Below average — CMS composite of the measures below.
The next survey window likely opens around November 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 Kent County Nursing Home during CMS and state inspections, most recent first.
Food was not consistently served at a safe and appetizing temperature. Several residents reported receiving cold meals, and a test tray showed most sampled items were only slightly warm or cold. Staff said trays may sit too long on carts before CNA delivery, while the DM said temperatures were checked at the steam table and the log showed proper temps, but she did not know why the test tray was cold.
Two residents with severely impaired cognition were observed with position change alarms in use even though neither had a physician order for the alarm. One resident’s care plan noted the alarm had been discontinued because the resident could manipulate it, while the other resident’s care plan addressed falls related to confusion but did not include the alarm. The DON and ADM both confirmed the alarms should have had orders, and the ADM stated the facility did not have a system to monitor position change alarms.
Missing Care Plans for Position Change Alarms: Two residents with severe cognitive impairment had position change alarms in use, but their care plans did not include the alarms as interventions. The DON and ADM both stated the alarms should have been care planned, and the ADM said the facility did not have a system to monitor position change alarms. The facility policy required comprehensive, person-centered care plans with measurable objectives and timetables.
Loose Pills Found in Medication Cart: An observation of Medication Cart 2 found 11 loose pills in the second drawer. An LVN stated staff were trained to check carts daily for loose pills and weekly for expired items, and the DON identified the pills as multiple medications including pantoprazole, gabapentin, potassium chloride, metoprolol, AZO, duloxetine, levothyroxine, and Eliquis. The facility policy stated medications and biologicals are to be stored in the packaging or dispensing systems in which they are received.
A facility failed to protect a resident from abuse when another resident allegedly touched her inappropriately. Despite multiple reports to the Interim DON and Regional Director, no effective action was taken, and the incident was not documented or reported to authorities. The involved residents had cognitive impairments, and their care plans lacked necessary interventions. Staff interviews revealed inadequate training and awareness, contributing to the deficiency.
The facility failed to report and document allegations of abuse and neglect involving several residents. Staff, including the Interim DON and Former ADM, did not adhere to the facility's abuse policy by not reporting incidents to HHSC or documenting investigations. Interviews revealed a lack of specific training and instructions for handling such behaviors, contributing to the deficiency.
The facility failed to investigate and document allegations of abuse, neglect, exploitation, or mistreatment involving inappropriate sexual touching between residents. The Interim DON and Former ADM did not follow the facility's abuse policy, resulting in a lack of documentation and reporting to the appropriate authorities. Staff interviews revealed that incidents were not thoroughly investigated, and no special instructions or training were provided regarding the residents' behavior.
The facility failed to report alleged abuse and neglect incidents involving inappropriate sexual touching between residents to the State Agency as required. Incidents involving a resident with dementia touching another resident's breast and another resident unzipping a peer's pants were not reported or documented properly. The Interim DON and Former ADM did not follow the facility's abuse policy, leaving residents at risk for continued abuse.
The facility failed to implement person-centered care plans for two residents with dementia, who exhibited inappropriate behaviors. A male resident displayed flirtatious behavior and inappropriate touching, while a female resident engaged in inappropriate behavior in common areas. These behaviors were not documented in their care plans, and staff lacked specific training to manage them. The oversight was attributed to administrative challenges and lack of awareness among staff.
A resident's care plan inaccurately reflected a Full Code status despite having a documented DNR order. The facility's ADON, responsible for updating care plans, was unable to keep up with the task, leading to this oversight. The Administrator and DON were unaware of the discrepancy and acknowledged the potential for the resident's final wishes to be missed.
A facility failed to update a resident's care plan to reflect their current Do Not Resuscitate (DNR) status, despite having the correct status documented in physician orders and an Out of Hospital DNR form. The care plan inaccurately indicated a Full Code status, which was not revised after the resident's status changed upon entering hospice care. The ADON, responsible for care plan updates, was reportedly struggling to keep up with these tasks.
Expired medications were found on a medication cart in a facility, including Lactulose, Senna Plus, and Melatonin. LVN B confirmed the expired status, and the medications were removed. The DON and ADM stated that nursing staff and medication aides are responsible for checking expiration dates, with training provided quarterly. The facility's policy requires proper storage and handling of expired medications.
An LVN at the facility was observed handling a resident's bread roll with bare hands during dining services, contrary to professional standards for food safety. The LVN admitted to the error and acknowledged the potential risk of illness. Interviews with the ADM and DON revealed uncertainty about staff training responsibilities, despite the facility's policy requiring the use of utensils to avoid manual contact with food.
The facility failed to ensure accurate documentation and administration of controlled medications for two residents. A resident received an extra dose of Norco due to a medication aide's failure to check the MAR and document the administration properly. Another resident's medication was not logged on the narcotic count sheet by an LVN, leading to discrepancies. These errors were attributed to lapses in following established procedures for medication administration and documentation.
A resident in a long-term care facility received an extra dose of Norco 5-325 mg due to a medication aide's failure to follow physician orders and check the MAR. The error was not documented or reported immediately, although the resident showed no adverse effects. Interviews revealed that the aide was trained but did not adhere to proper procedures.
Food Served at Improper Temperature
Penalty
Summary
The facility failed to provide food that was palatable, attractive, and at a safe and appetizing temperature for residents receiving meals from the kitchen. Residents #12, #15, and #49 each reported that meals were often served cold, with one resident stating the food was rarely ever hot or warm enough, another stating the issue had been ongoing and most meals had been served cold, and another stating the food was cold and did not taste good because it was not hot or warm enough. The residents also reported eating in their rooms at times or most of the time. During the meal tray observation, a test tray was requested after the last hall tray was served, and 7 of 9 sampled food items were found to be cold or only slightly warm, including pork, black-eyed peas, and spinach in regular, mechanical, and puree forms. Kitchen staff stated the carts may stay too long before CNA staff delivered trays to residents, and one CNA stated the food was not warm enough because it took time to set up residents and open carts were used. The DM stated she took temperatures before service and that the log showed lunch was served at proper temperatures, but she did not know why the test tray was only slightly warm and/or cold and did not know how long it took nursing staff to distribute room trays. The facility policy required hot foods to be served at 135 F or greater and adjusted for holding time on the steam table and tray cart.
Unordered chair alarms used for two residents
Penalty
Summary
The facility failed to ensure that two residents were free from the use of physical restraints unless needed for medical treatment. Resident #3 had diagnoses including dementia, muscle weakness, unsteadiness on feet, anxiety, hypertension, and major depressive disorder, and had a BIMS score of 05 indicating severely impaired cognition. Resident #48 had diagnoses including dementia, muscle wasting and atrophy of the left lower leg, anxiety, hypertension, and major depressive disorder, and had a BIMS score of 0 indicating severely impaired cognition. For both residents, the record review showed no physician order for a position change alarm (chair alarm). Resident #3’s care plan addressed falls related to weakness, history of falls, and dementia, and noted the resident was able to manipulate the chair/bed pressure alarm physically, turn the alarm off, and the alarm was discontinued. Despite this, observations on 12/3/25 and 12/4/25 showed Resident #3 up in a wheelchair with a position change alarm in place and turned on. Resident #48’s care plan addressed falls related to confusion, but did not include a care plan for a position change alarm. Observations on 12/3/25 and 12/4/25 showed Resident #48 up in a reclined Geri-chair with a position change alarm in place and turned on. During interviews, the DON stated position change alarms were used as an intervention for falls and that residents should have an order for the alarm. The DON reviewed the physician orders and confirmed that Residents #3 and #48 did not have orders for the position change alarm. The ADM also stated that position change alarms should have an order, that the facility did not have a system to monitor position change alarms, and that he was not aware these two residents did not have physician orders for the alarms.
Missing Care Plans for Position Change Alarms
Penalty
Summary
The facility failed to develop a comprehensive care plan for position change alarms for 2 of 22 residents reviewed, Resident #3 and Resident #48. Both residents had diagnoses including dementia and other chronic conditions, and both had severely impaired cognition based on their BIMS scores. Resident #3’s record showed a care plan for falls related to weakness, history of falls, and dementia, but no care plan for the chair alarm that was being used. Resident #48’s record showed a care plan for falls related to confusion, but no care plan for the chair alarm that was being used. Resident #3’s record review showed the resident was able to manipulate the chair/bed pressure alarm physically, turn the alarm off, and the alarm was discontinued. Despite this, observations on 12/3/25 and 12/4/25 showed Resident #3 up in a wheelchair with a position change alarm in place and turned on. Resident #48’s record review showed severe cognitive impairment and no chair alarm in use in the MDS section, but the care plan still did not include a position change alarm. Observations on 12/3/25 and 12/4/25 showed Resident #48 up in a reclined Geri-chair with a position change alarm in place and turned on. During interviews, the DON stated the position change alarm should be care planned and confirmed that Residents #3 and #48 did not have a care plan for it. The ADM also stated position change alarms were used as an intervention for falls and should be care planned, and that the facility did not have a system to monitor position change alarms. The facility policy stated that a comprehensive, person-centered care plan must include measurable objectives and timetables and describe services to meet the resident’s physical, psychosocial, and functional needs.
Loose Pills Found in Medication Cart
Penalty
Summary
The facility failed to ensure drugs and biologicals used in the facility were stored and maintained in accordance with currently accepted professional standards for 1 of 2 medication carts reviewed, Medication Cart 2. During an observation of Medication Cart 2 with an LVN and the DON, 11 loose pills were found in the second drawer of the cart. During interviews, the LVN stated she had been trained to check medication carts daily for loose pills and weekly for expired items, and that the person receiving the cart was responsible for making sure it was clean and free of loose pills. The DON identified the loose pills as Pantoprazole Sodium Delayed-Release 40 mg, Gabapentin 300 mg, Potassium Chloride 20 mEq, metoprolol 25 mg, AZO, duloxetine delayed release 30 mg, levothyroxine 50 mcg, and Eliquis 2.5 mg. The ADM and DON stated staff were expected to check carts for cleanliness and narcotic counts, report loose pills, and destroy any loose pills in the medication room after confirming they were not narcotics. The facility policy stated medications and biologicals are to be stored in the packaging, containers, or other dispensing systems in which they are received.
Failure to Protect Resident from Abuse and Neglect
Penalty
Summary
The facility failed to protect a resident from abuse and neglect, specifically failing to keep a resident safe from another resident who allegedly touched her breast in the dining room. The incident was reported by a dietary aide to the Interim DON and the Regional Director multiple times over several months, but no effective action was taken to address the situation. The facility's policies on abuse prevention and investigation were not adequately followed, as there was no documentation of a thorough investigation or reporting to the appropriate authorities. The resident involved in the incident was a female with a diagnosis of dementia and depression, indicating moderate cognitive impairment. Despite the allegations, her care plan did not reflect any information regarding the incident or any measures to prevent further occurrences. The male resident accused of the inappropriate behavior had a history of flirtatious behavior, but his care plan also lacked documentation of any interventions or monitoring related to these behaviors. Interviews with staff revealed a lack of training and awareness regarding the handling of such incidents. Several staff members, including the Interim DON, admitted to not reporting the incident to the state health department, citing a lack of evidence and the residents' denials. The facility's failure to document and report the incident, as well as to provide adequate training and supervision, contributed to the deficiency identified by the surveyors.
Removal Plan
- Residents #1, and #2 received a head-to-toe assessment and an emotional assessment.
- Resident #1 was placed on 1:1. Resident #1 was no longer deemed a risk to others.
- Resident safe surveys completed to establish affected residents. Any other concerns noted will receive a head-to-toe assessment and an emotional assessment.
- Education provided to Administrator and Regional Director by Regional Nurse Consultant. All available facility staff were in-serviced by the Administrator. All identified staff that continues to work for the nursing facility by Administrator will be in-serviced over the abuse policy and investigating and reporting abuse per HHS and CMS regulations.
- All staff educated on immediately intervening to protect residents in the event of abuse, reporting to the abuse coordinator, assessing the resident, and following up with the abuse coordinator. All staff will be educated prior to working their next shift.
- 5 staff and 5 residents will be interviewed weekly to ensure any allegations of abuse have been reported to the administrator per the regulation. Any allegations made during the interview will be reported immediately. Staff noted not following policy will be reeducated on the facility's abuse policy.
- Medical Director notified of the Immediate Jeopardy template and the facility's plan to remove it.
Failure to Report and Document Abuse Allegations
Penalty
Summary
The facility failed to develop and implement written policies and procedures that prohibit and prevent abuse and neglect for several residents. The Interim Director of Nursing (DON) and the Former Administrator (ADM) did not report allegations of sexual abuse to the Health and Human Services Commission (HHSC) and failed to document their investigation measures regarding multiple residents. Specifically, allegations involving inappropriate sexual touching between residents were not reported or documented as required by the facility's abuse policy. The report highlights several instances where staff members, including the Interim DON, Former ADM, and other personnel, did not adhere to the facility's abuse policy. For example, allegations of inappropriate behavior between residents were not reported to the appropriate authorities, and there was a lack of documentation of any investigation measures taken. Interviews with staff revealed that some were aware of the incidents but did not report them due to various reasons, including not witnessing the incidents personally or believing that the incidents had already been reported. The report also details the behaviors and interactions of specific residents involved in the allegations. For instance, one resident was known to be flirtatious and had been reported to have touched another resident inappropriately. Despite these reports, there was no documentation in the resident's care plan or progress notes regarding these behaviors. Additionally, interviews with residents and staff indicated a lack of specific training or instructions on how to handle such behaviors, further contributing to the deficiency in preventing and addressing abuse and neglect.
Failure to Investigate and Document Allegations of Abuse
Penalty
Summary
The facility failed to ensure that allegations of abuse, neglect, exploitation, or mistreatment were thoroughly investigated and that preventative measures were implemented during the investigation process. This deficiency was identified for five residents who were reviewed for abuse. The Interim Director of Nursing (DON) and the Former Administrator (ADM) did not document investigation measures or implement protective measures regarding incidents involving inappropriate sexual touching between residents. Specifically, incidents involving two residents were reported by a dietary aide, but the facility's abuse policy was not followed, and the incidents were not documented or reported to the appropriate authorities. The report highlights several instances where the facility's staff, including the Interim DON, Licensed Vocational Nurse (LVN), and Certified Nursing Assistant (CNA), failed to document investigation measures or implement protective measures. For example, a dietary aide reported an incident of inappropriate touching between two residents, but the Interim DON did not document the investigation or report the incident to the Health and Human Services Commission (HHSC). Additionally, the facility's staff did not provide any special instructions or training regarding the behavior of the residents involved, and there was a lack of documentation to support the efforts to address the allegations. Interviews with staff and residents revealed that the facility did not conduct thorough investigations into the allegations of inappropriate touching. Staff members were aware of the incidents but did not report them to the appropriate authorities or document their findings. The facility's administration, including the Regional Directors and the Corporate MDS Consultant, were also unaware of the incidents or did not follow up on them. As a result, the facility failed to protect residents from potential abuse and neglect by not investigating and implementing preventative measures.
Failure to Report Alleged Abuse and Neglect
Penalty
Summary
The facility failed to report alleged violations involving abuse, neglect, exploitation, or mistreatment, including injuries of unknown source and misappropriation of resident property, to the appropriate authorities within the required timeframe. Specifically, incidents involving inappropriate sexual touching between residents were not reported to the State Agency as required. The Interim DON and the Former ADM did not follow the facility's abuse policy by failing to report these incidents, which involved multiple residents, to the Health and Human Services Commission (HHSC). Resident #1, a male with a diagnosis of dementia, was involved in an incident where he allegedly touched Resident #2's breast. Despite being reported by Dietary Aide B, the incident was not documented in Resident #1's progress notes or care plan. Interviews revealed that the Interim DON and other staff were aware of the allegations but did not report them to HHSC, citing a lack of evidence and the residents' denials. The facility's administration did not document any investigation or follow-up actions, and the incident was repeatedly brought up by new administration without resolution. Another incident involved Resident #3 and Resident #5, where Resident #5, who had severe dementia, was observed unzipping Resident #3's pants. This incident was also not reported to HHSC, and there was no documentation of an investigation. The facility's policy required all allegations of abuse to be reported to the state agency, but this was not adhered to, leaving residents at risk for continued abuse and neglect.
Failure to Implement Person-Centered Care Plans for Residents
Penalty
Summary
The facility failed to develop and implement person-centered care plans for two residents, which included measurable objectives and timeframes to address their identified needs. Resident #1, a male with a diagnosis of dementia, exhibited flirtatious and inappropriate behavior towards female residents, including touching a female resident's breast. Despite these behaviors being known to some staff members, they were not documented in his care plan. Interviews with staff revealed that while some were aware of his behavior, there was no specific training or instructions provided on how to manage it. Resident #4, a female with dementia, displayed inappropriate behavior by masturbating on the outside of her clothing in common areas. This behavior was known to some staff, who attempted to redirect her, but it was not included in her care plan. Interviews indicated that staff had not received specific training on how to handle her behavior, and there was no formal documentation or care plan addressing this issue. The facility's failure to update and revise care plans for these residents meant that staff were not adequately informed or trained to meet the residents' needs. The Director of Nursing and other administrative staff acknowledged the importance of accurate and up-to-date care plans but admitted to being unaware of some of the behaviors and the lack of documentation. The MDS Coordinator, who was responsible for care plans, cited being overwhelmed with multiple roles as a reason for the oversight.
Care Plan Inaccuracy Regarding Code Status
Penalty
Summary
The facility failed to ensure that the comprehensive care plan for a resident was reviewed and revised by the interdisciplinary team after each assessment. Specifically, the care plan for a resident did not reflect the resident's current code status. The resident, who was moderately cognitively impaired, had a documented code status of Do Not Resuscitate (DNR) in the physician orders and an Out of Hospital Do Not Resuscitate (OOH-DNR) form. However, the care plan inaccurately indicated a Full Code status, which could lead to inappropriate care in a medical emergency. During an interview, the Administrator and Director of Nursing acknowledged that the Assistant Director of Nursing (ADON), responsible for updating care plans, was having difficulty keeping up with the task. They were unaware of the discrepancy in the resident's care plan and confirmed the resident's correct code status as DNR. The facility's policy requires care plans to be updated when changes occur, but the care plan consultant and ongoing training did not prevent this oversight. The Administrator and DON recognized that inaccurate care plans could result in the resident's final wishes being missed.
Failure to Update Resident's Care Plan with Current Code Status
Penalty
Summary
The facility failed to ensure that the comprehensive care plan for a resident was reviewed and revised by the interdisciplinary team after each assessment. Specifically, the care plan did not reflect the resident's current code status. The resident, who was slightly cognitively impaired, had a documented code status of Do Not Resuscitate (DNR) in the physician orders and an Out of Hospital Do Not Resuscitate (OOH-DNR) form. However, the care plan still indicated a Full Code status, which was not updated after the resident's code status changed to DNR upon being placed on hospice services. During an interview, the Administrator (ADMIN) and Director of Nursing (DON) acknowledged that the Assistant Director of Nursing (ADON), who was responsible for ensuring care plans were completed and updated, was having trouble keeping up with the care plans. The ADMIN and DON were unaware that the care plan for the resident indicated a Full Code status, despite the resident's current DNR status. The ADMIN stated that the change in code status should have been updated on the care plan immediately, and the ADON should have been trained to complete and update care plans accurately. The facility's policy on care plans requires that they be comprehensive, person-centered, and reflect the resident's current needs and conditions. The policy also mandates that care plans be reviewed and updated when there is a significant change in the resident's condition, such as a change in code status. The failure to update the care plan to reflect the resident's DNR status could place residents at risk of not receiving appropriate care to meet their current needs.
Expired Medications Found on Medication Cart
Penalty
Summary
The facility failed to ensure proper storage of medications on one of its medication carts, specifically the cart assigned to hall 100-200. During an observation, expired medications were found on this cart, including Lactulose liquid with an expiration date of May 2024, Senna Plus with an expiration date of June 2024, and Melatonin with an illegible expiration date. These expired medications were verified by LVN B and subsequently removed for destruction. LVN B indicated that it was the responsibility of charge nurses to check for expired medications, and she had been trained on proper medication storage. Interviews with the Director of Nursing (DON) and the Administrator (ADM) revealed that nursing staff and medication aides were responsible for checking medication carts for expired medications. The DON stated that staff training on proper medication storage was conducted quarterly and as needed, emphasizing the importance of following policy and procedure. The ADM also highlighted the expectation for staff to check medication dates before administration. The facility's policy on medication labeling and storage, dated 2001, outlines the procedures for storing medications and handling expired or discontinued medications, which were not adhered to in this instance.
Failure to Maintain Sanitary Food Handling Practices
Penalty
Summary
The facility failed to adhere to professional standards for food service safety during dining services, as observed in one dining room. Specifically, an LVN was seen handling a resident's bread roll with bare hands while serving food. The LVN used a fork to separate the bread roll and applied butter, then placed the bread roll back on the resident's plate using her bare hand. During an interview, the LVN acknowledged her mistake, stating she should have used gloves and recognized the potential risk of making the resident sick due to her actions. She confirmed that she had been trained not to touch residents' food with bare hands. Interviews with the ADM and DON revealed a lack of clarity regarding who is responsible for training staff on food handling procedures. Both acknowledged that food should not be touched with bare hands, and the DON highlighted the risk of cross-contamination, which could lead to illness or even death among the elderly population. The facility's policy on food preparation and handling, dated 2010, specifies that food should be prepared and served using clean utensils to avoid manual contact, which was not followed in this instance.
Medication Administration and Documentation Errors
Penalty
Summary
The facility failed to provide pharmaceutical services that ensured the accurate acquiring, receiving, dispensing, and administering of controlled medications for two residents. For Resident #1, the facility did not ensure that the medication aide (MA) accurately documented the narcotic count sheet for the administration of Norco 5-325 mg. The MA administered an extra dose of Norco to Resident #1 at 6:00 a.m., one hour after the licensed vocational nurse (LVN A) had already administered a dose at 5:00 a.m. This error was not immediately reported, and the MA did not document the 2:00 p.m. dose on the narcotic count sheet, leading to discrepancies in the medication records. For Resident #2, the facility failed to ensure that LVN B documented the narcotic count sheet for the administration of Norco 7.5-325 mg. LVN B administered the medication at 1:00 p.m. but did not log it on the controlled substance/narcotic count sheet, resulting in a discrepancy between the count sheet and the actual number of pills remaining. LVN B acknowledged the error, attributing it to being in a hurry and not having the controlled substance logbook at the time of administration. Interviews with the Director of Nursing (DON) and staff revealed that the errors were due to lapses in following established procedures for medication administration and documentation. The DON stated that the MA and LVN B were trained and experienced in administering and logging medications but failed to adhere to the facility's policies. The facility's policies require that medication errors be documented, reported, and reviewed, and that staff verify the right resident, medication, dosage, time, and method before administration. The failure to follow these procedures could have led to residents receiving extra doses, posing risks of adverse effects.
Medication Administration Error in LTC Facility
Penalty
Summary
The facility failed to ensure that residents were free from significant medication errors, specifically for one resident who was administered an additional dose of Norco 5-325 mg one hour after the scheduled dose. The medication aide (MA) did not follow the physician's orders, which specified that the medication should be given every eight hours. This error was not documented in the Medication Administration Record (MAR) or the narcotic count sheet, and the MA did not notify any staff about the extra dose until later in the day. The resident involved was an elderly female with a history of dementia, muscle weakness, depression, insomnia, hypertension, osteoarthritis, and joint pain. Her care plan included administering medications as ordered by the physician and monitoring for side effects and effectiveness. Despite the error, the resident did not exhibit any adverse reactions or respiratory distress following the administration of the extra dose. Interviews with the Director of Nursing (DON) and other staff revealed that the MA was aware of the proper procedures for medication administration but failed to check the MAR before administering the medication. The MA admitted to not verifying the MAR and did not inform anyone of the error until the narcotic count was conducted. The facility's policy requires that medication errors be documented, reported, and reviewed, but this protocol was not followed in this instance.
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Illustrative
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
Illustrative
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Illustrative
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Nursing homes near Jayton
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Stonewall Living Center | 21 mi | ★★★★★ | 2 | 0 |
| Homeplace Manor Healthcare Center | 36.5 mi | ★★★★★ | 25 | 0 |
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