires premises to be maintained free of pests and routinely inspected for evidence of pests, which the facility failed to comply with, increasing the potential for contamination and foodborne illness.
Failure to Assess Resident for Self-Administration of Medications
Penalty
Summary
The facility failed to assess a resident, identified as R52, for self-administration of medications, resulting in medications being left at the resident's bedside. During an observation, two medications were found in a clear medicine cup on R52's bedside table. R52 reported that nurses sometimes leave medications on the table if the resident is sleeping, to be taken upon waking. A review of R52's electronic medical record showed no assessment or physician's order for self-administration of medications. R52 was admitted to the facility with a primary diagnosis of chronic obstructive pulmonary disease (COPD) and had intact cognition with a BIMS score of 15/15. Interviews with an LPN and the interim DON confirmed that medications should not be left at the bedside unless the resident has been assessed and has a physician's order to self-administer medications. The facility's policy on medication administration requires that all medications be administered safely and appropriately per physician order.
Failure to Complete PASARR Level II Evaluation
Penalty
Summary
The facility failed to ensure that the Pre-Admission Screening and Resident Review (PASARR) Level I determination was reviewed, revised, and sent to the Local Community Mental Health Services Program (CMHSP) for a Level II OBRA evaluation for one resident. This deficiency was identified during a review of the medical record of a resident who was admitted with multiple mental health diagnoses, including excoriation disorder, undifferentiated schizophrenia, and depression. The resident's Level I screening indicated the need for a Level II evaluation, but the medical record did not contain evidence of this evaluation. The Social Service Designee (SSD) acknowledged that the Level II evaluation was not completed because the physician had not yet signed the necessary form. The facility's policy requires that a positive Level I screen necessitates a Level II evaluation, which should be documented in the resident's medical record. The absence of the Level II evaluation in the resident's chart was attributed to the physician's delay in completing and signing the OBRA 3878 form, which is crucial for outlining the mental health plan of care and treatment for the resident.
Inappropriate Language Used by CNA During Resident Care
Penalty
Summary
The facility failed to prevent the use of inappropriate language during care to one resident. The incident involved a CNA who used profane language in front of a resident with unspecified dementia and impaired cognition. The resident became combative during care and scratched the CNA, who then responded with inappropriate language. The incident was reported by another CNA to the Executive Director, and the offending CNA was subsequently terminated for violating company policies and procedures. Interviews with the Director of Nursing and the Executive Director confirmed the inappropriateness of the staff's behavior.
Failure to Develop Care Plan and Obtain Consent for Psychotropic Medication
Penalty
Summary
The facility failed to develop and implement a care plan for a resident who was prescribed Seroquel, an antipsychotic medication, for a mood disorder. The resident, who had a diagnosis of dementia and impaired cognition, required assistance with Activities of Daily Living (ADLs). Despite the physician's order for Seroquel, the resident's care plan did not include any interventions to assess or monitor the resident's progress or side effects from the medication. Additionally, the Medication Administration Record (MAR) for the month of September 2023 showed no documentation of assessment or monitoring for possible side effects of Seroquel. The Director of Nursing (DON) confirmed that the facility should have developed and implemented a care plan when the medication was ordered and that residents should be monitored when receiving antipsychotic medications. The facility also failed to obtain consent for the use of the psychotropic drug Seroquel for the same resident. The Medication Informed Consent form was incomplete, with no information documented related to the antipsychotic medication and no indication that the resident's responsible party was informed or consented to the use of Seroquel. The DON confirmed that the facility should obtain consent before administering an antipsychotic medication and that there was no evidence in the resident's electronic medical record that the responsible party was informed or consented to the use of Seroquel. The facility's policy on Psychotropic Medication Informed Consent requires that consent or refusal be documented to reflect that the intended or actual benefit is understood by the resident and, if appropriate, their family or representative.
Inaccurate Documentation in EHR for Resident with Paraplegia
Penalty
Summary
The facility failed to ensure complete and accurate documentation in the Electronic Health Record (EHR) for a resident with paraplegia, resulting in inaccurate and incomplete medical records and inadequate care delivery. The resident, who had severe impaired cognition and required substantial assistance with Activities of Daily Living (ADLs), was admitted to the facility and most recently readmitted on 3/16/24. A review of the May 2024 Treatment Administration Record (TAR) revealed that a Registered Nurse (RN) documented performing wound care on 5/13/24 and 5/14/24. However, during an interview, the RN admitted that wound care was not performed on 5/14/24, despite the documentation indicating otherwise. The Nursing Home Administrator confirmed that documentation should be accurate and timely. The facility's policy on skin integrity and pressure ulcer/injury prevention and management emphasized the importance of accurate and detailed documentation to reflect the extent and quality of care provided.
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Illustrative
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 Riverview
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Rivergate Terrace | 0.1 mi | ★★★★★ | 13 | 0 |
| Belle Fountain Nursing & Rehabilitation Center | 0.8 mi | ★★★★★ | 0 | 0 |
| The Orchards At Southgate | 0.9 mi | ★★★★★ | 8 | 0 |
| Aerius Health Center | 2 mi | ★★★★★ | 0 | 0 |
| The Lodge At Taylor | 3.8 mi | ★★★★★ | 16 | 0 |
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