Above 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 Stanton Health Center during CMS and state inspections, most recent first.
A resident with schizophrenia, depression, and later severe cognitive impairment repeatedly pursued another resident, with records showing obsessive, aggressive, and sexually inappropriate behaviors, including yelling, cursing, hovering, and distress when the other resident was unavailable. The other resident, who had Alzheimer’s disease and later severe cognitive impairment, told staff the resident was always there and that they wanted nothing to do with the resident. The DON and SSD confirmed the pursuit continued and that no assessment had been completed to ensure intimacy rights and self-determination while protecting both residents from potential abuse.
A resident with dementia, severe cognitive impairment, wandering, and behavioral symptoms had a care plan with anxiety-related interventions, but staff did not consistently provide meaningful behavior management services. After a resident-to-resident altercation caused a superficial skin break, staff identified activity engagement when the resident entered others’ personal space, yet this intervention was not added to the care plan. Observations showed the resident wandering into rooms and approaching others without resident engagement activities in place, while staff mainly relied on separation, snacks, toileting, or redirection.
A resident was transferred in a bath chair through a corridor while wearing an open-back hospital gown, leaving their lower back and buttocks exposed and visible to others. The bath aide confirmed the resident should have been fully covered during the transfer.
The facility did not report or investigate incidents involving inappropriate physical contact and potential abuse between two cognitively impaired residents, despite facility policy requiring immediate reporting to the State Agency. Documentation and interviews confirmed that these events were not reported as required.
A resident with multiple medical conditions and cognitive impairments experienced several unwitnessed falls, after which staff failed to complete and document neurological assessments as required by facility policy. Instead, staff often recorded that the resident was sleeping, resulting in missed assessments and vital sign checks at scheduled intervals.
The facility did not establish or maintain an infection prevention and control program as required, resulting in a deficiency identified by surveyors.
A facility failed to notify a resident's PCP of significant changes in the resident's condition, including fluid buildup, altered mental status, and self-harming behaviors. The resident, with multiple diagnoses, exhibited concerning behaviors and physical symptoms over several days, but the PCP was not informed until later, contrary to facility policy.
A facility failed to complete the required Discharge Summary for a resident at the time of their planned discharge. The facility's policy requires a Discharge Summary to include a recapitulation of the resident's stay, a final summary of their status, medication reconciliation, and a post-discharge care plan. However, a review of the resident's records showed no evidence of this summary, which was confirmed by the DON.
The facility failed to follow physician orders for two residents, leading to deficiencies in care. One resident, with a fluid restriction due to health conditions, was observed with excessive fluids in their room, and staff were unaware of the restriction. Another resident, with multiple diagnoses, had orders for daily weights and as-needed Lasix, but the facility failed to obtain weights on numerous days and did not administer Lasix despite significant weight gains. Interviews confirmed these lapses, resulting in deficiencies in care.
A resident admitted with a stage 1 pressure ulcer did not receive the required weekly assessments, leading to the ulcer's progression to stage 2 without proper documentation. An LPN identified the change during a wound care observation, and the DON confirmed the facility's failure to monitor the ulcer effectively.
A facility failed to maintain infection prevention measures during wound and catheter care for two residents. Staff did not properly secure gowns or perform hand hygiene between glove changes, increasing the risk of infection transmission. One resident had chronic wounds and a catheter, while another had self-care deficits and skin issues. The Director of Nursing confirmed the need for proper hand hygiene and gown use during high-contact care activities.
Failure to Protect Two Residents From Adverse Behaviors
Penalty
Summary
The facility failed to ensure that two residents were protected from adverse behaviors by another resident. The deficiency was cited under the requirement to protect each resident from all types of abuse, including physical, mental, sexual abuse, physical punishment, and neglect. Survey review found that Resident 5 and Resident 10 were involved in a relationship that was initially described in the care plans as consensual, with both residents’ POAs aware of it, but the record also showed repeated episodes of escalating, obsessive, and aggressive behavior by Resident 5 toward Resident 10. Resident 5’s record showed multiple incidents of yelling, cursing, pacing, throwing or slamming a walker, wandering into other residents’ spaces, and becoming distressed when unable to locate Resident 10. The resident was documented as obsessive toward Resident 10, repeatedly seeking the resident out, becoming angry when Resident 10 was not available, and at times hovering over Resident 10 until the resident became anxious. Resident 5 also had episodes of sexually inappropriate behavior, including an order for estradiol after sexually inappropriate behaviors were documented, and later had a BIMS score of 5 indicating severe cognitive impairment. The resident’s diagnoses included prostate cancer, anemia, heart failure, diabetes, depression, schizophrenia, and insomnia, and the resident was receiving antipsychotic, antidepressant, and antianxiety medications. Resident 10’s record showed diagnoses of atrial fibrillation, hypertension, and Alzheimer’s disease, with the resident initially assessed as cognitively intact and later documented as severely impaired. The care plan also described the relationship as consensual and noted that the POA was aware and fine with it. However, Resident 10 told staff that Resident 5 was always there and that the resident wanted nothing to do with Resident 5. During interview, the DON and SSD confirmed that Resident 5 continued to pursue Resident 10, that Resident 10 initially did not want the relationship, and that no assessment had been completed of either resident to ensure rights to intimacy and companionship or self-determination while also protecting against potential abuse.
Failure to Implement Behavior Interventions for a Resident with Dementia
Penalty
Summary
The facility failed to provide appropriate treatment and services to a resident with dementia and behavioral symptoms. The resident’s MDS documented long- and short-term memory problems, severe cognitive deficits, rejection of care, wandering, and physical and verbal behaviors, along with diagnoses of Alzheimer’s disease, non-Alzheimer’s dementia, anxiety, depression, and psychotic disorder. The care plan identified behaviors including constant worry, repeated voicing of concerns, crying, restlessness, pacing, attention seeking, verbal statements of nervousness, looking for parents, and fear, with interventions such as reassurance, redirection, 1:1 bedside activities, and environmental changes during anxiety. The facility investigation report showed the resident had an altercation with another resident after invading that resident’s personal space, and the other resident made physical contact that caused a superficial break in the skin. After the incident, staff separated the residents and identified that staff would engage the resident in an activity when the resident began consistently entering other residents’ personal spaces. However, there was no evidence that this intervention was added to the resident’s care plan, and staff later confirmed that no new intervention had been implemented for the resident-to-resident incident. Survey observations showed the resident wandering, entering other residents’ rooms, approaching residents in the sitting area, and spending time without any documented resident engagement activity in place. Staff were observed moving the resident back to the recliner or redirecting the resident, but no independent activities were offered during several observations. Interviews with nursing assistants, medication aides, social services, and the DON showed the unit staff generally relied on separating residents, offering snacks, toileting, or calming the setting, and stated that unit staff did not provide activities, while activity staff only did 1:1 activities a few times per week.
Resident Dignity Not Maintained During Bathhouse Transfer
Penalty
Summary
A resident's right to dignity and privacy was not maintained during a transfer to the bathhouse. Observation revealed that the resident was positioned in a bath chair in the corridor outside their room, with their lower legs and feet uncovered and hanging from the chair. The resident was wearing a hospital gown with the back open, exposing their lower back and buttocks, leaving these areas visible to other residents, staff, and visitors passing through the corridor. The bath aide responsible for the transfer confirmed that the resident should have been covered with no bare skin exposed during the transfer to the bathhouse.
Failure to Report and Investigate Alleged Abuse Incidents
Penalty
Summary
The facility failed to report, investigate, and submit a completed investigation report to the State Agency within the required timeframe regarding allegations of potential abuse involving two residents. Facility policy mandates immediate reporting of any allegations or suspicions of abuse, neglect, misappropriation, or exploitation to the Administrator, DON, or designee, and requires notification to law enforcement and the State Agency within specified timeframes. Despite this, incidents involving a resident with moderate cognitive impairment and a history of inappropriate sexual comments and touching were documented in progress notes, including one event where the resident pulled another resident's shirt and another where the resident held hands with a different resident and attempted to follow them. These incidents were not reported to the State Agency as required. The residents involved had significant cognitive impairments and required substantial assistance with daily activities. One resident had diagnoses including Alzheimer's Disease, dementia, anxiety, and depression, and a history of inappropriate behaviors. The other resident had severe cognitive impairment, exhibited physical and verbal behaviors, and was dependent on staff for care. Documentation revealed that the incidents were not reflected in the facility's reported incidents log for the past 12 months, and interviews with the Administrator and DON confirmed that the required reporting did not occur.
Failure to Complete Neurological Assessments After Unwitnessed Falls
Penalty
Summary
The facility failed to complete required neurological assessments following unwitnessed falls for one resident, as outlined in their policy. According to the policy, after an unwitnessed fall or a fall with a potential head injury, staff are to perform neurological assessments at specific intervals: every 15 minutes for 1 hour, every hour for 4 hours, and every 4 hours for 19 hours. Record reviews showed that after multiple unwitnessed falls, staff did not document or complete neurological assessments and/or vital signs at several required times, often noting that the resident was sleeping instead of performing the assessments. The resident involved had significant medical conditions, including non-traumatic brain dysfunction, heart failure, diabetes, Alzheimer's dementia, anxiety, and depression, and was assessed as having severely impaired memory, decision-making, and balance, as well as being dependent on staff for mobility and personal care. Despite these vulnerabilities, neurological assessments were omitted after several unwitnessed falls, with documentation gaps noted on multiple occasions. An RN confirmed that these assessments should not be skipped unless the resident was out of the building.
Failure to Implement Infection Prevention and Control Program
Penalty
Summary
The facility failed to provide and implement an infection prevention and control program. This deficiency was identified during the survey process, indicating that the required measures to prevent and control infections were not established or maintained as per regulatory standards. The report notes the absence or inadequacy of a comprehensive infection prevention and control program, but does not provide specific details about individual residents, staff actions, or particular infection events.
Failure to Notify PCP of Resident's Condition Changes
Penalty
Summary
The facility failed to notify a resident's Primary Care Physician (PCP) of significant changes in the resident's condition, which included fluid buildup, altered mental status, and behavioral changes. The resident, who had diagnoses of paranoid schizophrenia, diabetes, cerebral palsy, depression, and anxiety, exhibited escalating behaviors such as hearing voices, making strange noises, and being combative and resistive with care. The resident also displayed self-harming behaviors, such as pulling out chunks of hair and wrapping a call light cord around their head, and experienced significant fluid retention in the lower extremities. Despite these concerning changes, the facility did not notify the PCP until several days later, specifically regarding the resident's increased fluid retention and warmth/redness in the lower extremities. The facility's policy required timely notification of the PCP for any significant alterations in a resident's condition, which was not adhered to in this case. The Director of Nursing confirmed that the PCP was only informed via facsimile after the resident's condition had already escalated significantly.
Failure to Complete Required Discharge Summary
Penalty
Summary
The facility failed to complete the required Discharge Summary for a resident, identified as Resident 63, at the time of their planned discharge. The facility's policy on Transfer and Discharge, revised on 5/21/24, mandates that a Discharge Summary must be completed, which includes a recapitulation of the resident's stay, a final summary of the resident's status, reconciliation of medications, and a post-discharge plan of care. However, upon review of Resident 63's Admission/Discharge Record and Medical Record, there was no evidence that this summary was completed. The Director of Nursing confirmed the omission of the required Discharge Summary for Resident 63.
Failure to Follow Physician Orders for Fluid Restriction and Medication Administration
Penalty
Summary
The facility failed to adhere to physician orders for two residents, leading to deficiencies in care. Resident 2, who had a history of coronary artery disease, schizophrenia, diabetes, cerebral palsy, depression, and anxiety, was on a fluid restriction due to the risk of weight fluctuations related to fluid retention. Despite this, observations revealed that the resident had access to excessive fluids, including a large amount of soda and other beverages, far exceeding the prescribed 1500 cc fluid restriction. The dietary aide was unaware of the fluid restriction, and the Director of Nursing confirmed that the resident was non-compliant with the restriction, yet the facility allowed unlimited fluids in the resident's room. Resident 3, diagnosed with non-traumatic brain dysfunction, Alzheimer's disease, anemia, coronary artery disease, heart failure, non-Alzheimer's dementia, malnutrition, depression, and Parkinson's disease, had orders for daily weights and as-needed Lasix for weight gain of 2 pounds or more in one day. However, the facility failed to obtain daily weights on multiple occasions, missing 21 out of 40 days reviewed. Additionally, despite documented weight gains of 4 pounds and 3 pounds on specific days, the as-needed Lasix was not administered as ordered. Interviews with the Director of Nursing confirmed the lapses in following physician orders for both residents. The facility's failure to comply with these orders resulted in deficiencies in the care provided to the residents, as the necessary monitoring and medication administration were not conducted as required.
Failure to Monitor and Document Pressure Ulcer Progression
Penalty
Summary
The facility failed to provide adequate assessment and monitoring of a resident's pressure ulcer, leading to a deficiency in care. The resident, who was admitted with a stage 1 pressure ulcer on the coccyx, did not receive the required weekly assessments to monitor the ulcer's progression. The facility's policy mandated that a licensed nurse conduct a full body assessment at admission and weekly thereafter, with findings documented in the medical record. However, there was no evidence that the stage 1 pressure ulcer was assessed or documented, and the resident's electronic medical record lacked an assessment of the buttocks/coccyx area. The deficiency was further highlighted during an observation where an LPN identified the ulcer had progressed to a stage 2 pressure ulcer, measuring approximately 1.5 cm by 0.2 cm. The LPN confirmed that the facility had been treating the ulcer since admission but was uncertain when the ulcer changed stages. The Director of Nursing also acknowledged the failure to assess and monitor the pressure ulcer, resulting in the progression from stage 1 to stage 2 without proper documentation or intervention.
Infection Control Deficiencies in Wound and Catheter Care
Penalty
Summary
The facility failed to maintain infection prevention measures for Enhanced Barrier Precautions (EBP) during the provision of wound care and catheter care for two residents. The facility's policy on EBP, revised on 3/27/24, required the use of gowns and gloves during high-contact resident care activities to reduce the transmission of multidrug-resistant organisms. However, during an observation, a Medication Aide (MA-C) did not fully secure a gown while assisting a resident with a catheter, and the gown was not worn at all during wound care for another resident. Additionally, hand hygiene was not performed at appropriate intervals, such as between glove changes, which is a critical step in preventing the spread of infections. Resident 52, who had a terminal condition and was dependent on staff for toileting and hygiene needs, was observed during care provision. The resident had chronic wounds and a catheter, necessitating the use of EBP. However, during the care, the MA-C did not secure the gown properly and lifted the catheter drainage bag above the resident's bladder, which could lead to potential infections. Furthermore, during wound care, the RN did not wear a gown and failed to perform hand hygiene between glove changes, increasing the risk of infection transmission. Resident 22, who had self-care deficits and a history of skin issues, was also observed during wound care. The RN did not perform hand hygiene between glove changes and wound sites, which is essential to prevent the spread of infection. The Director of Nursing confirmed that staff should perform hand hygiene between glove changes and when changing dressings, as these are high-contact care activities requiring adherence to EBP.
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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 Stanton
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| St. Joseph's Rehabilitation And Care Center | 12.1 mi | ★★★★★ | 17 | 0 |
| Heritage Of Bel Air | 12.1 mi | ★★★★★ | 0 | 0 |
| Arbor Care Centers-countryside Llc | 13.5 mi | ★★★★★ | 16 | 0 |
| Clarkson Community Care Center Inc | 16 mi | ★★★★★ | 23 | 0 |
| Wisner Care Center | 17.1 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.