Above average — CMS composite of the measures below.
The next survey window likely opens around September 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 Snyder Nursing Home during CMS and state inspections, most recent first.
Advance Directive Information Not Documented: The facility failed to provide evidence that advance care planning information was given to residents or their representatives upon admission and reviewed periodically. Clinical record review showed an Advance Directives/Medical Treatment Decisions Acknowledge of Receipt form in each record, but none were signed by the resident or representative. The DON stated the form was only a worksheet and that residents' code status was reviewed on admission, while the facility policy required residents or legal representatives to be notified of their right to implement advance directives.
Comprehensive care plans did not include residents’ current code status. During record review, surveyors could not find code status information on the care plans, and an RN stated that code status had not been included. The DON later provided the facility’s Comprehensive Care Plan policy, which states that each resident must have a person-centered comprehensive care plan developed within 7 days of the comprehensive assessment.
Facility staff declined the readmission of a resident after hospitalization, despite a paid bed hold and an anticipated return, due to the resident electing hospice services. The facility cited the absence of a universal hospice contract as the reason for refusal, even though individualized hospice contracts were offered. The facility also failed to provide appropriate discharge documentation or ensure the discharge process met the resident's needs and preferences.
Failure to Follow Alarm Orders: Staff failed to ensure one resident had a current provider order for a chair alarm and failed to follow another resident’s provider order to discontinue a bed alarm. One resident with memory impairment and a wheelchair was observed with a chair alarm despite no current order, while another resident with cognitive intactness was observed with a bed alarm in place even though the MD had ordered it discontinued.
Incomplete Documentation of Fluid Restriction Monitoring: A resident with CHF, CKD, COPD, and other chronic conditions had a provider order for a 1500 mL fluid restriction, but the MAR/TAR did not consistently document monitoring of fluid intake. The DON stated nursing was honoring the restriction and had written instructions for how fluids were to be provided, yet the TAR showed only one entry before it was later updated, leaving the resident's fluid restriction monitoring incompletely recorded.
Advance Directive Information Not Documented
Penalty
Summary
The facility failed to provide evidence that advance care planning information was provided to residents or their resident representatives upon admission and reviewed periodically. During clinical record review, each record contained an Advance Directives/Medical Treatment Decisions Acknowledge of Receipt form stating that the resident had been informed in writing, in a language understood by the resident, of the right to accept or refuse medical or surgical treatment and to formulate advance directives, but none of the forms reviewed were signed by the resident or the resident's representative. During interview, the DON stated that the form in each resident's clinical record was only a worksheet and that, when a resident is admitted, she goes over code status with them. The DON also stated that residents or representatives do not sign the form to acknowledge receipt of the information. The facility policy titled Advance Directives (Self Determination Rights for Residents) stated that upon admission each resident will be advised of and given the opportunity to execute advance directives, and that the resident or legal representative will be notified of the right to implement an advance directive if desired.
Comprehensive Care Plans Did Not Include Code Status
Penalty
Summary
The facility failed to develop comprehensive care plans that included each resident’s current code status for all current residents. During clinical record review, the survey team was unable to identify any information regarding residents’ current code status on the comprehensive care plans. On 10/27/2025 at 5:10 p.m., RN #2 stated that the residents’ code status was not included on the comprehensive care plan. On 10/28/2025 at 8:20 a.m., RN #2 told the surveyor that she had updated the residents’ care plans to include their current code status. Later that day, at 2:30 p.m., the issue was reviewed with the DON and Administrator, and at 4:40 p.m. the DON provided the facility policy titled Comprehensive Care Plan, which stated that each resident will have a person-centered comprehensive care plan developed within 7 days of completion of the comprehensive assessment and implemented to meet the resident’s preferences and goals and address medical, physical, mental, and psychosocial needs.
Failure to Provide Valid Basis for Declining Readmission and Inadequate Discharge Process
Penalty
Summary
Facility staff failed to provide a valid basis for declining the readmission of a resident following a hospital stay, despite the resident having a paid bed hold and an anticipated return. The resident, who was cognitively intact and had multiple diagnoses including Multiple Sclerosis, Paraplegia, Osteoarthritis, and Congestive Heart Failure, was discharged to the hospital with a return anticipated, as documented in the clinical record and MDS. Upon discharge planning, the hospital communicated that the resident and family wished to return to the facility with hospice services, and coordination between the facility and hospice was requested. However, the facility administrator declined readmission, citing the lack of a universal hospice contract and the resident's new hospice order as reasons, despite the facility's practice of individualized hospice contracts. The administrator confirmed that a discharge notice was only provided at the time of the resident's transfer to the hospital, not after the decision to decline readmission. Facility policy requires documentation supporting the basis for discharge and specific unmet needs, but no further information was provided to the survey team. The surveyor's review found that the facility did not develop or implement an appropriate discharge process for the resident or their representative, and failed to ensure the transfer/discharge met the resident's needs and preferences.
Failure to Follow Alarm Orders
Penalty
Summary
Facility staff failed to ensure that Resident #39 had a current provider order for a chair alarm. Resident #39 had diagnoses including adult failure to thrive and muscle weakness, and the annual MDS indicated problems with long- and short-term memory and moderate impairment in cognitive skills for daily decision making. The resident used a wheelchair, had a care plan focused on falls with a bed alarm intervention, and current provider orders included a bed alarm and low bed with mat, but no order for a chair alarm. During observation, Resident #39 was seen up in a wheelchair in the dining room with a chair alarm in place, and the DON later confirmed there was no current order for the chair alarm and that it was being removed. Facility staff also failed to follow a medical provider order to discontinue a bed alarm for Resident #2. Resident #2 had diagnoses including Type 2 diabetes mellitus, mild cognitive impairment, macular degeneration, weakness, lack of coordination, and lymphedema, and the MDS BIMS score was 13 out of 15, indicating cognitive intactness. The resident was observed with a bed alarm in place, and when asked what happened when the alarm sounded, the resident stated she turned it off. A provider order dated 10/20/25 directed to discontinue the bed alarm, but the alarm remained on the bed during survey observations and interviews.
Incomplete Documentation of Fluid Restriction Monitoring
Penalty
Summary
The facility failed to maintain a complete and accurate clinical record for one sampled resident by not documenting fluid intake monitoring in accordance with a provider order for a 1500 mL fluid restriction. The resident had diagnoses including chronic atrial fibrillation, hypothyroidism, chronic kidney disease stage 4, chronic obstructive pulmonary disease, chronic diastolic congestive heart failure, and cognitive communication deficit. The most recent quarterly MDS showed a BIMS score of 13 out of 15, indicating the resident was cognitively intact. A provider order dated 9/15/25 specified a 1500 mL fluid restriction, and the quarterly nutritional assessment also noted fluid restriction, edema, therapeutic diet related to CHF, and daily weights with extra Lasix per orders. A review of the September and October 2025 MARs did not show any indication that the resident's fluid restriction was being monitored. The DON stated that nursing had been honoring the restriction and that the RD had provided written instructions breaking down how fluids were to be given, including no water pitcher in the room, 1260 cc on meal trays, and 4 oz of water or other liquid with medication pass three times daily, but these instructions were not documented on the TAR. The DON provided the September and October TARs, which showed only one entry on 9/16/25 for the 1500 mL fluid restriction and no other entries until the October TAR was updated on 10/29/25 with a fluid restriction entry. The DON also provided an Accurate Intake and Output Record that was stated would be used to monitor daily fluid intake.
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Illustrative
What surveyors actually found near you
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Salem
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Salem Health & Rehabilitation | 2.3 mi | ★★★★★ | 9 | 0 |
| Davis And Mcdaniel Veterans Care Center | 2.7 mi | ★★★★★ | 3 | 0 |
| Brandon Oaks Nursing And Rehabilitation Center | 3.2 mi | ★★★★★ | 0 | 0 |
| Richfield Health Center - Salem | 3.9 mi | ★★★★★ | 0 | 0 |
| Raleigh Court Health And Rehabilitation Center | 4.9 mi | ★★★★★ | 0 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.