Below average — CMS composite of the measures below.
The next survey window likely opens around February 2027
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 East Carolina Health And Rehabilitation Center during CMS and state inspections, most recent first.
Repeated linen shortages left residents without towels, washcloths, sheets, and pillowcases, and staff reported having to use incontinence wipes, cut up towels, or search resident rooms to find supplies. A cognitively intact resident said soiled bed linens were not replaced until later that night, another resident said the lack of linens prevented a full bath, and a third resident used a dried washcloth from the prior day to wash his face. Staff and observations confirmed empty linen carts and an empty linen room, while laundry and maintenance staff reported a broken dryer and depleted backup linen supply.
Failure to implement wound care orders and obtain supplies for a resident with a worsening pressure ulcer. A resident with severe neurologic impairment, immobility, incontinence, and a low air loss mattress developed bilateral buttock blisters that progressed to an unstageable pressure injury. The Wound NP changed the treatment plan several times, but the revised orders were not entered and the new care plan was not started because supplies were not obtained through the facility’s ordering process. The wound later worsened and hospital records described a butterfly-shaped wound with odor, bogginess, cellulitis, myositis, and a fluid collection suggesting abscess.
A resident with Alzheimer’s disease and other diagnoses was identified as a fall risk, but staff did not adequately supervise her or communicate care needs. During one fall, the assigned NA had not yet arrived for duty, the nurse was not aware of the delay, and the resident tried to go to the bathroom after her call light went unanswered. After the care plan was updated to toilet her before bed, staff on later shifts reported they did not know about the toileting instruction, and the resident fell again while trying to get to the bathroom, resulting in head swelling and hospital evaluation.
A resident with panhypopituitarism and sleep apnea missed a scheduled daily dexamethasone dose and a one-time albuterol neb treatment because the meds were not obtained from the pharmacy and the backup supply was not used. The MAR showed non-administration notations without explanation, staff reported waiting on pharmacy refills, and the DON stated both meds were available in backup supply and should have been pulled for administration.
The facility failed to ensure required RN coverage for 8 consecutive hours on two reviewed days, during which there were more than 70 residents in the building and no RN worked any shift. Review of daily nurse staffing sheets showed blank RN sections on those days, reflecting the absence of RN coverage. The Scheduler stated she completed the sheets from the schedule and left RN spaces blank when no RN was present, and she acknowledged not knowing that blanks were not allowed or what to do when there was no RN coverage. The DON reported being unaware of the lack of RN coverage on those days, and the Administrator stated his expectation that an RN be present in the building for 8 consecutive hours each day.
A resident with dementia, severe behavioral disturbance, and agitation was receiving scheduled oral haloperidol for behaviors, but the facility failed to complete ongoing AIMS assessments after the last one documented several months earlier. The resident’s quarterly MDS reflected cognitive impairment, behavioral symptoms, and antipsychotic use, yet no corresponding quarterly AIMS was found in the EMR. The unit manager and DON reported that AIMS assessments were expected at admission, readmission, with new prescriptions, and quarterly, but acknowledged that required assessments were missed following a change in facility ownership. The pharmacy consultant and Medical Director both indicated AIMS should be performed at least every 6 months for residents on antipsychotics, confirming that the resident’s monitoring was not completed as expected.
A resident with dysphagia, hemiplegia, and hemiparesis following a cerebral infarction was receiving ordered enteral nutrition via feeding tube with documented administration on the MAR, but the quarterly MDS failed to code the presence of a feeding tube or percent of intake by artificial route. The nutrition section of the MDS was completed by the Dietary Manager instead of the MDS Coordinator, and facility staff acknowledged this resulted in erroneous MDS coding that did not accurately reflect the resident’s tube feeding status and intake.
A deficiency occurred when the Pharmacy Consultant did not identify or report missing Abnormal Involuntary Movement Scale (AIMS) assessments for a resident receiving haloperidol for behavioral symptoms. The resident, who had dementia with severe behavioral disturbance and agitation, had an ongoing order for oral haloperidol, but the last documented AIMS assessment in the EMR was several months old, with no subsequent assessments recorded. During monthly drug regimen reviews over multiple months, the Pharmacy Consultant did not document any need for updated AIMS monitoring and stated that he relied on physician and psychiatric notes for side effects and left AIMS assessment decisions to the treating physician.
A resident with ESRD on hemodialysis, chronic respiratory failure, COPD, and moderate protein-calorie malnutrition had multiple ordered medications, including phosphate binders, Carvedilol, and Sertraline. Review of MARs showed that these medications were repeatedly not administered when the resident was out of the building for dialysis, and they were not given upon return. The care plan did not address medication administration on dialysis days or medication availability. The dialysis dietician/NP reported uncontrolled phosphorus levels and believed the facility was not giving the phosphate binder as ordered, while the unit manager acknowledged that medications were routinely held during dialysis days without notifying the Medical Director or on-call provider, contrary to the DON’s stated expectations. The Medical Director confirmed he had not been informed of the missed doses and that medication times could have been adjusted.
Three highly dependent residents with significant mobility and self-care limitations had room call lights that did not illuminate in the hallway when activated, and each was instead provided with a handheld bell. One cognitively intact resident reported her call light had not worked for about a month, stated she had informed staff, and said maintenance told her a part was needed but did not return; another moderately cognitively impaired resident reported her call light had not worked properly for weeks and that a maintenance worker said he would address it later. Observations confirmed the malfunctioning call lights, and review of records showed no work orders for these repairs, while the Maintenance Director acknowledged repeated problems with bulbs and panels and a lack of documentation. Multiple staff, including CNAs, a nurse, the Unit Manager, the DON, and the Administrator, reported they were unaware of the non-functioning call lights and described inconsistent practices for reporting and documenting maintenance issues.
The facility failed to ensure daily nurse staffing sheets were complete and accurate on numerous days, with required entries for total numbers of RNs, LPNs, NAs, total hours worked for evening and night shifts, and resident census left blank. The Scheduler, who was responsible for completing these sheets, reported that she used the schedule to fill them out but frequently stopped to manage staff call-outs and then forgot to finish the forms, and she was unaware that no blanks were permitted. The DON and Administrator both stated that the Scheduler was responsible for the staffing sheets and acknowledged that the forms were expected to include complete staffing and census information for each shift.
A resident who was fully dependent on staff for transfers sustained a fractured humerus when a mechanical lift sling strap broke during a transfer, causing the resident to be lowered to the floor and strike her head and shoulder. Staff reported no visible defects in the sling prior to use, and the resident was hospitalized for evaluation and treatment before returning to the facility.
Two residents developed pressure sores that were not promptly reported to a physician, resulting in delayed treatment orders and incomplete documentation. Nursing staff initiated wound care without physician consultation, and facility protocols requiring physician notification for new pressure sores were not followed. The Wound Physician was only made aware of the wounds during routine rounds, rather than at the time of discovery.
Two residents experienced deficiencies in pressure ulcer care due to delayed reporting, lack of timely communication among nursing staff and the Wound Physician, and failure to promptly implement and document treatment orders. In one case, a pressure sore was not reported until it was unstageable, and diagnostic studies ordered for a non-healing wound were not completed in a timely manner. In another case, a sacral wound was not properly documented or treated for several days, and a change in wound care orders for a heel injury was not transcribed. Additionally, an air mattress was repeatedly set incorrectly for a resident's weight, compromising pressure relief.
A facility failed to involve a resident, who was cognitively intact and had multiple diagnoses, in the development of his person-centered care plan. Despite the expectation for a care planning meeting within 21 days of admission, neither the resident nor his representative were invited to participate. Interviews confirmed the absence of a scheduled meeting, highlighting a lapse in the facility's procedures.
The facility failed to complete a quarterly MDS assessment within 14 days following the ARD for a resident. The assessment remained in progress due to staffing challenges, as confirmed by MDS Nurses. The Administrator acknowledged that assessments should follow the RAI manual's schedule.
The facility inaccurately coded MDS assessments for three residents, leading to discrepancies in their medical records. One resident was incorrectly marked as receiving antipsychotic medication, another was not coded for hospice services despite being admitted to hospice, and a third was wrongly coded as having a pressure ulcer instead of a surgical wound. These errors were due to improper validation of assessment data by MDS nurses.
The facility failed to develop comprehensive care plans for three residents, including one with verbal behavioral symptoms, another prescribed antipsychotic medication, and a third with a surgical wound. Staff interviews revealed that expected care plans were not implemented, leading to deficiencies in addressing the residents' specific needs.
A nurse failed to properly store a bolus enteral feeding syringe after administering medication through a gastrostomy tube to a resident. The nurse did not separate the syringe parts to dry, instead placing the wet syringe back into a storage bag. The DON confirmed that the syringe should have been separated to prevent bacterial growth.
The facility failed to implement Enhanced Barrier Precautions (EBP) when a nurse, a wound nurse, and a wound physician did not wear gowns while providing care to two residents requiring EBP due to indwelling devices and wounds. The staff were unaware of the EBP requirements, despite being trained upon hire, and the facility did not use signage to indicate residents needing EBP.
The facility did not follow its infection control policy, failing to ensure staff received training on Enhanced Barrier Precautions (EBP). The Wound Care Nurse, employed since May 2024, was not trained on EBP and was unaware of its use. The DON could not confirm the nurse's training and could not locate the records, as the SDC responsible for training was no longer employed. The Administrator was unaware of the missing records.
A resident admitted with essential hypertension and dysphagia did not have a comprehensive care plan developed or implemented within the required timeframe. The MDS nurse confirmed the oversight, attributing it to the previous MDS nurse's departure around the time of admission. The DON and Administrator were unaware of the missing care plan, citing communication issues due to the resident's transfer and staff changes.
The facility failed to analyze and address the causes of a resident's multiple falls, leading to an impacted arm fracture, and did not ensure adequate supervision for a paraplegic resident during care, resulting in a fall and injury.
A facility failed to provide appropriate care for a resident with a feeding tube, leading to poor hygiene and a malfunctioning tube. Despite documentation indicating that care was provided, staff could not recall specifics, and an emergency room physician found the site to be unclean and leaking gastric contents.
The facility failed to follow physician orders and proper procedures for administering and documenting narcotic pain medications for three residents. An LPN repeatedly removed narcotics from the medication cart outside prescribed parameters and failed to document the administration, leading to discrepancies between the Controlled Drug Receipt/Record/Disposition form and the MAR.
The facility failed to document the administration of narcotic medication in the MAR for three residents. Multiple doses of narcotics were removed from the medication cart by various staff members, but there was no corresponding documentation on the MAR. The staff involved admitted to either forgetting to document or being bad at documentation. The DON confirmed the discrepancies.
The facility's Quality Assessment and Assurance Committee failed to maintain procedures and monitor interventions, resulting in repeated deficiencies in supervision to prevent accidents, hospice services, and pharmacy services. Issues included not analyzing falls, improper management of narcotic medications, and poor communication with hospice services, leading to multiple incidents of harm to residents.
The facility failed to protect residents' rights to be free from potential diversion of narcotics, involving two residents. Discrepancies in the administration records for Dilaudid and Oxycodone, signed out by an LPN but not documented, raised concerns about potential misuse. Despite staff concerns, the DON and ADON did not suspect drug diversion, as the narcotics were accounted for on the medication cart. The facility's Medical Director and Pharmacist expressed concerns about the potential effects of undocumented administration of narcotics.
The facility failed to communicate and coordinate with hospice services regarding a resident who sustained a dislocated finger. Despite the resident's severe cognitive impairment and behavioral issues, the facility did not document or address the deformity, which was first noted by hospice staff. The lack of communication led to a delay in identifying and addressing the dislocation, resulting in inadequate care.
Repeated Linen Shortages and Inadequate Access to Bathing and Bed Linens
Penalty
Summary
The facility failed to ensure linens were available for residents and staff, and multiple residents and staff reported repeated shortages of towels, washcloths, sheets, and pillowcases. Resident #9, who was cognitively intact, reported that when her bed linens were soiled with jelly during breakfast, staff did not have bed linens available and she had to wait until later that night for them to be replaced. She also reported that obtaining washcloths and towels was a problem and that she had seen nurse aides cut up towels to make washcloths, which led her to purchase her own towels and washcloths for personal use. Resident #10, who was coded as moderately cognitively impaired on the most recent quarterly MDS, reported that linens were an everyday problem and that staff did not have towels. She wanted linens for bathing and hygiene, but because linens were not available, staff were only able to provide incontinence care that morning and could not provide a full bath. Resident #11, who was documented as alert and oriented, was observed with a dirty pillowcase and reported there were no washcloths or towels that morning. He stated he kept a used washcloth from the prior day, let it dry, and used it to wash his face. A family member of Resident #12 reported seeing the same food stains on bed sheets from day to day. Staff interviews and observations showed the linen shortage was widespread and ongoing. Multiple nurse aides reported arriving to work without washcloths, towels, or sheets on their linen carts, and some said they had to use incontinence wipes, cut up towels, or search resident rooms for linens. One aide reported having six washcloths and six towels for eight residents, while another showed a cart with seven washcloths and no towels, sheets, or pillowcases. Linen carts on several halls were observed with no towels or washcloths, and the linen room was observed to have no linens. Laundry staff reported one dryer was broken and could not dry all needed linens, and the Maintenance Director stated the backup linen supply had been depleted after the Environmental Services Manager went on leave and no linens had been ordered for about two months. The Rehab Director also reported that therapy sessions were sometimes moved or rescheduled because linens could not be found, and said this happened about twice per week.
Failure to Implement Wound Care Orders and Obtain Supplies
Penalty
Summary
The facility failed to obtain supplies and implement the Wound NP’s treatment plan for a resident with a pressure sore. The resident had a history of surgery and radiation treatment for a brain tumor that resulted in aphasia and quadriparesis, along with seizure disorder, hypertension, dysphagia, and gastrostomy placement. The care plan identified the resident as being at risk for pressure sores because of decreased mobility, incontinence, and dependence on staff for positioning, and it included use of a low air loss pressure relieving mattress. The resident’s responsible party reported that the air mattress appeared sunken on one visit, and the Unit Manager found the plug partially out of the wall socket and reinserted it. Nursing documentation then showed the resident developed fluid-filled blisters on both buttocks that progressed to a large bilateral wound. The Wound NP initially described the wound as a pressure ulcer with rapid progression and later documented that the wound was consistent with inadequate pressure offloading after learning the mattress had malfunctioned before the wound appeared. Although the Wound NP changed the treatment plan multiple times, the revised orders were not entered into the electronic record and the new wound care plan was not initiated. The Wound Nurse stated she delayed entering the orders until supplies could be obtained, but supplies were difficult to secure through the facility’s ordering process. The DON stated the orders should have been entered after the Wound NP changed the plan and that the supplier needed the resident-specific order to send wound supplies. The resident’s wound continued to worsen, and hospital records later showed a butterfly-shaped wound with odor, bogginess, cellulitis, myositis, and an intramuscular fluid collection suggesting abscess or developing abscess.
Failure to Supervise a Fall-Risk Resident and Communicate Bedtime Toileting Instructions
Penalty
Summary
The facility failed to ensure adequate supervision and accident prevention for a resident who was at risk for falls and had diagnoses including Alzheimer’s disease and multiple myeloma. The resident’s care plan identified her as a fall risk and initially directed staff to keep common items within reach. After a fall, the resident’s care plan and Kardex were updated to direct staff to toilet her before bed, but the record did not specify a particular toileting time or clearly identify which shift was responsible for carrying out the intervention. Following the first fall, the resident was found on the floor after her call light had been on and she had been trying to go to the bathroom because the Nurse Aide did not arrive in time. The facility’s investigation documented that the fall occurred while the assigned Nurse Aide had not yet clocked in for the shift. The assigned Nurse Aide was scheduled to care for the resident beginning at 11:00 PM but did not clock in until 11:41 PM, and the nurse on duty reported she had not been aware the aide was late. The nurse also stated she had not checked on the resident before the fall occurred. During the investigation, the DON and Nurse Consultant did not identify that the assigned aide’s absence at the time of the fall and the lack of notification to nursing staff may have contributed to the event. After the toileting intervention was added, the resident had another fall while assigned staff reported they were unaware of any bedtime toileting instruction. One aide assigned to the resident did not recall having the resident or knowing about toileting at bedtime, and another aide reported she had not been aware of any toileting instructions. The nurse assigned to the resident during that shift also stated she did not know anything about directions that the resident should be toileted at bedtime. The resident was found on the floor again after saying she was trying to go to the bathroom, and she had swelling on her head and was sent to the hospital for evaluation. The resident’s RP reported concern about two falls during the resident’s short stay and believed staff were not monitoring the resident.
Failure to Obtain Ordered Medications and Use Backup Supply
Penalty
Summary
The facility failed to have effective systems in place to ensure ordered medications were obtained from the pharmacy and available for administration, and the backup supply was not used when medications had not been received. A resident admitted with panhypopituitarism and sleep apnea was ordered dexamethasone 1 mg daily. On 5/6/26, the MAR showed a notation of "9" for the scheduled dexamethasone dose, with no explanation documented, and the resident also had a new order for an albuterol sulfate inhalation nebulizer treatment that day. The MAR again showed "9" instead of administration, and the nurse documented only that pharmacy was aware. The nurse reported she did not recall why dexamethasone was not given and stated the albuterol was not available to administer. Another nurse reported the resident missed dexamethasone because the facility was out of the medication and the pharmacy had not refilled it, and that the albuterol was also not given while waiting for the pharmacy. The DON stated both medications were in the facility's backup supply and should have been pulled from it and administered. The resident was discharged to the hospital later that day without receiving either medication.
Failure to Provide Required Daily RN Coverage
Penalty
Summary
The facility failed to provide required RN coverage for 8 consecutive hours on 2 of 142 days reviewed, specifically on 12/28/25 and 1/24/26, despite having daily censuses of 85 and 77 residents, respectively. Review of daily nurse staffing sheets from 11/1/25 through 3/22/26 showed that on those two days there was no RN working any shift, and the RN sections on the staffing sheets were left blank. The Scheduler reported that she completed the daily nurse staffing sheets based on the schedule and, when there was no RN coverage, she left the RN spaces blank, acknowledging that there was no RN coverage on those dates and that she was unaware that blank spaces were not permitted or what steps to take when there was no RN coverage. The DON stated she was unaware there was no RN coverage on those two days and affirmed that there should be an RN in the building for 8 consecutive hours daily, while the Administrator stated his expectation that the facility have an RN in the building for 8 consecutive hours.
Failure to Complete Ongoing AIMS Assessments for Resident on Antipsychotic Medication
Penalty
Summary
The deficiency involves the facility’s failure to provide ongoing Abnormal Involuntary Movement Scale (AIMS) assessments for a resident receiving antipsychotic medication. The resident was admitted with dementia with severe behavioral disturbance and agitation and had a physician’s order for haloperidol lactate 2 mg/ml, 0.5 ml by mouth twice daily for behaviors. Review of the electronic medical record showed the last AIMS assessment was dated 7/29/25, with no subsequent AIMS assessments found. The resident’s quarterly MDS documented cognitive impairment, behavioral symptoms, and use of antipsychotic medication, but there was no corresponding quarterly AIMS assessment in the record. Facility staff interviews confirmed that required AIMS assessments were not completed as expected. The Unit Manager stated that when new ownership took over in November 2025, some assessments were not scheduled and acknowledged that AIMS assessments should be done on admission, readmission, and quarterly, and that this resident’s quarterly AIMS was missed. The DON similarly stated that AIMS assessments were expected at admission, readmission, with new prescriptions, and quarterly, and that unit managers were responsible for completing them. The Pharmacy Consultant stated AIMS should be done at the start of antipsychotic therapy and again at 6 months if no dose changes occurred, and the Medical Director stated AIMS should be completed at least every 6 months, noting that a recent hospitalization might have interfered with timing but that the 6‑month AIMS should still have been completed. The Administrator stated he expected all assessments needed for antipsychotic medications, including AIMS, to be completed timely and reviewed as necessary.
Inaccurate MDS Coding for Tube-Fed Resident
Penalty
Summary
The facility failed to ensure an accurate Minimum Data Set (MDS) assessment for one resident when it did not code the presence of a feeding tube or the percent of intake by artificial route. The resident had a history of dysphagia, hemiplegia, and hemiparesis following a cerebral infarction and had physician orders for enteral nutrition via feeding tube at 60 ml per hour from 6 p.m. to 6 a.m., with 200 ml water flushes every four hours. Review of the Medication Administration Record for the month showed the ordered tube feeding and water flushes were administered as ordered. However, the quarterly MDS assessment did not reflect that the resident had a feeding tube or any intake by artificial route. During interviews, the Regional MDS Consultant reported that the Dietary Manager, rather than the MDS Coordinator, had completed the nutrition section of the MDS, and acknowledged that the MDS coding indicating the resident did not have a feeding tube and lacked intake by artificial route was an error. The Administrator also acknowledged that the MDS assessments should have been coded accurately to reflect the feeding tube and the amount of intake by artificial route.
Pharmacy Consultant Failed to Identify Missing AIMS Monitoring for Antipsychotic Therapy
Penalty
Summary
A deficiency occurred when the facility’s Pharmacy Consultant failed to identify and report irregularities related to required monitoring for an antipsychotic medication during monthly drug regimen reviews. Resident #3, admitted with dementia with severe behavioral disturbance and agitation, had a physician’s order dated 4/21/25 for haloperidol lactate 2 mg/ml, 0.5 ml by mouth twice daily for behaviors. Review of the resident’s electronic medical record showed the last Abnormal Involuntary Movement Scale (AIMS) assessment was dated 7/29/25, with no subsequent AIMS assessments documented after that date. Despite this, the Pharmacy Consultant’s monthly drug regimen reviews dated 10/10/25 and pharmacy reports from November 2025 through February 2026 contained no documentation or recommendations indicating the need for updated AIMS assessments. During an interview, the Pharmacy Consultant stated that AIMS assessments should be completed at the start of antipsychotic therapy and, if no dose changes occur, again at six months. He explained that his reviews focused on physician and psychiatric progress notes for medication-related side effects and that if no issues were noted, he did not make recommendations. He further stated that he left AIMS assessment decisions to the treating physician, resulting in the omission of identifying and reporting the lack of current AIMS assessments for Resident #3 while the resident continued on haloperidol.
Failure to Administer Ordered Medications for Dialysis Resident
Penalty
Summary
The deficiency involves the facility’s failure to ensure medications were administered in accordance with physician orders for a resident with ESRD on hemodialysis, chronic respiratory failure, COPD, and moderate protein-calorie malnutrition. The resident’s care plan addressed ESRD, fluid volume management, medication administration as ordered, monitoring vital signs, and diet, and was later revised for ADL assistance, but did not include interventions for medication availability, administration on dialysis days, or medication refusals. Physician orders included Sevelamer (later changed to Sevelamer HCl and then to Velphoro) as phosphate binders, Carvedilol for blood pressure/heart failure, and Sertraline for depression/anxiety. Review of the MARs showed multiple dates on which Sevelamer, Sertraline, and Carvedilol were not administered because the resident was out of the facility or at dialysis at the scheduled administration times. The Dialysis Dietician/Nurse Practitioner reported that the resident’s phosphorus levels were not controlled and believed the facility was not administering the phosphate binder as ordered, noting that the resident did not take medications at the dialysis center and that the medication should have been given with meals or snacks upon return to the facility. She stated the resident’s phosphorus level was 6.5 and that his phosphorus had been well controlled before coming to this facility. The DON stated that when medications are held or not available, nurses should call the on-call provider for direction, but the Nurse Unit Manager acknowledged that medications were held when the resident was out for dialysis, were not given upon return, and that staff did not contact the Medical Director or on-call provider when medications were held. The Nurse Unit Manager also stated that a scheduled afternoon dose of Carvedilol was held every Monday, Wednesday, and Friday during dialysis. The Medical Director stated he had not been informed of missed medications, that his expectation was to be contacted when medications were missed due to the resident being out of the building, and that medication times could have been adjusted so they were not scheduled during dialysis.
Failure to Maintain Functioning Call Light System for Multiple Dependent Residents
Penalty
Summary
Surveyors identified that the facility failed to ensure the resident call light system was functioning properly for three residents whose call systems did not illuminate in the hallway when activated. Maintenance purchase records showed light bulbs were ordered in early February with a noted delivery date in February, but the Maintenance Director later clarified the shipment was actually delayed until mid-March. Work orders from January through March contained no entries for call light repairs for these three residents, and the Maintenance Director acknowledged he had no documentation of the dates and times he worked on the call lights and stated he should have kept a record. One resident with inflammatory and immune myopathies, generalized weakness, and significant dependence on staff for most ADLs, including toileting, transfers, and bathing, reported that her call light had not lit up outside her door for about a month. She stated she informed her nurse aide and nurse, and that maintenance told her a part had to be ordered but never returned to fix it; she was given a handheld bell by the Activities Director. During observation, pressing her call light did not illuminate the hallway light, and a handheld bell was seen in her room. The Activities Director reported learning of this issue during a Resident Council meeting, confirmed the call light was not working when she checked it, and stated she verbally notified maintenance and provided the resident with a bell. Two additional residents, both with generalized weakness, mobility impairments, and high dependence on staff for toileting, transfers, and bathing, also had non-functioning call lights that did not illuminate in the hallway when tested, and handheld bells were observed in their rooms. One of these residents, who was moderately cognitively impaired, stated her call light had not worked properly for a few weeks, reported she told a nurse aide, and that a maintenance staff member told her he would get to it later. The other resident was severely cognitively impaired and not interviewable. The nurse aides, nurse, Unit Manager, DON, and Administrator all stated they were unaware that these residents’ call lights were not working, and staff described varying expectations for reporting repairs, including verbal reports to maintenance, use of a maintenance communication book, and use of a web-based building management system, but there was no documented follow-through for these specific call light issues.
Incomplete and Inaccurate Daily Nurse Staffing Sheets Across Multiple Dates
Penalty
Summary
The deficiency involves the facility’s failure to ensure that daily nurse staffing sheets were complete and accurate for 36 of 53 days reviewed between 12/1/25 and 3/22/26. Record review showed that on multiple specific dates, the sections for total numbers of staff by discipline (RN, LPN, NA) and total hours worked for each discipline on the evening (3:00 pm–11:00 pm) and night (11:00 pm–7:00 am) shifts were left blank. On several of these dates, the resident census was also left blank. These omissions occurred repeatedly across many days in December, February, and March. The incomplete documentation was identified through review of the facility’s daily nurse staffing sheets for the listed dates. For each of those days, the forms lacked required entries for staffing totals and hours worked for evening and night shifts, and on some days, the census field was not completed. The report specifies that this pattern of missing information affected a substantial portion of the review period, indicating that the required daily posting and documentation of staffing levels and census were not consistently recorded as required on the forms. Interviews with facility staff further clarified how these omissions occurred. The Scheduler reported that she used the work schedule to complete the daily nurse staffing sheets but would stop and start this task while addressing staff call-outs and searching for coverage, and then forgot to return to complete the forms for the affected dates. She also stated she was unaware that there could be no blank spaces on the daily nurse staffing sheets. The DON stated that the Scheduler was responsible for completing the daily nurse staffing sheets and that she was unaware they were not fully filled out, and confirmed that the sheets should include total staff numbers and hours by discipline and shift, as well as the census. The Administrator similarly stated that the Scheduler was supposed to complete the daily nurse staffing sheets and that his expectation was that they be completed correctly.
Mechanical Lift Sling Failure During Resident Transfer
Penalty
Summary
A deficiency occurred when a resident, who was totally dependent on staff for transfers and had a history of stroke and chronic pain, was being transferred using a mechanical lift. During the transfer, one of the four straps on the lift sling broke at the seam where it joined the body of the sling. Both nurse aides assisting with the transfer reported that they had not noticed any issues with the sling prior to use and confirmed that the correct size sling was being used. As a result of the strap failure, the resident was lowered to the floor, hitting her head and left shoulder on the bed rail during the process. The resident was subsequently sent to the hospital for evaluation, where she was found to have sustained a left humerus fracture. Hospital records indicated that the resident was on anticoagulant medication and was already receiving multiple medications for chronic pain. Imaging confirmed the fracture, and the resident's arm was immobilized with a sling. She was discharged back to the facility in stable condition after assessment and treatment. Interviews with staff and a representative from the lift manufacturer revealed that the cause of the sling failure could not be definitively determined without examining the sling, but possibilities included normal wear from use and laundering or a manufacturing defect. The facility's Director of Nursing and Administrator confirmed that the sling was not old and that the resident's weight did not exceed the sling's capacity. Prior to the incident, there was no indication that the sling was in disrepair, and staff had not identified any visible defects.
Failure to Notify Physician of New Pressure Sores
Penalty
Summary
The facility failed to notify physicians in a timely manner when two residents developed pressure sores. In the first case, a resident with multiple comorbidities, including cellulitis, lymphedema, and chronic kidney disease, developed a sacral pressure sore that was first identified by the Wound Care Nurse. The nurse did not immediately notify the physician or enter treatment orders into the electronic record, instead applying skin prep and later Santyl without physician consultation. The physician was not notified until several days later during routine rounds, at which point a more comprehensive treatment plan was initiated. In the second case, another resident with a history of diabetes, hypertension, and stroke returned from a hospital stay and was found to have an open area on the sacrum and a deep tissue injury to the right heel. Documentation was incomplete regarding the sacral wound, and there was no evidence that the physician was notified at the time of discovery. The Wound Care Nurse began treatment for the heel injury but did not notify the physician about the pressure sores. A one-time dressing order was obtained for the sacral wound, but there was no further documentation of physician notification or ongoing treatment orders until the resident was seen by the Wound Physician several days later, at which point a stage 4 pressure sore was identified. Interviews with nursing staff and the DON revealed that facility protocols required nurses to notify physicians and obtain orders for new pressure sores, but these protocols were not followed. The Wound Care Nurse and other staff members did not consistently communicate the presence of new wounds to the physician, and documentation was lacking. The Wound Physician confirmed that she was not made aware of the wounds until her scheduled visits, and the DON acknowledged that nurses should have contacted the physician and obtained appropriate orders when new pressure sores were identified.
Failure to Ensure Timely Pressure Ulcer Care, Communication, and Equipment Settings
Penalty
Summary
The facility failed to provide appropriate pressure ulcer care and prevent new ulcers from developing for two residents. In one case, a resident with multiple comorbidities, including cellulitis, lymphedema, and chronic kidney disease, developed a sacral pressure sore that was not reported by nurse aides to a nurse until it was already unstageable. The wound was first identified by the Wound Care Nurse, who did not immediately notify the Wound Physician or enter treatment orders into the electronic record. As a result, there was a delay in initiating appropriate wound care, and the primary care nurses were unaware of the wound or any treatment orders during weekends. The Wound Physician was not consulted at the time of initial discovery, and the treatment plan was not implemented until several days later. Additionally, when the wound failed to heal, further diagnostic studies ordered by the Wound Physician, such as lab work and x-rays, were not completed in a timely manner due to a lack of communication and oversight, resulting in a prolonged period before the underlying infection and other complications were identified. In another instance, a second resident returned from hospitalization and was found to have an open area on the sacrum, but the initial assessment lacked detailed documentation. The Wound Care Nurse did not observe the sacral wound during her assessment, and there was a delay in obtaining and documenting treatment orders. A one-time dressing order was obtained, but no ongoing treatment plan was established or documented for several days. Communication lapses between nursing staff, the Wound Care Nurse, and the Wound Physician led to the wound not being properly addressed until it was identified as a Stage 4 pressure sore by the Wound Physician. Additionally, a change in the treatment plan for a heel wound was not transcribed into the electronic record, resulting in continued use of an outdated treatment. The facility also failed to ensure that the settings of a pressure-relieving air mattress were correctly adjusted for a resident's weight. The air mattress was observed to be set for a much higher weight than the resident's actual weight on multiple occasions, which could have compromised pressure relief. Staff interviews revealed a lack of clarity regarding responsibility for checking and maintaining correct mattress settings, and the Wound Care Nurse acknowledged that the setting was incorrect and should have been adjusted to match the resident's weight.
Failure to Involve Resident in Care Planning
Penalty
Summary
The facility failed to invite a resident to participate in the development of his person-centered plan of care. This deficiency was identified for a resident who was admitted with diagnoses including non-traumatic brain dysfunction, renal insufficiency, diabetes, and hypertension. Despite being cognitively intact, the resident reported that he had never been invited to participate in the care planning process. The resident's care plan had a goal for discharge to the community, but there was no evidence that the resident or his representative had been involved in its development. Interviews with the resident's representative and the facility's social worker confirmed that no care plan meeting had been held within the expected timeframe of 21 days post-admission. The social worker acknowledged that the resident should have been included in a care plan meeting by a specific date but could not provide evidence of scheduling or invitations. The facility administrator also confirmed the expectation for timely care planning meetings, indicating a lapse in the facility's procedures for involving residents and their representatives in care planning.
Failure to Complete Timely MDS Assessment
Penalty
Summary
The facility failed to complete a quarterly Minimum Data Set (MDS) assessment within 14 days following the Assessment Reference Date (ARD) for one resident. Resident #48, who was admitted to the facility, had an MDS assessment with an ARD of 11/15/24 that remained in progress and was not completed timely. Interviews with MDS Nurses revealed that due to staffing challenges, they were behind in completing the assessment according to the Resident Assessment Instrument (RAI) manual requirements. The Administrator confirmed that MDS assessments should adhere to the RAI manual's schedule.
Inaccurate MDS Coding for Residents
Penalty
Summary
The facility failed to accurately code the Minimum Data Set (MDS) assessments for three residents, leading to discrepancies in their medical records. Resident #50 was incorrectly coded as receiving antipsychotic medication, despite the Medication Administration Record (MAR) showing no such medication was administered in November 2024. This error was attributed to MDS nurses pulling answers from previous assessments without proper validation, as confirmed by interviews with MDS Nurse #1 and MDS Nurse #2. The administrator acknowledged that MDS assessments should reflect the resident's current status. Resident #173, who was admitted to hospice on November 26, 2024, was not coded for hospice services in her MDS assessment, despite her face sheet indicating hospice Medicaid as her payor source. MDS Nurse #1 confirmed the oversight, and the administrator reiterated the need for accurate coding. Additionally, Resident #58 was incorrectly coded as having a stage III pressure ulcer, although he only had a surgical wound from an abscess removal. The Wound Care Nurse and MDS Nurse #1 both confirmed the miscoding, and the administrator acknowledged the error, emphasizing the importance of accurate MDS coding.
Failure to Implement Comprehensive Care Plans for Residents
Penalty
Summary
The facility failed to develop and implement comprehensive care plans for three residents, leading to deficiencies in addressing their specific needs. Resident #55, who was admitted with diagnoses including cerebral infarction and cognitive communication deficit, exhibited verbal behavioral symptoms. Despite being referred to psychiatric therapy multiple times, the care plan did not include measures to address these behaviors. The Social Worker acknowledged missing the inclusion of behavioral outbursts in the care plan update, and both the Social Worker and Administrator expected these behaviors to be documented in the care plan. Resident #62, diagnosed with conditions such as hypertension and dementia, was prescribed an antipsychotic medication. However, the care plan did not include information regarding the use of this medication. The Social Worker stated she would only include such information if side effects were exhibited, while the Director of Nursing and Administrator expected the medication to be part of the care plan. Additionally, Resident #58, who had a surgical wound from an abscess removal, did not have a care plan for wound care. The Wound Care Nurse and MDS Nurse were unaware of the absence of a wound care plan, and the Director of Nursing and Administrator confirmed that a care plan should have been implemented upon admission.
Improper Storage of Enteral Feeding Syringe
Penalty
Summary
The facility failed to properly store a bolus enteral feeding syringe used for medication administration through a gastrostomy tube for a resident. During an observation, Nurse #3 was seen administering medication to the resident using a 2-part piston and barrel syringe. After use, the nurse rinsed the syringe with water but did not separate the piston from the barrel to dry. Instead, she reassembled the wet syringe and placed it into a plastic storage bag. In an interview, Nurse #3 admitted to storing the syringe without separating the parts, which is against proper protocol. The Director of Nursing confirmed that the syringe should have been separated to prevent bacterial growth during storage.
Failure to Implement Enhanced Barrier Precautions
Penalty
Summary
The facility failed to implement its Enhanced Barrier Precautions (EBP) policy, which is designed to reduce the transmission of multidrug-resistant organisms through the use of gloves and gowns during high-contact resident care activities. This deficiency was observed when Nurse #3, the Wound Nurse, and the Wound Physician did not wear gowns while providing care to two residents, Resident #21 and Resident #58, who required EBP due to their medical conditions involving indwelling devices and wounds, respectively. During a medication administration observation, Nurse #3 entered Resident #21's room to administer medications via a gastrostomy tube without donning a gown, despite the resident being care planned for EBP due to the feeding tube. Nurse #3 was unaware of the requirement to wear a gown for residents with indwelling devices. The Wound Physician confirmed that EBP should have been followed to prevent the transmission of multidrug-resistant organisms. The Director of Nursing (DON) and the Administrator acknowledged that Nurse #3 should have worn a gown, and staff were trained on EBP upon hire. In another instance, the Wound Care Physician and Wound Care Nurse entered Resident #58's room to provide wound care without wearing gowns, despite the resident being on EBP for chronic wound care. Both the Wound Care Physician and the Wound Care Nurse were unaware of the EBP requirement, with the Wound Care Nurse stating she had not been trained on EBP. The DON and the Administrator confirmed that gowns should have been worn during wound care, and staff were educated on EBP upon hire, although the facility did not use EBP signage to indicate which residents required these precautions.
Failure to Train Staff on Enhanced Barrier Precautions
Penalty
Summary
The facility failed to adhere to its infection control policy and procedure by not ensuring that staff received training on Enhanced Barrier Precautions (EBP). The Wound Care Nurse, who had been employed since May 2024, reported not receiving any training on EBP and was unaware of its use within the facility. During an interview, the Director of Nursing (DON) admitted to not knowing whether the Wound Care Nurse had been educated on EBP and was unable to locate the training records, as the Staff Development Coordinator (SDC), who was responsible for the education, was no longer employed at the facility. The Administrator also confirmed that staff were supposed to be trained on EBP upon hiring, but was unaware that the DON did not have access to the training records.
Failure to Develop Comprehensive Care Plan
Penalty
Summary
The facility failed to develop and implement a comprehensive care plan for a resident who was admitted with diagnoses of essential hypertension and dysphagia. Upon review of the resident's medical record, it was found that no comprehensive care plans had been developed or implemented. The MDS nurse confirmed that the resident, who had been in the facility for about six weeks, should have had a care plan completed within the first 21 days after admission. The MDS nurse attributed the oversight to the departure of the previous MDS nurse around the time of the resident's admission. The Director of Nursing (DON) stated that the MDS nurse was responsible for developing care plans, and nurses could add to them if they notified the MDS nurse. The DON was unaware of the missing care plan and believed it was a communication issue due to the resident's transfer from assisted living to long-term care coinciding with the MDS nurse's departure. The Administrator also was not aware of the missing care plan and attributed it to the timing of the MDS nurse's departure on the day of the resident's admission to long-term care.
Failure to Prevent Falls and Ensure Resident Safety
Penalty
Summary
The facility failed to adequately analyze and address the causative factors of Resident #2's falls, leading to multiple incidents and an impacted arm fracture. Resident #2, who had severe cognitive impairment and a history of falls, experienced several falls between January and February 2024. Despite these incidents, there was no documented evaluation by therapy staff or a thorough review of the resident's medications, which included Risperdal and Minipress, both of which could contribute to orthostatic hypotension and falls. The facility's investigation into these falls was insufficient, as it did not result in effective interventions to prevent further falls or address the potential medication side effects contributing to the resident's condition. Resident #2's medical records revealed a series of falls, including an unwitnessed fall on January 11, 2024, where the resident reported that God had told her to walk. Subsequent falls occurred on January 21, January 26, and February 2, 2024, with the latter resulting in hospitalization for recurrent falls, orthostatic hypotension, and bradycardia. Despite these incidents, the facility's interventions remained largely unchanged, focusing on ensuring proper footwear, bed positioning, and nursing rounds without addressing the underlying issues. The resident's medications were not adequately reviewed in relation to her falls, and the Psychiatric Nurse Practitioner and Consultant Pharmacist were not fully aware of the frequency and potential medication-related causes of the falls. Additionally, the facility failed to ensure adequate supervision and safety measures for Resident #1, a paraplegic resident, during care. On February 21, 2024, Resident #1 fell out of bed while being bathed by a Nursing Assistant (NA #1), resulting in a superficial forehead laceration. The incident occurred despite the use of short upper side rails, which were later changed to half rails to aid in bed mobility and positioning. The Director of Nursing (DON) attributed the fall to improper body mechanics and positioning by the nursing assistant, and an in-service training on falls prevention was conducted for the staff. However, the facility's documentation and investigation into the incident were inadequate, as the DON did not document interviews with staff or conduct a thorough review of the events leading to the fall.
Failure to Provide Appropriate Care for Feeding Tube
Penalty
Summary
The facility failed to provide appropriate care for a resident with a feeding tube, leading to a deficiency. Resident #1, who had oropharyngeal dysphagia and a percutaneous gastrostomy tube, was readmitted to the facility after a hospital stay. Upon return, there was no documentation describing the condition of the gastrostomy tube site. Multiple nurses and a medication aide documented that they performed the required cleaning and dressing changes, but none could recall the specifics of the site or the dressing. Additionally, there was a day when the cleaning was not documented at all. The situation escalated when the medication aide noticed an issue with the gastrostomy tube and informed Nurse #2, who then sent Resident #1 to the emergency room. The emergency room physician found that the dressing on the gastrostomy tube was dated 12 days prior and was very unclean, with gastric contents leaking from the site and a ruptured balloon. The physician expressed concerns about the poor hygiene care of the gastrostomy tube site. Interviews with the Director of Nursing (DON) and the Assistant Director of Nursing (ADON) revealed that they believed the staff had completed the required care as documented. However, they did not believe the emergency room physician's description of the gastrostomy tube site. The DON and ADON stated that supplies for dressing changes were readily available and that there was good communication among the staff regarding wound care needs.
Failure to Adhere to Physician Orders and Document Narcotic Administration
Penalty
Summary
The facility failed to adhere to physician orders and proper procedures for administering and documenting narcotic pain medications for three residents. For Resident #6, Nurse #5 repeatedly removed Oxycodone with Acetaminophen from the medication cart outside the prescribed parameters and failed to document the administration on the Medication Administration Record (MAR). Despite the resident's severe cognitive impairment, the Director of Nursing (DON) confirmed that the resident was knowledgeable about his pain medication. However, the DON and Nurse #5 did not follow the physician's orders or document the administration properly, leading to discrepancies between the Controlled Drug Receipt/Record/Disposition form and the MAR. For Resident #7, Nurse #5 removed Hydromorphone (Dilaudid) tablets from the medication cart and failed to document the administration on the MAR. Additionally, a tablet was reported lost on the floor without a corresponding signature from another nurse, violating the facility's procedures for handling controlled substances. Resident #7, who was cognitively intact, stated she would not have taken more than the prescribed dose of Dilaudid, indicating a potential over-administration by Nurse #5. Resident #8 also experienced similar issues, with Nurse #5 removing Oxycodone HCL tablets from the medication cart without a physician's order and failing to document the administration on the MAR. The DON confirmed that the Controlled Drug Receipt/Record/Disposition form should match the MAR and that nurses should follow physician orders. The facility pharmacist and Medical Director both emphasized the need for proper documentation and adherence to physician orders, highlighting the facility's failure to monitor and reconcile controlled medications effectively.
Failure to Document Administration of Narcotic Medication
Penalty
Summary
The facility failed to document the administration of narcotic medication in the medication administration record (MAR) for three residents. For Resident #6, multiple doses of Oxycodone with Acetaminophen were removed from the medication cart by various nurses, but there was no corresponding documentation on the MAR. The nurses involved admitted to either forgetting to document or being bad at documentation. The Director of Nursing (DON) confirmed that the Controlled Drug Receipt/Record/Disposition form should match the MAR for accuracy of documentation. For Resident #7, doses of Hydromorphon were removed from the medication cart by a nurse, but there was no corresponding documentation on the MAR. Additionally, there was a dose documented on the MAR without a corresponding entry on the Controlled Drug Receipt/Record/Disposition form. The nurse involved did not respond to interview requests, and the DON confirmed the discrepancy. For Resident #8, multiple doses of Oxycodone HCL were removed from the medication cart by various staff members, but there was no corresponding documentation on the MAR. The staff members involved admitted to either forgetting to document or making human errors. The DON confirmed that the Controlled Drug Receipt/Record/Disposition form should match the MAR for accuracy of documentation.
Repeated Deficiencies in Supervision, Hospice, and Pharmacy Services
Penalty
Summary
The facility's Quality Assessment and Assurance Committee failed to maintain implemented procedures and monitor interventions following multiple surveys, resulting in repeated deficiencies in supervision to prevent accidents, hospice services, and pharmacy services. Specifically, the facility did not analyze a resident's falls to determine causative factors and implement interventions to reduce the risk of further falls. Additionally, the facility failed to ensure a paraplegic resident did not roll out of bed during care. These issues were observed in multiple surveys, including a failure to repair a loose siderail, ensure a fall mat was in place, and provide supervision to a resident assessed as a supervised smoker. The facility also failed to manage narcotic pain medications properly, including removing medications from the cart without physician orders, not following procedures for disposal of wasted narcotic medication, and lacking effective safeguards to control and reconcile controlled medications. Furthermore, the facility did not communicate and coordinate with hospice services effectively, resulting in a resident sustaining a dislocated finger without proper identification and intervention. These deficiencies were observed across several surveys, indicating a pattern of the facility's inability to sustain an effective Quality Assessment and Assurance Program.
Failure to Protect Residents from Potential Narcotic Diversion
Penalty
Summary
The facility failed to protect residents' rights to be free from potential diversion of narcotics, specifically involving two residents. Resident #7, who was cognitively intact, had an order for Dilaudid 2 mg tablets to be administered every 6 hours as needed for pain. However, documentation revealed discrepancies in the administration of the medication, with multiple doses signed out by Nurse #5 but not recorded on the Medication Administration Record. Resident #7 confirmed she would not have taken the medication in such a short time frame, and the facility's Medical Director expressed concerns about the potential effects of such administration. Nurse #5 admitted to poor documentation practices and did not seek physician approval for administering the medication outside the prescribed parameters. Resident #6, who had severely impaired cognition, had an order for Oxycodone with Acetaminophen 5-325 mg tablets to be administered every 4 hours as needed for severe pain. Similar to Resident #7, there were discrepancies in the administration records, with multiple doses signed out by Nurse #5 but not documented on the Medication Administration Record. Interviews with other staff members revealed concerns about the number of doses removed and the lack of documentation. Despite these concerns, the facility's DON and ADON did not suspect drug diversion, as the narcotics were accounted for on the medication cart. Nurse #5 admitted to administering the medication without proper documentation and without seeking physician approval for deviations from the prescribed order. The facility's failure to monitor and document the administration of narcotic medications accurately led to potential diversion and misuse of residents' medications. The discrepancies in the Controlled Drug Receipt/Record/Disposition forms and the Medication Administration Records for both residents raised concerns about the facility's adherence to its abuse prevention program policies and procedures. The facility's Medical Director and Pharmacist both expressed concerns about the potential effects of the undocumented administration of narcotics, highlighting the need for proper monitoring and documentation to ensure residents' safety and well-being.
Failure to Communicate and Coordinate Care for Hospice Resident
Penalty
Summary
The facility failed to communicate and coordinate with hospice services regarding a resident who sustained a dislocated finger. Resident #3, who had a history of stroke, hemiplegia, hemiparesis, dysphagia, and advanced dementia, was admitted to the facility as a hospice resident. The resident's care plan noted behavioral issues, and a significant change Minimum Data Set assessment indicated severe cognitive impairment. Despite these conditions, the facility did not document or address the deformity of the resident's left index finger, which was first noted by hospice staff on 2/27/24. Hospice Nurse #1, who routinely visited the resident twice per week, observed an open wound and a deformity in the resident's left index finger on 3/28/24. The Director of Nursing (DON) was unaware of the deformity, as there had been no documentation by facility staff. Hospice Nurse #2, who had cared for the resident during Nurse #1's absence, reported no deformity when she last saw the resident on 2/27/24. The facility physician, who was also the medical director, was not informed of the deformity until an x-ray was performed on 3/30/24, revealing a dislocated finger with possible septic arthritis. The facility administrator was also unaware of the dislocation until the x-ray results were obtained. The lack of communication between hospice staff and facility staff led to a delay in identifying and addressing the resident's dislocated finger. The hospice physician decided that no further treatment was necessary, and the facility continued with dressing changes as per the hospice orders. The deficiency highlights a significant lapse in communication and coordination between the facility and hospice services, resulting in inadequate care for the resident.
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Illustrative
What surveyors actually found near you
We read the 49 citations issued within 25 miles in the last 12 months — including the 3 immediate-jeopardy cases — and tell you exactly what happened, in plain English, matched to your record.
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
A prioritized, do-first checklist
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Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Greenville
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Greenville Health And Rehabilitation Center | 0.2 mi | ★★★★★ | 0 | 0 |
| Macgregor Downs Health Center By Harborview | 0.7 mi | ★★★★★ | 3 | 0 |
| Cypress Glen Retirement Community | 3.8 mi | ★★★★★ | 0 | 0 |
| Pruitthealth-farmville | 10.5 mi | ★★★★★ | 5 | 0 |
| Ayden Court Nursing And Rehabilitation Center | 10.7 mi | ★★★★★ | 6 | 1 |
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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.