Below average — CMS composite of the measures below.
A standard survey is most likely before around December 2026
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Ridgeview Healthcare And Rehabilitation Center during CMS and state inspections, most recent first.
A resident with HTN and staff-assisted daily care needs had an order for Carvedilol 3.125 mg BID with instructions to hold for systolic BP below 110 or HR below 55. Review of the MAR showed the medication was administered multiple times even when the resident's BP was below the hold parameter, and the DON confirmed the medication should have been held.
Late Completion of Admission and Annual MDS Assessments: The facility did not complete required admission and annual MDS assessments within the required timeframes for multiple residents. Review of clinical records and the MDS validation report showed several admission assessments were completed late and several annual assessments were completed after the allowed window, and the RNAC confirmed the assessments were not completed on time.
Quarterly MDS assessments were completed late for 4 of 68 residents reviewed. The RAI User's Manual required completion by the ARD plus 14 days, but the records showed that four residents' quarterly MDSs were finished after the allowed timeframe. The RNAC confirmed the late completion during interview, and the deficiency was cited under 28 Pa. Code 211.5(f) Clinical records.
A resident with Alzheimer’s dementia, depression, anxiety, and cognitive impairment was given escalating doses of Risperidone for dementia with agitation and later transitioned to Rexulti. The record lacked documentation that the resident’s representative was informed in advance of the risks, benefits, and treatment alternatives before the Risperidone increases or before Rexulti was initiated, and the DON confirmed the missing documentation.
A facility failed to ensure two residents were free from unnecessary psychotropic meds. One resident with Alzheimer’s dementia, depression, and anxiety received repeated PRN Trazadone doses for anxiety/agitation without documented nonpharmacological interventions, and another resident with dementia continued receiving scheduled quetiapine despite the guardian’s refusal to sign consent and request for dose reduction and Geri-Psych NP review.
Late submission of MDS assessments: The facility failed to transmit quarterly MDS assessments for three residents within the required timeframe. Review of the MDS validation report and clinical records showed that two residents’ assessments were submitted 15 days after completion, and another resident’s assessment was submitted months late. The RNAC confirmed the assessments were not submitted on time.
Failure to develop individualized care plans for two residents’ IV device needs. One resident was cognitively impaired, dependent for daily care, and had dementia, while the other had hemiparesis after a stroke and esophageal cancer and had recently returned from the hospital. Both had MD orders for peripheral IV insertion and maintenance, but the DON confirmed no care plans were in place to address the IV-related care and treatment needs.
Failure to follow physician orders affected two residents. One resident with dementia and atrial fibrillation had ordered cardiac monitoring and a neurology consult for an EEG that were not documented as scheduled or completed, per the DON. Another resident with multiple wounds and edema had repeated missed documentation for ordered wound care and dressing changes, and was observed without ordered tubigrips in place; staff confirmed the orders were not being followed.
Ordered pressure ulcer treatment was not in place for a cognitively impaired resident with a stage 3 wound on the right buttock. An LPN observed the resident without the prescribed dressing in place, and the TAR showed the treatment had been signed as completed previously without documentation that it had been dislodged or removed; the DON confirmed the order should have been in place.
Failure to obtain physician orders for catheter procedures: staff performed a straight cath to collect a urine sample for one resident and removed a Foley catheter for another resident without documented physician orders. The residents had significant care needs, including cognitive impairment and an indwelling catheter, and the DON confirmed the missing order documentation.
Dietary Supplement Order Entered Incorrectly: A resident with CKD on HD and a therapeutic diet had a RD recommendation for a protein supplement on non-dialysis days because he also received it during dialysis. The physician order was entered incorrectly, and the TAR showed the supplement was only given on M/W/F, with no documentation that it was provided BID on the other days as recommended.
Failure to Provide Ordered G-Tube Care for Two Residents: Two residents receiving enteral feedings did not have ordered dressing care provided to their G-tube/PEG sites. One resident with dysphasia had no dressing around the PEG tube area during treatment observation, and an LPN confirmed the omission. Another resident with hemiparesis and esophageal cancer had a soiled gown, no dressing at the G-tube site, and brown liquid draining down the abdomen during tube feeding; the DON confirmed the ordered dressing should have been in place.
Failure to flush an IV catheter before and after IV antibiotic administration for a resident receiving Ceftriaxone for pneumonia. The resident had a hx of stroke with hemiparesis and esophageal cancer, and the MAR showed multiple IV doses were given without documented evidence of flushing. The DON stated the facility policy is to flush IV devices before and after IV meds.
Improper Storage of Unopened Liraglutide Pen: A resident with type 2 DM had an order for daily liraglutide, but surveyors observed an unopened pen-injector on a med cart instead of in the refrigerator. The facility policy and manufacturer instructions required unopened liraglutide to be refrigerated, and both an LPN and the DON confirmed it should have been stored that way until opened.
Incomplete and inaccurate clinical record documentation was found for two residents. One resident’s fall with a skin tear was not documented in the chart despite the incident being confirmed in a fall investigation and by the ADON. Another resident with a feeding tube and an NPO order had multiple meds documented on the MAR as given by mouth, although the DON stated the meds were actually administered through the feeding tube.
The facility’s QAPI committee failed to resolve repeated deficiencies cited in a prior survey, including issues with comprehensive and quarterly assessments, care plan development and implementation, quality of care, and labeling and storage of drugs and biologicals. Surveyors found the same problems again on the current survey, showing the prior audit-based plans were not successfully implemented.
A resident who was cognitively impaired and dependent on staff had an order and care plan for a left hand splint to prevent contractures, to be applied with morning care and removed at bedtime. During observation, the splint was not in place, and an LPN could not locate it. The DON confirmed the splint should have been applied with morning care.
The facility failed to complete comprehensive admission MDS assessments within the required 14-day timeframe for 57 residents. Delays ranged from 15 to 216 days, with the Nursing Home Administrator confirming the issue. This deficiency indicates a systemic problem in timely assessments.
The facility failed to complete Quarterly MDS assessments within the required timeframe for 42 residents. The RAI User's Manual mandates that these assessments be completed every 92 days, but many were late, with some residents not having any assessment in the prior 92 days. The Nursing Home Administrator confirmed the non-compliance, violating state codes on clinical records and nursing services.
The facility failed to transmit MDS assessments to the CMS QIES ASAP System within the required 14 days for 31 residents. Specific cases included a resident with a hip fracture and another with renal failure and COVID, where necessary tracking records were not completed on time. The MDS validation report also showed late submissions for multiple residents, confirmed by the Nursing Home Administrator.
The facility failed to accurately complete MDS assessments for five residents, leading to deficiencies in documenting medication administration and vaccination status. Errors included not reflecting the administration of antipsychotic and hypoglycemic medications, as well as missing influenza vaccine documentation. These inaccuracies were confirmed through staff interviews.
The facility failed to follow physician's orders for medication administration for four residents. A resident with hypotension did not have blood pressure checked before receiving Midodrine. Another resident with diabetes had elevated blood sugar levels without physician notification. A resident with heart failure received Midodrine despite high blood pressure, and a resident with hypertension received Metoprolol without vital sign checks. These deficiencies were confirmed by facility staff.
The facility failed to discontinue unnecessary medications for two residents. One resident continued receiving Arixtra and insulin coverage despite a pharmacy recommendation to stop, while another resident was kept on a 14 mg nicotine patch without tapering as advised. These oversights were confirmed by facility staff.
A resident with cognitive impairment and anxiety was frequently administered Ativan without documented attempts of non-pharmacological interventions. The facility's records lacked evidence of such interventions before medication administration, as confirmed by the Nursing Home Administrator.
The facility did not comply with its policy to record dish machine temperatures for each meal, as required to ensure food safety. The policy specified wash and rinse temperatures of 150°F and 180°F, respectively. A review of logs from August to October 2024 showed missing entries, which was confirmed by the Dietary Manager.
A facility failed to assess a resident's ability to self-administer medication, as required by policy. The resident, who was cognitively intact but needed assistance for daily care, was left unsupervised with unlabeled pills. An LPN left the medication assuming the resident would take it, without observing or confirming the resident's ability to self-administer safely.
The facility failed to document the opportunity for residents and/or their representatives to formulate advance directives, as required by their policy. This deficiency was identified during a review of facility policies, clinical records, and staff interviews. For three residents reviewed, there was no documented evidence that they or their representatives were informed of their rights to develop advance directives, offered assistance, or had their directives reviewed annually. Despite the facility's policy, the Nursing Home Administrator could not produce any advance directives or documentation of the required processes for these residents.
A facility failed to provide a required notice to a resident after the end of Medicare coverage. The resident's Medicare coverage started and ended on specific dates, but there was no documented evidence of an Advance Beneficiary Notice of Noncoverage (ABN) being issued. The Director of Social Services was unaware of the need for the ABN.
The facility failed to provide written notification to residents and their legal guardians regarding hospital transfers. A resident with respiratory failure, another with uncontrolled bleeding, and a third with COPD were transferred without their responsible parties receiving written notice of the transfer and reasons. The Nursing Home Administrator confirmed the lack of notification, violating resident rights and discharge policy.
The facility failed to develop comprehensive care plans for two residents. One resident, with cognitive impairment and conditions including diabetes and dementia, lacked a care plan for anticoagulant medication use. Another resident, cognitively intact with a urinary tract infection, did not have a care plan for urinary catheter use. These deficiencies were confirmed by the Nursing Home Administrator.
The facility failed to update care plans for two residents to reflect their current medical treatments. One resident's care plan inaccurately stated they were receiving a diuretic, while another's care plan did not reflect the discontinuation of an indwelling catheter. These discrepancies were confirmed through staff interviews and reviews of medical records.
A resident choked on improperly pureed food, requiring the Heimlich maneuver, due to the facility's failure to provide the correct food consistency. Additionally, two residents using air mattresses did not have documented safety assessments, as confirmed by the Assistant DON.
A facility failed to timely address a pharmacy recommendation for a resident, resulting in a deficiency. The resident, who was cognitively intact and had diabetes, had a medication regimen review on June 4, 2024, suggesting changes to Allopurinol and Zoloft. The physician agreed, but the changes were delayed until July 6, 2024. This delay was confirmed by the Nursing Home Administrator.
The facility failed to properly label and store medications, including undated insulin pens, expired vials, and unsecured controlled drugs. Additionally, a resident was left with unsupervised and unlabeled medication, which she was unaware of. An LPN confirmed leaving the medication unsupervised, and the ADON acknowledged the error.
The facility's QAPI committee failed to address recurring deficiencies effectively, as evidenced by repeated issues in multiple surveys. Deficiencies included inaccurate MDS assessments, failure to create individualized care plans, and issues with quality of care, safety, drug storage, and food handling. Despite plans of correction involving audits and QAPI review, the facility did not maintain compliance, as shown in the latest survey.
A facility failed to implement Enhanced Barrier Precautions (EBP) for a resident with chronic wounds, as required by CDC and CMS guidelines. The resident, who had multiple wounds and an infection, did not have appropriate infection control measures in place, such as signage or the use of gowns and gloves during high-contact care activities. The Infection Preventionist confirmed the oversight, resulting in a deficiency.
A facility failed to offer an influenza vaccine to a resident, as required by their policy. Despite a request from the resident's representative and a policy mandating annual vaccination offers, there was no documentation that the resident was offered, received, or refused the vaccine since admission. This was confirmed by the Infection Control Nurse.
A facility failed to comply with state regulations by not paying employees' wages and vendor invoices on time, placing residents in immediate jeopardy. The facility owed $189,422.71 in unpaid wages, risking staff shortages and inadequate resident care. Additionally, $106,697.88 in vendor invoices were outstanding, affecting essential services like lab work, primary care, and elevator maintenance. This financial mismanagement led to significant risks to resident health and safety, as confirmed by staff and union representatives. The non-compliance with 28 PA Code 201.14(g) highlighted the facility's financial instability and its impact on care quality.
Failure to Follow Hold Parameters for Blood Pressure Medication
Penalty
Summary
The facility failed to follow physician's orders for Carvedilol for one resident who was cognitively intact, required staff assistance with daily care needs, and had a diagnosis of high blood pressure. The resident's orders, dated May 5, 2026, directed staff to give Carvedilol 3.125 mg twice daily and to hold the medication if systolic blood pressure was less than 110 or heart rate was less than 55. Review of the Medication Administration Record showed that on multiple occasions the resident's blood pressure was below the ordered hold parameter, including 106/62, 108/62, 98/62, 98/56, 102/60, and 98/60, yet the Carvedilol was still administered.
Late Completion of Admission and Annual MDS Assessments
Penalty
Summary
The facility failed to ensure that comprehensive admission and annual MDS assessments were completed within the required timeframes for 11 of 68 residents reviewed. The RAI User’s Manual required admission MDS assessments to be completed no later than the admission date plus 13 calendar days, and annual MDS assessments to be completed no later than 14 days after the ARD. Review of the CMS MDS validation report, clinical records, and staff interviews showed that multiple residents had assessments completed late, including admission assessments for Residents 26, 36, 38, 44, 79, 108, and 113, and annual assessments for Residents 31, 35, 54, and 110. Specific examples included Resident 26’s admission MDS, completed 4 days late; Resident 31’s annual MDS, completed 1 day late; Resident 35’s annual MDS, completed 13 days late; Resident 36’s admission MDS, completed 1 day late; Resident 38’s admission MDS, completed 1 day late; Resident 44’s admission MDS, completed 1 day late; Resident 54’s annual MDS, completed 8 days late; Resident 79’s admission MDS, completed 1 day late; Resident 108’s admission MDS, completed 1 day late; Resident 110’s annual MDS, with the next annual ARD set 10 days late; and Resident 113’s admission MDS, completed 1 day late. The RNAC confirmed on interview that the listed admission and annual MDS assessments were not completed within the required timeframes.
Late Completion of Quarterly MDS Assessments
Penalty
Summary
Quarterly MDS assessments were not completed within the required time frame for 4 of 68 residents reviewed. The RAI User's Manual dated October 2024 stated that quarterly MDS assessments must be completed no later than the ARD plus 14 calendar days. Review of the clinical records and CMS MDS validation report showed that Resident 19's quarterly MDS dated February 14, 2025 was completed on March 4, 2025, Resident 49's quarterly MDS dated July 2, 2025 was completed on July 17, 2025, Resident 69's quarterly MDS dated April 22, 2025 was completed on June 16, 2025, and Resident 120's quarterly MDS dated January 21, 2025 was completed on March 25, 2025. The RNAC, who is responsible for completion of MDS assessments, was interviewed on September 18, 2025 at 2:58 p.m. and confirmed that the quarterly MDS assessments for these residents were not completed within the required time frames. The deficiency was cited under 28 Pa. Code 211.5(f) Clinical records.
Failure to Inform Representative Before Psychotropic Medication Changes
Penalty
Summary
The facility failed to inform Resident 63’s resident representative in advance of the risks and benefits of psychotropic medication use and the treatment alternatives before initiating increased doses of Risperidone and before starting Rexulti. Resident 63’s quarterly MDS dated July 11, 2025 showed cognitive impairment, need for assistance with care needs, use of antipsychotic and antidepressant medications, and diagnoses of Alzheimer’s dementia, depression, and anxiety. Physician orders showed Risperidone 0.25 mg at bedtime was started on April 23, 2025 for dementia with agitation, then increased to 0.25 mg twice daily on June 18, 2025 and to 0.25 mg three times daily on July 7, 2025. Later, on August 28, 2025, Risperidone was ordered to taper while Rexulti was initiated and increased, with a September 8, 2025 order for Rexulti 2 mg daily starting September 13, 2025. The clinical record contained no documented evidence that the resident’s representative was informed in advance of the risks and benefits and treatment alternatives before the Risperidone dose increases or before Rexulti was started, and the DON confirmed this during interview.
Unnecessary Psychotropic Medication Use and Lack of Documented Nonpharmacological Measures
Penalty
Summary
The facility failed to ensure that two residents were free from unnecessary psychotropic medications. Resident 63 had cognitive impairment and diagnoses of Alzheimer’s dementia, depression, and anxiety, and was receiving antipsychotic and antidepressant medications. Physician orders directed PRN Trazadone for anxiety and later agitation, with the dose changed from 25 mg to 50 mg. Review of the MAR showed multiple administrations of PRN Trazadone from June through September 2025, but the clinical record contained no documented evidence that non-pharmacological interventions were attempted before the medication was given. The DON confirmed that there was no documented evidence of non-pharmacological interventions prior to the PRN Trazadone administrations. Resident 67 had cognitive impairment and a diagnosis of dementia and was ordered quetiapine 100 mg at bedtime. A nurse’s note documented that the legal guardian did not sign consent for Seroquel and wanted the dose reduced and the Geriatric-Psychiatry NP to manage and evaluate the medication. The MAR showed that quetiapine 100 mg was administered nightly for multiple days after that note. The DON stated that a referral should have been sent to the Geriatric-Psychiatry NP before the resident could be seen and the Seroquel orders addressed, but as of the survey date there was no documentation that the referral had been sent and the requested dose reduction had not been addressed.
Late Submission of MDS Assessments
Penalty
Summary
The facility failed to transmit Minimum Data Set (MDS) assessments to the required electronic system within 14 days of completion for 3 of 68 residents reviewed. Review of the Resident Assessment Instrument (RAI) User's Manual, clinical records, and the CMS MDS validation report showed that quarterly MDS assessments for Resident 14 and Resident 77, both with completion dates of May 14, 2025, were not submitted until May 29, 2025. Resident 120 had a quarterly MDS assessment with a completion date of March 25, 2025, but it was not submitted until June 26, 2025. The iQIES MDS validation report dated March 25, 2025, through August 25, 2025, identified these late submissions. During an interview on September 18, 2025, the RNAC, who is responsible for completing MDS assessments, confirmed that the quarterly MDS assessments were not submitted within the required time frames.
Failure to Develop Care Plans for IV Device Needs
Penalty
Summary
The facility failed to develop individualized comprehensive care plans for two residents, Resident 6 and Resident 130, to address their intravenous device needs. Facility policy stated that comprehensive person-centered care plans with measurable objectives and timetables are to be developed and implemented for each resident, reflecting services needed to attain or maintain the resident’s highest practical physical, mental, and psychosocial well-being. Resident 6’s quarterly MDS dated August 29, 2025, showed cognitive impairment, dependence on staff for daily care needs, and a diagnosis of dementia. Physician’s orders dated September 13, 2025, included an order for staff to insert and maintain a peripheral IV device. Resident 130 was admitted with hemiparesis following a stroke and esophageal cancer, was transferred to the hospital on September 7, 2025, and returned on September 10, 2025. Physician’s orders dated September 14, 2025, included an order for staff to insert and maintain a peripheral IV device for IV antibiotics. On September 18, 2025, the DON confirmed that neither resident had care plans in place to address the care and treatment needs related to their IV devices.
Failure to Follow Physician Orders for Diagnostic Testing and Wound Care
Penalty
Summary
The facility failed to follow physician's orders for two residents. One resident was cognitively impaired, had dementia, and required assistance with daily care needs. Orders dated August 21, 2025, directed use of an event recorder for a seven-day monitor related to atrial fibrillation and dizziness, and orders dated August 22, 2025, directed a neurology consult within five to seven days for an EEG. As of September 18, 2025, there was no documented evidence that either the event monitor or the neurology consult had been scheduled or completed, and the DON confirmed this during interview. The second resident was cognitively intact and required assistance with daily care needs, with venous ulcers, surgical wounds, a foot infection, and wound care needs. Physician's orders directed cleansing and dressing care for the right lower leg surgical incision, left lower leg open area, abdominal surgical incision sites, right great toe, right bunion, and bilateral legs with specific dressings and frequency. Review of the TAR showed multiple dates with no documented evidence that these ordered treatments were completed, including repeated missed documentation for the leg, abdominal, toe, bunion, and bilateral leg treatments. The ADON confirmed that there was no documented evidence that the treatments were completed as ordered on the identified dates. The record also showed that tubigrips were ordered for the resident's bilateral lower legs for edema, first in a wound consult note and then in physician's orders. On September 18, 2025, the resident was observed after returning from therapy without the tubigrips in place, and a small skin tear was noted on the right shin. A nurse aide stated she was not sure the resident was supposed to have tubigrips, an LPN confirmed the resident was to have them and thought they may have been soiled and thrown away, and the ADON confirmed the tubigrips should have been on and were not.
Ordered pressure ulcer treatment not in place
Penalty
Summary
The facility failed to ensure that ordered treatment for a stage 3 pressure ulcer on a resident’s right buttock was provided as prescribed. The resident was cognitively impaired, dependent on staff for daily care needs, and had a stage 3 pressure area documented on the right buttock on the quarterly MDS assessment. A physician’s order directed staff to cleanse the wound with soap and water, pat dry, apply medical grade honey to the wound bed, and cover it with an ABD pad every day shift and as needed for soilage and dislodgement. During an observation of treatment administration, an LPN entered the resident’s room with supplies for the ordered treatment, but the resident was positioned on the left side and did not have the treatment in place on the right buttock. The LPN confirmed that the treatment was not in place. The TAR showed the treatment was signed as completed the prior day, but there was no documented evidence that it had become dislodged or been removed. The DON later confirmed that the resident should have had the treatment in place per the physician’s order.
Failure to Obtain Physician Orders for Catheter Procedures
Penalty
Summary
The facility failed to obtain appropriate physician's orders before performing a straight catheter procedure on one resident and before removing an indwelling Foley catheter from another resident. Resident 6 had a quarterly MDS assessment dated August 29, 2025, showing cognitive impairment, dependence on staff for daily care needs, and a diagnosis of dementia. A nurse's note dated September 3, 2025, documented that staff obtained a urine sample using a straight catheter procedure without difficulty, but there was no documented evidence that a physician's order had been obtained before the procedure. Resident 108 had a quarterly MDS assessment dated June 13, 2025, showing the resident was cognitively intact, needed assistance with daily care needs, had an indwelling catheter, and had a diagnosis that included a right thigh bone fracture. A licensed practical nursing note dated September 19, 2025, documented that a verbal order was obtained from an RN to remove the resident's Foley catheter and that the catheter was discontinued, but there was no documented evidence that a physician's order had been obtained before the catheter was removed. The DON confirmed on interview that there was no documented evidence of a physician's order for either the straight catheter procedure for Resident 6 or the removal of the indwelling catheter for Resident 108.
Dietary Supplement Order Entered Incorrectly
Penalty
Summary
The facility failed to ensure that a dietitian’s recommendation for a dietary supplement was accurately ordered for one resident who was cognitively intact, required partial assistance with care needs, had stage four chronic kidney disease, received hemodialysis, and was ordered a therapeutic diet. The resident’s care plan addressed risk for weight gain or loss related to dialysis and included encouragement and assistance to consume foods, supplements, and fluids offered at and between meals. The registered dietitian’s nutritional update noted that the resident was receiving a protein supplement during dialysis and recommended 30 cc of LPS once daily at the nursing facility on dialysis days and twice daily on non-dialysis days. The physician’s order entered for the resident instead directed 30 cc of LPS Sugar Free Oral Liquid two times a day only on Monday, Wednesday, and Friday. Review of the TAR for August and September showed the supplement was given only on Mondays, Wednesdays, and Fridays, with no documented evidence that it was administered twice daily on Tuesdays, Thursdays, Saturdays, or Sundays. The registered dietitian confirmed that the recommendation was for the resident to receive the supplement on non-dialysis days because he was already receiving it at dialysis, and that there was an error when the order was entered into the medical record.
Failure to Provide Ordered Care for Feeding Tube Sites
Penalty
Summary
The facility failed to ensure that two residents receiving enteral feedings had appropriate treatment and services to prevent complications related to their feeding tubes. Resident 118 had a G-tube and a diagnosis of dysphasia, and physician orders required the area around the PEG tube to be cleansed with soap and water and covered with a drain dressing daily and as needed. During an observation of treatment administration, Resident 118’s abdomen was exposed and no dressing was present around the PEG tube site as ordered. The LPN present confirmed that the resident did not have the ordered dressing in place, and the DON later confirmed that a dressing should have been around the PEG tube area per the physician’s orders. Resident 130 was admitted with diagnoses including hemiparesis following a stroke and esophageal cancer, and had physician orders to cleanse the G-tube perimeter with normal saline, pat it dry, and apply a dry dressing daily and as needed for soilage for skin protection. The care plan identified the potential for complications of the PEG/feeding tube and included an intervention for staff to provide care of the ostomy site as ordered by the physician. During an observation of tube feeding administration, the resident’s gown was soiled, the G-tube site was visible, no dressing was observed on or around the insertion site, and a brown liquid was noted draining down the resident’s stomach before, during, and after the tube feed. The DON confirmed that the resident should have had a dressing on the G-tube site per physician’s orders.
Failure to Flush IV Catheter During IV Antibiotic Administration
Penalty
Summary
The facility failed to ensure that physician orders were obtained to flush an IV catheter before and after IV medication administration for one resident. The resident was admitted with hemiparesis following a stroke and esophageal cancer, was transferred to the hospital and then returned to the facility, and later had physician orders for 2 grams of Ceftriaxone IV every 12 hours for five days for pneumonia. Review of the MAR showed Ceftriaxone was administered multiple times over several days, but there was no documented evidence that the resident's IV device was flushed before and after each medication administration. The DON stated that the facility's policy is to flush IV devices before and after IV medication administration, and there was no documented evidence that staff were flushing the resident's IV device.
Improper Storage of Unopened Liraglutide Pen
Penalty
Summary
The facility failed to ensure that medications were stored in accordance with currently accepted professional principles for one resident, who had an order for liraglutide for type 2 diabetes. The facility policy stated that medications and biologics are to be stored in locked compartments under proper temperature, humidity, and light controls, and that medications requiring refrigeration are to be stored in a refrigerator in the medication room or other secured location. Manufacturer instructions for liraglutide stated that unopened pens should be stored in a refrigerator at 36 degrees Fahrenheit to 46 degrees Fahrenheit before use. Physician orders for the resident included daily subcutaneous liraglutide. During observation of the Oak medication cart, surveyors found an unopened liraglutide pen-injector for the resident that was not stored in the refrigerator. An LPN confirmed at the time of observation that the unopened pen should have been refrigerated until opened, and the DON later confirmed the same.
Incomplete and Inaccurate Clinical Record Documentation
Penalty
Summary
The facility failed to maintain clinical records that were complete and accurately documented for two residents. For one resident, a fall investigation report dated August 14, 2025, showed that she was found on the floor and sustained a skin tear after sliding off the side of the bed, but there was no documented evidence of the fall and skin tear in her clinical record as required by facility policy. The Assistant Director of Nursing confirmed on September 18, 2025, that the incident was not documented in the medical record and should have been. For another resident, the clinical record showed diagnoses including hemiparesis following a stroke and esophageal cancer, with a feeding tube in place and an order for nothing by mouth except ice chips and thin water. Despite this, the MAR documented multiple medications as being administered by mouth, including trazodone, acetaminophen, oxycodone, iron, and alprazolam, even though the DON stated that the resident received all medications through the feeding tube and that the MAR documentation was incorrect.
QAPI Committee Failed to Correct Repeated Deficiencies
Penalty
Summary
The facility’s QAPI committee failed to correct repeated quality deficiencies identified in a prior State Survey and Certification survey ending October 24, 2024. The prior plans of correction for deficiencies involving comprehensive assessments and timing, quarterly assessments and timing, development and implementation of comprehensive care plans, quality of care, and labeling and storage of drugs and biologicals included audits and reporting the results to the QAPI committee for review. On the current survey ending September 18, 2025, surveyors found repeated deficiencies under F636, F638, F656, F684, and F761. The current findings showed that the facility’s QAPI committee did not successfully implement the prior plans to ensure ongoing compliance with regulations related to comprehensive assessments and timing, quarterly assessments and timing, comprehensive care plans, quality of care, and labeling and storage of drugs and biologicals.
Failure to Apply Ordered Left Hand Splint
Penalty
Summary
The facility failed to ensure that physician-ordered contracture management services were provided as care planned for a resident who was cognitively impaired and dependent on staff for daily care needs. The resident had an order for staff to wash the left hand, dry it, apply a splint to prevent contractures with morning care, and remove it at bedtime, and the care plan also directed staff to wash and dry the left hand and apply the splint with morning care and remove it on the second shift. During observation, the resident was sitting up in bed and the splint for the left hand was not in place. An LPN confirmed that the resident did not have the splint in place and that she was unable to locate it, and the DON confirmed that the left hand splint should have been applied with morning care.
Delayed MDS Assessments in LTC Facility
Penalty
Summary
The facility failed to complete comprehensive admission Minimum Data Set (MDS) assessments within the required time frame for 57 out of 138 residents reviewed. According to the Long-Term Care Facility Resident Assessment Instrument (RAI) User's Manual, an admission MDS assessment must be completed no later than 14 days following admission. However, the facility did not adhere to this guideline, resulting in delayed assessments for numerous residents. Specific examples of these delays include Resident 6, whose admission MDS assessment was completed 16 days after admission, and Resident 10, whose assessment was completed 18 days after admission. Other residents experienced even longer delays, such as Resident 13, with a 27-day delay, and Resident 27, with a 29-day delay. The most significant delay was observed in Resident 118, whose assessment was completed 216 days after admission. The Nursing Home Administrator confirmed during an interview that the admission MDS assessments were not completed within the required time frames. This deficiency indicates a systemic issue in the facility's process for conducting timely assessments, affecting a significant portion of the resident population.
Failure to Complete Timely MDS Assessments
Penalty
Summary
The facility failed to ensure that Quarterly Minimum Data Set (MDS) assessments were completed within the required timeframe for 42 out of 138 residents reviewed. According to the Long-Term Care Facility Resident Assessment Instrument (RAI) User's Manual, a quarterly assessment is due every 92 days, with the completion date being the Assessment Reference Date (ARD) plus 14 days. However, the facility did not adhere to these guidelines, resulting in late assessments for numerous residents. Specific instances of non-compliance include assessments for several residents being completed days after the required timeframe. For example, one resident's assessment with an ARD of June 27, 2024, was completed eight days late, while another resident's assessment with an ARD of July 5, 2024, was completed six days late. Additionally, two residents did not have any quarterly assessment completed in the prior 92 days, indicating a significant oversight in maintaining up-to-date clinical records. The Nursing Home Administrator confirmed during an interview that the admission MDS assessments were not completed within the required time frames. This failure to comply with the mandated assessment schedule is a violation of the 28 Pa. Code 211.5(f) Clinical Records and 28 Pa. Code 211.12(d)(5) Nursing Services, highlighting a systemic issue in the facility's assessment process.
Failure to Timely Transmit MDS Assessments
Penalty
Summary
The facility failed to transmit Minimum Data Set (MDS) assessments to the Centers for Medicare and Medicaid Services (CMS) Quality Improvement and Evaluation System (QIES) Assessment Submission and Processing (ASAP) System within the required 14 days of completion for 31 out of 138 residents reviewed. This deficiency was identified through a review of the Resident Assessment Instrument, clinical records, and the MDS validation report, as well as staff interviews. Specific instances included Resident 37, who was transferred to the hospital for a hip fracture and readmitted to the facility, yet the required Discharge and Entry/reentry tracking records were not completed by the specified date. Similarly, Resident 84 was admitted to the hospital and returned with new admission orders, but the necessary tracking records were not completed in a timely manner. The MDS assessment validation report from iQIES further revealed that several MDS assessments were completed and submitted late for multiple residents, with specific examples including assessments for Residents 13, 15, 38, 43, 46, 71, 95, 96, 100, 110, 116, 122, 126, 127, 128, 133, 144, 146, 147, 148, and 154. These delays in submission were confirmed during an interview with the Nursing Home Administrator. The report highlights the facility's non-compliance with the requirement to transmit comprehensive MDS assessments within 14 days of the Care Plan Completion Date and other MDS assessments within 14 days of the MDS Completion Date, as outlined in the Long-Term Care Facility Resident Assessment Instrument (RAI) User's Manual.
Inaccurate MDS Assessments for Medications and Vaccinations
Penalty
Summary
The facility failed to complete accurate Minimum Data Set (MDS) assessments for five residents, leading to deficiencies in documenting medication administration and vaccination status. For one resident, the MDS assessment did not reflect the administration of olanzapine, an antipsychotic medication, nor the attempt at a gradual dose reduction, despite physician's orders and medication administration records indicating otherwise. Another resident's MDS assessment lacked documentation of influenza vaccine status, with no evidence of the vaccine being offered, received, or refused since admission. Additionally, the facility did not accurately code the administration of hypoglycemic medications for two residents, as their MDS assessments failed to reflect the administration of Metformin and insulin, despite physician's orders and medication administration records confirming their use. Another resident's MDS assessment inaccurately documented the administration of Risperidone, an antipsychotic medication, and did not reflect a gradual dose reduction that had been ordered and administered. These inaccuracies were confirmed through staff interviews, including with the Nursing Home Administrator.
Failure to Follow Physician's Orders for Medication Administration
Penalty
Summary
The facility failed to adhere to physician's orders for medication administration for four residents, leading to deficiencies in care. Resident 67, who was cognitively intact and diagnosed with hypotension, had specific orders for Midodrine administration based on blood pressure readings. However, staff did not obtain or document the resident's blood pressure before administering the medication, as confirmed by the Nursing Home Administrator. Resident 97, who was cognitively impaired and diagnosed with diabetes, had orders to receive Insulin Lispro for blood sugar levels over 400 mg/dl, with a requirement to notify the physician. Despite multiple instances of elevated blood sugar levels, there was no documented evidence that the physician was notified, as confirmed by the Assistant Director of Nursing. This oversight occurred on several dates in August, September, and October. Resident 100, who was cognitively intact and diagnosed with heart failure, had orders to hold Midodrine if the systolic blood pressure exceeded 130 mmHg. The Medication Administration Record showed that the medication was administered despite blood pressure readings above the specified threshold. Similarly, Resident 311, diagnosed with hypertension, had orders to hold Metoprolol if the systolic blood pressure was below 100 or heart rate was below 60, but staff failed to obtain these vital signs before administration. These deficiencies were confirmed through interviews with the Nursing Home Administrator.
Failure to Discontinue Unnecessary Medications for Two Residents
Penalty
Summary
The facility failed to ensure that residents were free from unnecessary drugs, as evidenced by the cases of two residents. Resident 74, who was cognitively intact and diagnosed with diabetes, continued to receive Arixtra, a blood thinner, and fingerstick monitoring with sliding scale insulin coverage despite a pharmacy recommendation to discontinue these medications. The recommendation was made on August 10, 2024, but the physician did not act on it until September 15, 2024, resulting in the resident receiving unnecessary medication for 36 days. This delay was confirmed by the Nursing Home Administrator during an interview. Similarly, Resident 81, who was also cognitively intact and had diagnoses including atrial fibrillation and peripheral vascular disease, was prescribed a 14 mg nicotine patch for smoking cessation without a stop date. The pharmacy recommended tapering the patch and adding a stop date, which the CRNP agreed to on September 28, 2024. However, there was no evidence that these recommendations were implemented, and the resident continued to receive the 14 mg patch beyond the recommended period. This oversight was confirmed by the Infection Control Nurse, who acknowledged that the pharmacy's recommendations were not followed as agreed.
Failure to Document Non-Pharmacological Interventions Before Administering Ativan
Penalty
Summary
The facility failed to ensure that non-pharmacological interventions were attempted before administering anti-anxiety medication to a resident. The resident, who was cognitively impaired and diagnosed with anxiety, was prescribed Ativan as needed for mild anxiety and shortness of breath. Despite the requirement to attempt non-medication interventions first, the clinical records showed no evidence of such attempts before administering Ativan on multiple occasions in September and October 2024. The resident's Medication Administration Records indicated frequent administration of Ativan without documented non-pharmacological interventions. An interview with the Nursing Home Administrator confirmed the absence of documentation for non-medication interventions prior to administering the medication. This oversight was a violation of the facility's protocol and state regulations, as staff were expected to document any non-medication interventions attempted.
Failure to Record Dish Machine Temperatures
Penalty
Summary
The facility failed to adhere to its policy regarding the recording of dish machine temperatures, which is crucial for ensuring food safety. The policy, dated January 16, 2024, required dietary aides to record the wash and rinse temperatures of the dish machine for each meal period, with specified temperatures of 150 degrees Fahrenheit for washing and 180 degrees Fahrenheit for rinsing. However, a review of the Dish Machine Temperature Log from August 21 to October 21, 2024, revealed significant gaps in documentation, indicating that proper temperatures were not consistently recorded for each meal. This lapse was confirmed during an interview with the Dietary Manager, who acknowledged the incomplete temperature logs and the staff's failure to record the necessary data as required by the facility's policy.
Failure to Assess Resident's Ability to Self-Administer Medication
Penalty
Summary
The facility failed to determine if a resident was safe to self-administer medications, as required by their policy. The policy, dated January 16, 2024, states that self-administration is permitted only when the interdisciplinary team has determined it is clinically appropriate and safe. However, for Resident 69, who was cognitively intact but required assistance for daily care needs and had multiple diagnoses including stroke, anxiety, depression, and hypertension, no such assessment was completed. This oversight was confirmed by the Nursing Home Administrator during an interview. On October 21, 2024, an observation revealed that Resident 69 was left unsupervised with a medicine cup containing 11 unlabeled pills on her over-bed table. The resident was unaware of the pills and had forgotten to take them. An LPN admitted to leaving the medication in the resident's room without observing her take it, assuming she would take them when she sat up. This action was contrary to the facility's policy, as there was no assessment confirming the resident's ability to self-administer medication safely.
Failure to Document Advance Directives for Residents
Penalty
Summary
The facility failed to document the opportunity for residents and/or their representatives to formulate advance directives, as required by their policy. This deficiency was identified during a review of facility policies, clinical records, and staff interviews. The facility's policy, dated January 16, 2024, mandates that upon admission, residents or their representatives should be provided with information about their rights to accept or refuse medical treatment and to formulate advance directives. If a resident has not established advance directives, the staff should offer assistance, document the offer, and record the resident's decision to accept or decline assistance in the medical record. Additionally, the policy requires that advance directives be reviewed annually with the resident during the assessment process and documented in the medical record. For three residents reviewed, there was no documented evidence that they or their representatives were informed of their rights to develop advance directives, offered assistance, or had their directives reviewed annually. Resident 37 was cognitively impaired with diagnoses including diabetes and dementia, while Residents 40 and 53 were cognitively intact with various medical conditions such as chronic kidney disease, peripheral vascular disease, COPD, atrial fibrillation, and cerebral infarction. Despite the facility's policy, the Nursing Home Administrator could not produce any advance directives or documentation of the required processes for these residents, indicating a failure to comply with the established procedures.
Failure to Provide Medicare Coverage Notice
Penalty
Summary
The facility failed to provide the required notice to a resident or their representative after the end of Medicare coverage. Specifically, for one of the three residents reviewed, Medicare coverage began on August 2, 2024, and the last covered day was September 16, 2024. Despite the discontinuation from Medicare Part A coverage, there was no documented evidence that the resident received an Advance Beneficiary Notice of Noncoverage (ABN). An interview with the Director of Social Services revealed that the ABN was not issued because she was unaware of the form and its necessity.
Failure to Notify Residents and Guardians of Hospital Transfers
Penalty
Summary
The facility failed to provide timely written notification to residents and their legal guardians regarding the reasons for hospitalization, as required by regulations. Specifically, three residents were transferred to the hospital without their responsible parties receiving written notice of the transfer and the reasons for it. Resident 12 was admitted to the hospital with respiratory failure, Resident 74 with uncontrolled bleeding, and Resident 106 with chronic obstructive pulmonary disease. The Nursing Home Administrator confirmed that no written notices were provided to the residents or their responsible parties at the time of transfer, which is a violation of the residents' rights and discharge policy as per 28 Pa. Code 201.25 and 28 Pa. Code 201.29(f)(g).
Failure to Develop Comprehensive Care Plans for Residents
Penalty
Summary
The facility failed to develop comprehensive care plans for two residents, which is a requirement according to their policy for Comprehensive Person-Centered Care Plans. For Resident 37, who was cognitively impaired and had diagnoses including diabetes and dementia, there was no care plan developed to address her treatment needs related to the use of anticoagulant medication, Enoxaparin. This oversight was confirmed by the Nursing Home Administrator during an interview. Similarly, for Resident 84, who was cognitively intact and had a urinary tract infection, there was no care plan developed to address his treatment needs related to the use of a urinary catheter. Despite nurse aide documentation indicating that catheter care was provided each shift, the care plan did not include the use of a urinary catheter before the resident was discharged to the hospital. This deficiency was also confirmed by the Nursing Home Administrator.
Failure to Update Resident Care Plans
Penalty
Summary
The facility failed to ensure that the care plans for two residents were updated to reflect their current care needs. For Resident 33, a quarterly Minimum Data Set (MDS) assessment indicated that the resident was cognitively intact and not receiving a diuretic medication. However, the resident's care plan inaccurately stated that they were receiving a diuretic. A review of the Medication Administration Record (MAR) and current physician's orders confirmed that there was no order for a diuretic, and an interview with the Nursing Home Administrator confirmed the care plan was not revised accordingly. Similarly, Resident 81's care plan was not updated to reflect changes in their medical treatment. An admission MDS assessment showed that the resident was cognitively intact and had an indwelling catheter. A nurse's note later indicated that the resident was ordered to trial discontinuing the catheter, and a review of the Treatment Administration Record (TAR) and current physician's orders confirmed there was no order for an indwelling catheter. Despite this, the care plan still indicated the presence of an indwelling catheter, as confirmed by the Nursing Home Administrator.
Failure to Ensure Proper Food Consistency and Safety Assessments
Penalty
Summary
The facility failed to provide the correct consistency of food to a resident who required a mechanically-altered diet. The resident, who was cognitively intact, had a physician's order for a pureed texture diet with nectar consistency liquids. However, on one occasion, the resident choked on a chunk of chicken during lunch, necessitating the Heimlich maneuver by a licensed practical nurse. A speech therapist confirmed that the pureed chicken was not the proper consistency and contained chunks, which led to the choking incident. Additionally, the facility did not complete safety assessments for two residents who used air mattresses. Both residents were cognitively intact and required assistance with mobility. They had pressure ulcers and were using air mattresses as part of their care plan. However, there was no documented evidence that the use of air mattresses was assessed for potential safety hazards before being placed on their beds. The Assistant Director of Nursing confirmed the lack of safety assessments for these residents, acknowledging that such assessments should have been conducted.
Delayed Response to Pharmacy Recommendation
Penalty
Summary
The facility failed to respond in a timely manner to a pharmacy recommendation for a resident, leading to a deficiency. A quarterly Minimum Data Set (MDS) assessment indicated that the resident was cognitively intact and had a diagnosis of diabetes. A pharmacy medication regimen review conducted on June 4, 2024, recommended changes to the resident's medication, specifically adjusting Allopurinol dosage and the timing of Zoloft administration. Although the physician agreed to these recommendations, the changes were not implemented until July 6, 2024, over a month later. This delay was confirmed by the Nursing Home Administrator during an interview on October 23, 2024, acknowledging that the pharmacy medication regimen reviews were not addressed in a timely manner for the resident.
Medication Labeling and Storage Deficiencies
Penalty
Summary
The facility failed to adhere to proper medication labeling and storage protocols, as evidenced by several deficiencies observed during the survey. In the Walnut hall medication cart, a Lantus insulin Solostar pen for a resident was found opened and undated, which was confirmed by an LPN. Additionally, in the Maple hall medication cart, two expired multi-dose vials of insulin, Novolog and Lantus, were not discarded after 28 days of being opened, as confirmed by the same LPN. Furthermore, the medication room on the East Wing lacked a separately-locked, permanently-affixed compartment in the refrigerator for controlled drugs, as a narcotic box containing Dronabinol was found unsecured and not permanently affixed. The report also highlighted an incident involving a resident who was cognitively intact and required assistance for daily care needs. This resident was found with an unsupervised medicine cup containing 11 unlabeled pills on her overbed table, which she was unaware of and had forgotten to take. An LPN admitted to leaving the medication in the resident's room without supervision, assuming the resident would take them upon sitting up. The Assistant Director of Nursing confirmed that medications should not have been left unsupervised and unlabeled at the bedside.
Repeated Deficiencies in Quality Assurance Processes
Penalty
Summary
The facility's Quality Assurance Performance Improvement (QAPI) committee failed to address recurring deficiencies effectively, as evidenced by repeated issues identified in multiple surveys. The deficiencies included inaccurate Minimum Data Set (MDS) assessments, failure to create individualized plans of care, and issues related to quality of care, safety/accidents, labeling and storing drugs and biologicals, and food procurement/storage/preparation. These deficiencies were initially identified in a State Survey and Certification survey ending in November 2023 and a complaint visit in May 2024. Despite developing plans of correction that included quality assurance systems, the facility did not maintain compliance with the cited nursing home regulations. The facility's plans of correction involved completing audits and reporting the results to the QAPI committee for review. However, the current survey ending in October 2024 revealed that the QAPI committee did not successfully implement these plans to ensure ongoing compliance. Specific deficiencies were cited under F641 for inaccurate MDS assessments, F656 for individualized plans of care, F684 for quality of care, F689 for safety/accident hazards, F761 for labeling/storing drugs and biologicals, and F812 for food procurement/storage/preparation. The repeated nature of these deficiencies indicates a failure in the facility's quality assurance processes.
Failure to Implement Enhanced Barrier Precautions for Resident with Chronic Wounds
Penalty
Summary
The facility failed to adhere to infection control guidelines as outlined by the CDC and CMS, specifically regarding the implementation of Enhanced Barrier Precautions (EBP) for a resident with chronic wounds. Resident 81, who was cognitively intact and required assistance with care needs, was admitted with arterial and pressure ulcers and had a diagnosis of peripheral vascular disease. The resident's care plan indicated actual skin breakdown and an infection in the left toe. Despite these conditions, the facility did not implement EBP, which includes the use of gowns and gloves during high-contact care activities for residents with chronic wounds or indwelling medical devices. Observations revealed that there was no signage at the entrance or within Resident 81's room to indicate that infection control measures were in place. The resident had multiple wounds, including unstageable pressure ulcers and wounds with purulent drainage, which required antibiotic treatment. The Infection Preventionist confirmed that EBP should have been in place for Resident 81 due to the chronic wounds, but it was not implemented, leading to a deficiency in infection control practices.
Failure to Offer Influenza Vaccine to Resident
Penalty
Summary
The facility failed to ensure that a resident was offered and/or received the influenza immunization, as required by their policy. The policy, dated January 16, 2024, mandates that all residents and employees without contraindications be offered the influenza vaccine annually between October 1 and March 31. A quarterly Minimum Data Set (MDS) assessment for the resident, dated September 11, 2024, indicated cognitive impairment and lacked influenza vaccine information. An informed consent form, dated October 31, 2023, showed that the resident's representative requested the vaccine. However, a review of the immunization records revealed no documentation that the resident was offered, received, or refused the vaccine since admission on July 20, 2023. This was confirmed by the Infection Control Nurse during an interview on October 22, 2024.
Non-Compliance with State Regulations Due to Unpaid Wages and Vendor Invoices
Penalty
Summary
The facility in question failed to comply with state regulations and codes by not paying their employees' wages and vendor invoices in a timely manner, placing the residents in immediate jeopardy. The facility owed $189,422.71 in unpaid wages to employees, leading to a significant risk of staff walking off the job and leaving residents without adequate care. Additionally, vendor invoices totaling $106,697.88 were outstanding, including payments to essential service providers like a lab, primary care associates, and an elevator corporation, which could impact the quality of care provided to residents. The Immediate Jeopardy situation was identified on February 28, 2024, when it was discovered that the facility had not paid its employees for the payroll due on February 23, 2024. The facility's accounts payable ledger showed significant outstanding balances to various vendors, indicating a pattern of financial mismanagement. The failure to meet these financial obligations jeopardized the health and safety of the residents, as confirmed by interviews with staff members and the union president, who expressed concerns about staffing shortages due to unpaid wages. The facility's non-compliance with state regulations, specifically 28 PA Code 201.14(g), regarding timely payment of bills incurred in the operation of the facility, led to the Immediate Jeopardy situation. The lack of financial responsibility and failure to prioritize essential payments put the residents at risk of serious harm or even death. The facility's inability to meet its financial obligations not only impacted employee morale and retention but also raised concerns about the continuity and quality of care provided to the residents.
What surveyors are citing around you — mapped
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Repeat citations, what's rising near you, and quality measures — ranked so department heads know exactly where to look first.
Illustrative
What surveyors actually found near you
We read the 128 citations issued within 25 miles in the last 12 months — 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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Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Curwensville
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Mountain Laurel Healthcare And Rehabilitation Ctr | 6.8 mi | ★★★★★ | 33 | 0 |
| Dubois Nursing Home | 14.2 mi | ★★★★★ | 22 | 0 |
| Christ The King Manor | 16.4 mi | ★★★★★ | 4 | 0 |
| Heritage Ridge Senior Living At Windy Hill | 18 mi | ★★★★★ | 0 | 0 |
| Highland View Rehabilitation & Healthcare Center | 23.1 mi | ★★★★★ | 7 | 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.