Average — CMS composite of the measures below.
A standard survey is most likely before around October 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 Bolivar Medical Center Ltc during CMS and state inspections, most recent first.
Hair Restraints Not Used During Food Prep: A chef was observed preparing food without a hair net, despite facility policy requiring hair restraints at all times in the kitchen. The DM acknowledged the chef should have been wearing a hair net and said she had told him to wear it, and the ADM stated she had previously addressed the issue with him regarding the facility's food safety policy.
Inaccurate PBJ Staffing Data Submission: The facility failed to submit accurate PBJ staffing data for one quarter after transitioning to a new payroll system. The CASPER report triggered for excessively low weekend staffing, no RN hours on multiple days, and less than 24 hours/day of licensed nursing coverage on multiple days. The ADM stated the new system did not automatically transfer time clock data and acknowledged she did not verify the accuracy of the data before submission.
Inaccurate MDS coding for a resident with mental illness. The MDS showed the PASRR mental illness item as "No," even though the PASRR Summary of Findings identified the resident as meeting criteria for mental illness and the admission record listed Bipolar Disorder. The MDS Coordinator confirmed the coding was incorrect, and the DON agreed the MDS was expected to be coded correctly.
Hair Restraints Not Used During Food Preparation
Penalty
Summary
The facility failed to ensure hair restraints were used during food preparation, as required by its policy and professional standards. The facility policy, SANITATION AND INFECTION CONTROL, revised 1/2025, stated that team members must wear hair restraints regardless of hair or beard length at all times in the kitchen. During a kitchen tour on 7/30/2025, the Dietary Manager observed Chef #1 preparing food without a hair net in place; he was wearing a black baseball hat and had hair sticking out approximately 3-4 inches from under the hat. The Dietary Manager stated she knew he was required to wear a hair net and had told him he had to wear it. The Administrator later stated she had previously spoken with Chef #1 about the hair net and the facility's food safety policy.
Inaccurate PBJ Staffing Data Submission
Penalty
Summary
The facility failed to submit accurate staffing data into the Payroll-Based Journal (PBJ) system for one quarter of the 2025 reporting period. A review of the facility policy titled, "Electronic Staffing Data Submission Payroll-Based Journal," showed that the facility was required to submit complete and accurate direct care staffing information, including agency and contract staff, based on payroll and other verifiable and auditable data in a uniform format according to CMS specifications, and that the staffing and census data had to be timely and accurate. A review of the PBJ Staffing Data Report CASPER Report 1705D for Quarter 2 of Fiscal Year 2025 showed triggers for excessively low weekend staffing, no RN hours on four or more days within the quarter, and failure to have licensed nursing coverage 24 hours per day on four or more days within the quarter. During interview, the Administrator stated the facility had recently transitioned to a new payroll system, and unlike the prior system, the new system did not automatically transfer data from the time clock, resulting in missing staffing data for the second quarter PBJ submission. The Administrator acknowledged she did not verify the accuracy of the data before it was transferred and submitted, which led to discrepancies and errors in the quarterly PBJ report.
Inaccurate MDS Coding for Resident with Mental Illness
Penalty
Summary
The facility failed to code the MDS accurately for a resident with mental illness. Review of the facility policy stated that the LTC facility will conduct a comprehensive, accurate, standardized, reproducible assessment on admission and at regular intervals to ensure each resident meets his or her highest practicable level of physical, mental, and psychosocial functioning. For Resident #19, the Significant Change MDS with ARD of May 16, 2025, showed Section A1500, asking whether the resident is currently considered by the state level II PASRR process to have serious mental illness and/or intellectual disability or a related condition, was coded as "No." However, the PASRR Summary of Findings Report dated 2/13/24 stated under Mental Health that the individual meets criteria for having a diagnosis of mental illness as defined by PASRR. The MDS Coordinator verified during interview that the MDS was coded incorrectly and agreed it should be coded correctly to ensure the resident is receiving the correct level of care. The DON also agreed it was her expectation that the MDS would be coded correctly. The admission record showed the resident was admitted on 2/14/2024 with a diagnosis of Bipolar Disorder.
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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.
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Nursing homes near Cleveland
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Delta Rehabilitation And Healthcare Center | 0.3 mi | ★★★★★ | 0 | 0 |
| Cleveland Community Care Center | 0.6 mi | ★★★★★ | 8 | 0 |
| Walter B Crook Nursing Facility | 9.4 mi | ★★★★★ | 7 | 0 |
| Ruleville Community Care Center | 9.5 mi | ★★★★★ | 13 | 0 |
| Diversicare Of Shelby | 14.2 mi | ★★★★★ | 0 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.