Below average — CMS composite of the measures below.
The next survey window likely opens 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 Renton Health & Rehabilitation during CMS and state inspections, most recent first.
Unsafe and Non-Homelike Environment: The facility failed to maintain a safe, clean, and homelike environment on multiple units. Surveyors observed gouges and scrapes on walls, broken and dirty baseboards, damaged hallway flooring, bent or missing blind slats, a missing privacy curtain, and a makeshift plastic bag/string setup used to turn on a bedside light. A resident using supplemental O2 also had a dirty concentrator with dust and stains. The Mnt Supervisor and DON confirmed the damaged conditions and stated residents should have a homelike environment.
Failure to Provide Privacy During Assessment and Treatment: A nurse practitioner discussed pain and began treatment for one resident with stroke-related weakness, pain, and depression in the dining room, where other residents were present, before another staff member stopped the injection. The same staff member also assessed another resident with a hip fracture and pain in the dining room during lunch, discussing pain and treatment in front of other residents and staff. The DON stated residents should be treated in a dignified manner and should not be assessed, treated, or provided care in the dining room.
A facility failed to keep several resident care plans current with assessed needs and newly identified interventions. One resident on anticoagulants had unexplained bruising that was observed but not added to the CP, another resident’s stroke CP did not address a left-hand contracture, a third resident’s CP still reflected tube feeding despite current orders for a soft diet, and a fourth resident’s fall CP did not include new safety measures such as a visual reminder and grabber device.
A resident on blood thinners had multiple purple bruises on the arm, but staff did not identify or order monitoring for the bruising during skin checks. Another resident with severe cognitive impairment had a black scab on the great toe, yet staff documented no new skin issues and there was no order to monitor or treat the toe lesion.
Failure to assess, monitor, and prevent pressure ulcers affected two residents with significant mobility limitations and other risk factors. One resident with stroke-related weakness was found with open areas on both buttocks after prior skin checks documented no issues, and staff were unaware of the wounds. Another resident with a hip fracture, diabetes, and dependence for care developed heel and ankle wounds that staff linked to wheelchair footrests, while weekly skin checks had continued to show no skin issues and preventive orders and care plan updates were not in place.
Restorative Nursing Programs were not implemented for two residents who were assessed to need them. One resident with stroke-related weakness and a left hand contracture was discharged from OT to a splint/brace and PROM program, but staff had no current RNP and no care plan directions were in place. Another resident with bilateral BKA and left-sided weakness was discharged from OT to a ROM program for the affected arm, yet staff confirmed no current RNP was active and the resident reported no exercise assistance after therapy ended.
Unsecured sharps and chemicals were found in an unlocked maintenance office and at the West nurse station. The maintenance door was propped open with chemicals, sharp tools, and other objects inside, and three bottles of a chemical used to dispose of old or unneeded meds plus a container of sanitizing wipes were left unsecured at the nurse station. The Maintenance Supervisor, RN Mgr, Administrator, and DON all stated these items should be kept locked for resident safety.
Medication Cart A was left unlocked and unattended, and Medication Cart C contained expired pain medications, an opened blood sugar injectable beyond the staff’s understanding of its usable period, and eye lubricant for a discharged resident. An RN said the cart should have been locked before being left unattended, and an LPN said expired and discontinued medications should be discarded. The DON stated medication carts should be secured and expired or discontinued medications should not remain in the carts.
Food storage practices were not followed in the main kitchen and a nursing unit refrigerator. A tray of house-made Jello cups was found uncovered and undated, and multiple items in the unit fridge were expired or undated, including thickened liquid, bread, carrots, avocados, and sliced meat and cheese. The Dietary Supervisor and RN Mgr confirmed the Jello should have been covered and that expired items should have been discarded.
An RN left resident health information unsecured and visible on a medication cart, contrary to facility confidentiality policy. The facility also inaccurately documented bathing services for a resident who was dependent on staff for showers, with a CNA and therapy staff describing shower documentation that did not match the services actually provided.
Staff failed to follow posted EBP precautions for a resident with a stroke, left-sided weakness, an indwelling catheter, and max assist toileting needs when a CNA provided incontinence care and an RN provided wound care without wearing gowns. The facility also allowed a visitor to handle a communal ice scoop with bare hands and pour ice into a personal bottle without gloves or hand hygiene, despite infection control concerns.
The facility failed to notify Medicaid recipient residents when their personal fund balances approached the $2,000 limit, risking their Medicaid coverage. Additionally, a resident's funds were not transferred to the state Office of Financial Recovery within 30 days of discharge, as required. The Business Office Manager acknowledged the broken system and lack of timely fund management.
The facility failed to maintain a homelike environment in several resident rooms, with issues such as gouged walls, unmounted TVs, dirty fans, and unsanitary bathrooms. Observations included exposed drywall, dusty fans, and bathrooms with rust and stains. The Maintenance Supervisor and RN Manager acknowledged the need for repairs and cleaning.
The facility failed to maintain a safe environment, with an unlocked laundry room door allowing access to chemicals and an open exterior door posing elopement risks. Additionally, a resident with a history of falls had a cluttered room and inappropriate footwear, contrary to the facility's fall prevention policy. Staff interviews confirmed awareness of these issues, but care plans lacked specific interventions to mitigate risks.
The facility failed to properly store, label, and dispose of medications, resulting in several deficiencies. Narcotics were found in an unlocked refrigerator, expired medications were not removed, and a resident had medication at their bedside without proper assessment. Additionally, medication carts were left unlocked and unsupervised, posing safety risks.
The facility failed to maintain sanitary conditions in its kitchen and unit refrigerator, posing risks for foodborne illness. Observations revealed mold-like debris on the ice machine, dirty wall fans, and inadequate hand hygiene practices among dietary staff. Uncovered food was transported in hallways, and the unit refrigerator was unclean, contrary to the facility's food safety policies.
The facility failed to obtain informed consent for psychotropic medications for two residents and for bed rails for another resident. One resident received medications for anxiety and depression without prior consent, while another had a verbal consent noted but not finalized until months later. Additionally, a resident with paralysis had bed rails installed without consent. Staff acknowledged the oversight, which placed residents at risk for unwanted treatment.
The facility failed to provide the required Skilled Nursing Facility Notice of Medicare Non-coverage (SNF-NOMNC) to two residents whose skilled services coverage was ending. This notice is crucial for informing residents about the end of their Medicare A benefits and their right to an expedited appeals process. The Social Services Director confirmed that the notices were not provided, which is a violation of the facility's policy.
The facility failed to ensure accurate MDS assessments for three residents, leading to potential risks for unmet care needs. One resident's dental status was incorrectly documented, another's mobility device was inaccurately recorded, and a third resident's communication abilities were misrepresented, affecting the accuracy of their preference assessment.
A facility failed to ensure an accurate PASRR assessment for a resident with dementia, anxiety, and schizophrenia, leading to an incomplete identification of mental health needs. The resident's PASRR inaccurately listed anxiety as the only serious mental illness and failed to update the assessment to include psychosis and schizophrenia diagnoses. Additionally, the resident's primary language was incorrectly recorded, contrary to staff's identification during admission.
The facility failed to develop and implement comprehensive care plans for four residents, leading to unmet care needs. A resident with paralysis had undocumented bed rails, another with a urinary catheter lacked care plan documentation, a third resident's care plan was outdated after transitioning from tube feeding, and a fourth resident's care plan did not address care refusals. Staff acknowledged these oversights.
The facility failed to adhere to physician's orders for pain medication administration for two residents, administering opioids for pain levels below prescribed thresholds. Additionally, two other residents had issues with pain patch orders not being clarified or documented correctly, leading to improper application and removal. The DON confirmed the need for order clarification.
Several residents in the facility did not receive necessary assistance with ADLs, leading to deficiencies in care. A resident with partial paralysis was not assisted to get out of bed as required, while another resident with intact cognitive abilities had unmet personal hygiene needs, including untrimmed nails and facial hair. A third resident reported not receiving nail care since admission, and a fourth resident was observed with greasy hair and long nails despite scheduled baths. Staff interviews revealed inconsistencies in following care plans and documenting refusals.
The facility failed to provide adequate end-of-life care for two residents receiving hospice services. One resident experienced poor personal hygiene due to a lack of coordination between facility and hospice staff, while another resident's records lacked documentation of hospice services and physician orders. Additionally, there was a discrepancy in medication management for one resident, highlighting a failure in communication between the facility and hospice.
A facility failed to implement a restorative nursing program (RNP) for a resident with mobility limitations following discharge from physical therapy. Despite recommendations for ROM exercises and positioning, the RNP was not established, as confirmed by staff interviews and record reviews. Observations showed the resident was not wearing a knee brace and was not on a restorative program.
A facility failed to monitor a resident's weight adequately during their transition from tube feeding to oral intake. Despite a physician's order for monthly weight checks, the resident was not weighed for over a month before and two weeks after the transition. The dietician confirmed the importance of weight monitoring during this period, but the resident's weight was not measured since mid-August, partly due to a refusal to be weighed and documentation issues.
The facility failed to provide timely dental services for two residents, resulting in oral discomfort and diminished quality of life. One resident needed new dentures but did not receive follow-up care, while another had loose-fitting dentures with no scheduled adjustments. Staff acknowledged the oversight in scheduling necessary appointments, contrary to facility policy.
The facility failed to maintain proper infection control practices, including inadequate use of Enhanced Barrier Precautions, poor hand hygiene, and improper catheter care. Staff did not follow precautionary measures, such as wearing gowns and gloves, and neglected hand hygiene protocols during resident care. Additionally, catheter drainage bags were improperly placed on the floor, and uncleanable surfaces were present, increasing the risk of infection.
The facility failed to implement an effective Antibiotic Stewardship Program, leading to inappropriate antibiotic use for three residents. A resident received antibiotics for a UTI without proper confirmation, another had delayed treatment for pneumonia due to lack of communication, and a third was treated for pneumonia despite negative X-ray results. These actions risked adverse outcomes for the residents.
A facility failed to provide adequate supervision to prevent altercations between two residents. One resident, with a history of hip fracture and anxiety, reported incidents involving another resident with dementia, who entered their room, consumed their snacks, and left feces on their bed. Despite being informed, staff did not document or respond to these incidents until the residents were separated. The facility did not assess the second resident's wandering risk or implement a care plan, leading to safety concerns.
The facility failed to promptly initiate CPR for two residents who were designated as Full Code, leading to delays in emergency response. In both cases, staff hesitated to start CPR due to uncertainty about code status and logistical challenges, such as moving residents to the floor. The lack of proper documentation and adherence to emergency protocols further exacerbated the situation, placing additional residents at risk.
The facility failed to ensure nursing assistants received the required 12 hours of annual in-service training, including dementia management and emergency response training. Documentation was lacking, and interviews revealed that the training calendar was not followed, and no system was in place to ensure compliance.
The facility failed to ensure the availability and completeness of POLST forms for two residents. One resident's POLST form was missing from medical records, while another's was incomplete, lacking a physician's signature. This deficiency was identified after one resident was found unresponsive and CPR was performed.
Unsafe and Non-Homelike Environment
Penalty
Summary
The facility failed to maintain a safe and homelike environment on 3 of 4 units reviewed for environment. Observation and record review showed damaged walls, broken or missing flooring and baseboards, bent or missing window blind slats, and a missing privacy curtain in multiple resident rooms and common areas. On Unit B, gouges were observed on the wall at the head of a bed, and the entrance tiles were broken with dirty and broken baseboards in another room. On Unit C, white paint patches were seen on the wall behind a bed, blind slats were bent and missing, and the privacy curtain was missing for one bed area. On Unit D, large black gouges were observed in hallway flooring, scrapes were seen on the wall behind a bed, and some blind slats were bent and missing in a resident room. In that same room, a plastic bag tied to a string was being used to turn the light on at the bedside. The resident in bed 2 stated the blinds had been broken for a while. The resident in bed 2 on Unit C used supplemental oxygen, and the oxygen concentrator was dirty with dust and stains. Staff C, the Maintenance Supervisor, confirmed the findings during the walkthrough and stated residents should have a homelike environment. Staff B, the DON, also stated the expectation was for residents to have a homelike environment and that the damaged walls, blinds, and flooring should be fixed.
Failure to Provide Privacy During Assessment and Treatment
Penalty
Summary
The facility failed to provide care in a manner that promoted dignity for 2 residents. Resident 11 had a history of stroke with left-sided weakness, pain, and depression, and the 5-day MDS indicated the resident had intact memory and made their own decisions. During observation, Resident 11 was sitting in the dining room with three other residents waiting for lunch when Staff I, a nurse practitioner, approached and began talking about the resident’s pain in the dining room. Staff I then started giving the resident an injection in the dining room before another staff member stopped the injection from being administered there. Resident 2 had a history of hip fracture and pain, and the 5-day MDS indicated the resident had intact memory and made their own decisions. During observation, Resident 2 was in the dining room with other residents during lunch when Staff I began assessing the resident in the dining room and talked about the resident’s pain and treatment in front of other residents and staff members. In interview, Staff I stated residents should not be assessed or treated in public places and should be provided privacy during assessment and treatment. The DON stated all residents should be treated in a dignified manner and staff should not assess, treat, or provide care in the dining room.
Care Plans Not Revised to Reflect Current Resident Needs
Penalty
Summary
The facility failed to ensure person-centered care plans were revised as needed to address all aspects of resident care for 4 residents reviewed for comprehensive care plans. The facility policy stated that care and treatments provided to residents would be included in the care plan. Surveyors found that the care plans for Residents 4, 5, 6, and 7 did not reflect current conditions or newly identified care needs documented in the record and observed during the survey. Resident 4 had multiple medically complex conditions, including heart problems, high blood sugar, and use of blood thinner medications during the assessment period. Surveyors observed multiple scattered purple bruises on the resident’s left arm on several occasions. The anticoagulation therapy care plan directed staff to monitor for bruising and bleeding and notify the provider for new bruises or bleeding, but the comprehensive record did not document the bruises, and the care plan was not updated to include the new bruising. Staff D stated staff should assess the skin, notify the provider, document the bruises, monitor for worsening, and update the care plan, but this was not done. Resident 5 had a stroke with left-sided weakness and a left hand contracture, but the stroke care plan did not include directions or interventions for managing the contracture. Resident 6 had diagnoses including traumatic brain injury and dysphagia, and the care plan still described the resident as dependent on tube feeding even though current physician orders directed a soft-textured regular diet and staff stated the resident no longer received nutrition via the feeding tube. Resident 7 had cognitive impairment and a recent fall, and the fall investigation identified new interventions of a visual reminder to lock wheelchair brakes and a grabber device, but the care plans were not revised to include those interventions. Staff D confirmed the care plans for Residents 5, 6, and 7 were not updated to reflect the residents’ current conditions and identified interventions.
Failure to Assess and Monitor Skin Changes
Penalty
Summary
The facility failed to ensure Resident 4’s skin was assessed, monitored, and treated as required for multiple scattered purple bruises on the left arm. Resident 4’s annual MDS indicated the resident had no cognitive impairment, could understand others in conversation, and received blood thinner medications during the assessment period. However, observations on 01/06/2026, 01/07/2026, 01/08/2026, and 01/12/2026 showed the bruises on the left arm, and the January 2026 physician orders contained no order directing staff to monitor the bruises. Weekly skin checks on 01/03/2026 and 01/10/2026 documented head-to-toe skin assessments but did not identify any skin issues on the resident’s arms. The RN Manager confirmed the resident was at risk for bruising and bleeding due to blood thinner use and that there was no order to monitor the bruises for changes or worsening. The facility also failed to ensure Resident 6’s left great toe scab was monitored and treated. Resident 6 had severe cognitive impairment and diagnoses including traumatic brain injury, fractures, and stroke, and required assistance with personal care. The resident’s spouse reported concern about a scab on the left great toe related to improper toenail trimming. On observation, the left great toe had a thick, black scab along the inside edge of the toenail, and the RN stated there should be a physician order to treat the toe. A prior nurse progress note documented the ingrown toenail as resolved and the surrounding skin as healing, but the physician orders reviewed showed only weekly skin checks and no order to treat or monitor the toe scab. A skin check completed on 01/08/2026 documented no new skin issues, and the RN later stated the scabbed area should be monitored and treated and that the toe had previously healed but was now worse.
Failure to Assess, Monitor, and Prevent Pressure Ulcers
Penalty
Summary
The facility failed to provide ongoing assessment, documentation, and prevention interventions for pressure ulcers for 2 of 4 residents reviewed. The report states the facility did not assess and monitor pressure ulcers and did not implement preventative measures, including repositioning, consistent with professional standards of practice. The cited deficiency was based on observations, interviews, and record review involving two residents with significant mobility limitations and other medical conditions that increased their risk for skin breakdown. Resident 5 had a history of stroke with left-sided weakness, required maximal assistance for transfers and bed mobility, and was identified as being at risk for pressure ulcers. The care plan called for skin monitoring, notification of the provider for any skin breakdown, preventative skin care, a pressure-reducing mattress, and pillows to protect the skin while in bed. Weekly skin checks on 12/31/2025 and 01/07/2026 documented no new skin issues, yet on 01/09/2026 the resident was observed with open areas on both buttocks. The wounds measured 2 cm x 1.4 cm x 0.1 cm on the right buttock and 2 cm x 1.0 cm x 0.1 cm on the left buttock. Staff interviewed stated they did not know about the open wounds, and the DON stated staff should have repositioned the resident side-to-side and documented refusals of care, but this was not done. Resident 2 had a hip fracture, pain, diabetes, edema, and was dependent on staff for transfers, toileting, and bed mobility. The resident was assessed as at risk for pressure ulcers and was using a wheelchair. The care plan directed weekly skin checks and use of a pressure-reducing wheelchair cushion, but weekly skin assessments through 12/22/2025 documented no new skin issues. Later, nursing documentation noted a popped blister on the right heel and an open wound on the right ankle, and the resident stated the blisters were caused by wheelchair footrests. Staff later stated the wounds developed in the facility because the resident’s feet rubbed against the wheelchair footrests, and they acknowledged they should have obtained orders for heel protectors and updated the care plan, but did not.
Restorative Nursing Programs Not Implemented for Two Residents
Penalty
Summary
The facility failed to ensure two residents assessed to require Restorative Nursing Program (RNP) services received those services. The facility policy stated residents identified through the comprehensive assessment process would receive restorative services, including ROM, splint/brace services, and walking, and that the Restorative Nurse was responsible for ensuring each resident’s program was implemented. Survey findings showed that the facility did not have the identified restorative programs in place for either resident reviewed. Resident 5 had a history of stroke with left-sided weakness and impairment to the right arm, and required maximal assistance for personal hygiene and daily activities. Observations on multiple days showed Resident 5 lying in bed with a contracture of the left hand, and a hand brace was observed sitting on another resident’s nightstand in the room. Resident 5 stated therapy had been working with the left hand contracture but staff had not provided therapy services for the last three months. The care plan had no directions for staff to provide care for the left hand contracture, and January 2026 physician orders had no documentation for an RNP for the contracture. OT records showed Resident 5 received OT from 10/13/2025 through 11/07/2025 and was discharged to an RNP with recommendations for a restorative splint and brace program. Resident 11 had diagnoses including bilateral below-the-knee amputations and stroke-related left-sided weakness, with functional limitation in ROM of the left arm and maximal assistance needs for bed mobility, toileting, and showers. The resident stated therapy ended on 01/03/2026 and no exercise assistance had been received since then. Observation showed both prosthetic devices sitting in a chair in the room. OT discharge documentation showed Resident 11 was discharged to an RNP for a ROM program to maintain ROM on the affected arm and prevent contractures, but staff interviews confirmed the resident did not have a current RNP. Staff stated they expected rehab to send restorative recommendations, while rehab staff stated they usually gave recommendations to the RNP supervisor but did not know what happened in these cases.
Unsecured sharps and chemicals in maintenance office and nurse station
Penalty
Summary
The facility failed to ensure sharps and chemicals were stored safely in 1 of 1 Maintenance Offices and 1 of 2 nurses stations reviewed. Observation on 01/06/2026 at 11:51 AM showed the maintenance door propped open without staff inside, and the unlocked maintenance office contained chemicals, sharp tools, and objects. In interview, the Maintenance Supervisor stated staff were expected to lock the door when exiting the maintenance office and noted there were a tremendous number of hazardous materials in the room, while the Administrator stated staff were expected to close and lock the maintenance office door for resident safety. At the West Nurse's Station, observation on 01/06/2026 at 8:52 AM showed three bottles of a chemical used to safely dispose of old or unneeded medications and a container of sanitizing wipes unsecured and unlocked at the station. The RN Manager stated the chemical compound and sanitizing wipes should be stored behind locked doors or cabinets, and the DON later stated staff were expected to secure all chemicals behind locked doors for resident safety. The facility policy titled Environmental Services Safety Procedures stated chemicals and unsafe equipment would not be left unattended and would be stored in a locking cabinet or storage area for resident safety.
Improper Medication Cart Security and Expired Medications
Penalty
Summary
The facility failed to ensure proper storage and labeling of medications in 2 of 4 medication carts reviewed. On Medication Cart A, observation showed the cart was unlocked and unattended. In interview, an RN stated they were expected to lock the medication cart before leaving it unattended but forgot to do so, and stated the cart should be locked before walking away for resident safety. The DON later stated staff were expected to lock medication carts prior to leaving them unattended and that medications needed to be properly secured and locked for resident safety. On Medication Cart C, observation showed a bottle of over-the-counter pain medication expired in 09/2025, another bottle of pain medication expired in 12/2025, an injectable medication used to control blood sugar opened on 12/06/2025, and a bottle of eye lubricant for a resident discharged from the facility in December 2025. An LPN stated the expired pain medications should be discarded upon expiration, was unsure how long the injectable medication was good for after opening, and stated the eye lubricant for the discharged resident should be discarded upon discharge. The DON stated expired or discontinued medications should not be in the medication carts, that staff should remove them upon expiration, and that the injectable medication was only good for 28 days after opening.
Food Storage Not Labeled, Covered, or Discarded When Expired
Penalty
Summary
Food was not stored in accordance with professional standards of safety in the facility's main kitchen and the [NAME] Unit refrigerator. During observation of the walk-in refrigerator in the main kitchen, a tray with 11 house made Jello cups was found uncovered and undated. In interview, the Dietary Supervisor confirmed the Jello should have been covered. In the [NAME] Nursing Unit refrigerator, staff observed a carton of thickened liquid dated 12/22/2025 with a use-by date of 12/29/2025, two packages of sliced bread dated 12/09/2025, one bag of carrots dated 12/14/2025, three undated avocados, and two undated packages containing sliced meat and cheese. The Registered Nurse Manager stated staff were supposed to date food when it was placed in the refrigerator and discard food if not used within a week, and confirmed the thickened liquid, bread, and carrots were expired and should be discarded.
Unsecured Resident Records and Inaccurate Bathing Documentation
Penalty
Summary
The facility failed to maintain confidentiality of resident records on Unit A when a medication cart was observed with a paper containing resident health information left unsecured and visible. Staff E, an RN, stated the information should have been covered and secured before leaving it unattended, and the DON stated staff were expected to secure resident information to prevent HIPAA violations. The facility policy stated resident information was to be secured and papers with resident information were not to be left unattended. The facility also failed to document bathing services accurately for Resident 17, who was dependent on staff for bathing/showers and had no memory impairment on the admission MDS. The care plan scheduled showers twice weekly on Monday and Thursday evenings, but the record showed multiple shower transfers and two-person assistance entries, while Resident 17 stated they had difficulty getting showers, had not received or been offered showers as scheduled, and had only received one shower since admission. Staff F, a CNA, stated they did not provide bathing to Resident 17 and documented showers provided by OT, while the DON stated staff should not document for other staff. Staff U, a COTA, stated therapy assisted Resident 17 with one shower since admission, and the therapy notes showed only one shower provided by therapy.
Infection Control Failures With PPE Use and Communal Ice Handling
Penalty
Summary
The facility failed to ensure staff used appropriate PPE for a resident on EBP precautions. Resident 5 had a history of stroke with left-sided weakness, an indwelling catheter, and required maximal assistance with toileting hygiene. An EBP sign was posted outside the resident’s room directing staff to perform hand hygiene and wear PPE during direct care, and an isolation cart with PPE was kept inside the room. During observations, Staff N provided incontinence care without wearing a gown, and Staff O provided wound care without wearing a gown, despite both staff stating they should have followed the posted precautions and worn PPE while caring for the resident. The facility also failed to ensure visitors used gloves while handling a communal ice bucket. A visitor was observed in the hallway touching their hair and corridor side rails, then picking up the ice scoop with bare hands and pouring ice into a personal water bottle without gloves or hand hygiene before or after using the scoop. Staff P stated the visitor should have asked staff for ice and that the ice bucket should not have been left in the hallway because it caused infection control concerns.
Failure to Notify Residents of Fund Balances and Timely Disbursement
Penalty
Summary
The facility failed to notify five Medicaid recipient residents when their personal fund account balances reached $1,800, which is within $200 of the $2,000 resource limit that could impact their Medicaid coverage. This oversight placed the residents at risk for personal financial liability for their care. The facility's revised Resident Personal Funds policy requires notification when a resident's account approaches the Supplemental Security Income (SSI) resource limit, but this was not adhered to. The Business Office Manager (BOM) acknowledged the issue, citing a lack of a BOM for several months and confirming that the system was broken, leading to residents exceeding the $2,000 limit. Additionally, the facility did not ensure that funds were reimbursed to the state Office of Financial Recovery (OFR) within 30 days of a resident's discharge or death. Specifically, Resident 219, who was discharged on May 30, 2024, had a balance of $3,286.02 that was not transferred to the resident or OFR until September 13, 2024, over three months later. The BOM confirmed that Resident 219's account was not closed in a timely manner and that the personal fund was not sent with the resident upon transfer to another facility.
Facility Fails to Maintain Homelike Environment
Penalty
Summary
The facility failed to maintain a homelike environment in several resident rooms, as observed during a survey. In nine out of eighteen sampled rooms, issues such as gouged walls, unmounted televisions, dirty fans, and unsanitary bathroom conditions were noted. Specific observations included gouges in the walls exposing drywall, televisions not mounted on walls, and fans covered in dust debris. Bathrooms in several rooms had rust, dirt, and brown stains on tiles and fixtures, with some toilets having dried smears and missing toilet paper holders. These conditions were confirmed by the Maintenance Supervisor, who acknowledged the need for repairs and cleaning. The report highlights that the facility's inaction in maintaining clean and sanitary conditions in resident rooms compromised the residents' right to a safe and comfortable environment. The Maintenance Supervisor and a Registered Nurse Manager acknowledged the deficiencies, noting that the walls needed repair, bathrooms required daily cleaning, and missing fixtures needed replacement. The presence of jagged foam on a sink and the poor condition of window blinds further contributed to the substandard living conditions observed in the facility.
Facility Fails to Prevent Accident Hazards and Falls
Penalty
Summary
The facility failed to ensure the environment was free of accident hazards, specifically in the laundry room and in the resident rooms. Observations on two consecutive days revealed that the laundry room door was unlocked due to a malfunctioning key code, allowing unrestricted access. Inside the laundry room, there were chemicals and an open exterior door leading outside, posing risks of elopement and chemical ingestion. Staff interviews confirmed that the lock had been broken for two weeks and that the issue had been reported to the Head of Maintenance, but no repairs had been made. Additionally, the facility did not adequately address fall hazards in the room of a resident with a history of falls and multiple medical conditions, including arthritis and altered mental status. The resident required maximal assistance for transfers and dressing, yet the care plan inaccurately stated they only needed supervision for dressing. Observations showed the resident's room was cluttered, with items scattered on the floor and furniture, creating a fall risk. The resident was also observed with inappropriate footwear, which was inconsistent with the facility's fall prevention policy. Interviews with staff revealed that the resident's room clutter was a known issue, and while some items were stored by the facility, the care plan lacked specific instructions on managing clutter and assisting with transfers. The resident's cognitive issues and failure to use the call light for assistance were also noted, contributing to the risk of falls. Despite these known risks, the facility's interventions were insufficient to prevent the resident from experiencing falls.
Medication Storage and Security Deficiencies
Penalty
Summary
The facility failed to ensure proper storage, labeling, and disposal of medications, leading to several deficiencies. Observations revealed that a narcotic medication was stored in an unlocked refrigerator within the West Hall Medication Room, contrary to the facility's policy requiring double locks for narcotics. Additionally, the Garden Wing Cart contained expired medications and eye drops without open dates, which were not removed or destroyed as required. Furthermore, a tube of medicated cream was found on Resident 60's bedside table without a self-medication assessment or physician order, violating the facility's policy on medication storage in resident rooms. The report also highlighted issues with unsecured medication carts. On the Catsablanca unit, a medication cart was left unlocked and unsupervised for 23 minutes, posing a safety risk. Similarly, on the Wild West unit, a medication cart was found unlocked with no staff present, allowing access to medications. Interviews with staff confirmed that these practices were against the facility's expectations and policies, which require medication carts to be locked when not in use to prevent unauthorized access.
Sanitation and Food Safety Deficiencies in Facility Kitchen
Penalty
Summary
The facility failed to maintain sanitary conditions in its kitchen and unit refrigerator, which posed a risk for foodborne illness and cross-contamination. Observations revealed that the ice machine in the kitchen had brownish-black and pink mold-like debris on its surfaces, indicating inadequate cleaning. Staff Z, the Dietary Supervisor, acknowledged that the kitchen staff performed daily wipes, while maintenance was responsible for deep cleaning, which was not documented since October 2023. Additionally, wall fans in the kitchen were observed to be dirty, with debris hanging from the grills, and were running during food preparation, further compromising sanitation. Hand hygiene practices were also found to be lacking among dietary staff. Staff DD was observed handling both dirty and clean dishes without changing gloves or performing hand hygiene. Similarly, Staff EE used a thermometer probe without sanitizing it between uses and handled food with soiled gloves. Staff FF was seen touching various surfaces and then handling food without changing gloves. These actions were contrary to the facility's expectations for hand hygiene and sanitation, as confirmed by Staff Z. Furthermore, food transport and storage practices were inadequate. Uncovered cookies were observed on lunch trays being distributed by nurse's aides, exposing them to the hallway environment. The unit refrigerator was found to be unclean, with dried fluid on the shelves and crisper. Staff Z confirmed the refrigerator's condition and the expectation that food should be covered during transport. These deficiencies highlight a failure to adhere to the facility's food safety policies, as outlined in their revised policies from 2024.
Failure to Obtain Informed Consent for Medications and Bed Rails
Penalty
Summary
The facility failed to obtain informed consent prior to administering psychotropic medications to two residents and before the use of bed rails for another resident. Resident 34, diagnosed with anxiety and depression, was administered two antidepressants and an antianxiety medication starting in May 2024, but the informed consent forms were only signed in September 2024. Staff P, an RN Manager, acknowledged that informed consent should have been obtained before administering these medications. Similarly, Resident 20, who was prescribed an antidepressant in May 2024, had a verbal consent noted but the form was not signed until September 2024, with Staff C finalizing the electronic record much later. Staff C could not demonstrate that consent was obtained prior to the electronic signature date. For Resident 60, who was admitted with paralysis on one side of the body, bed rails were ordered and installed without obtaining informed consent. The resident confirmed that staff did not discuss the risks and benefits of the bed rails with them. Staff C admitted that they had not obtained consent for the bed rails, although it was required by the facility's policy. This oversight in obtaining informed consent for both psychotropic medications and bed rails placed residents at risk for unwanted treatment.
Failure to Provide Medicare Non-coverage Notices
Penalty
Summary
The facility failed to provide the required Skilled Nursing Facility Notice of Medicare Non-coverage (SNF-NOMNC) to two residents, Resident 219 and Resident 119, whose skilled services coverage was ending. This notice is essential as it informs residents that their Medicare A benefits are ending and provides information about their right to an expedited appeals process. According to the facility's policy, the NOMNC should be given at least two days before the end of the Medicare-covered Part A stay. However, the records for both residents did not show that the NOMNC was provided, which was confirmed by the Social Services Director during an interview. Resident 219 was admitted to the facility and discharged to the community on May 15, 2024, with a physician's order for discharge dated May 14, 2024. Similarly, Resident 119 was admitted and discharged to the community on May 22, 2024, as noted in the nursing progress note. Despite these discharges, neither resident received the NOMNC, which is a violation of the facility's policy and regulatory requirements. This oversight placed the residents at risk of not being fully informed about their coverage and losing their right to appeal the decision.
Inaccurate MDS Assessments for Three Residents
Penalty
Summary
The facility failed to ensure the Minimum Data Set (MDS) assessments accurately reflected the status of three residents, leading to potential risks for unmet care needs and diminished quality of life. For Resident 37, the MDS inaccurately indicated the resident had no natural teeth, despite observations showing multiple lower teeth and the resident awaiting denture repair. Staff acknowledged the error upon review. Resident 51's MDS inaccurately documented the use of a walker as the normal mobility device, while observations showed the resident in a wheelchair. This discrepancy was also confirmed as an error by the staff. For Resident 61, the MDS contained conflicting information regarding the resident's ability to be understood. Although the resident was assessed to have clear speech and intact memory, the MDS incorrectly marked the resident as rarely or never understood, leading to a staff assessment of preferences instead of a resident interview. This resulted in less specific information about the resident's preferences. Staff acknowledged the need for a resident interview, potentially using translation services, to accurately capture the resident's preferences.
Inaccurate PASRR Assessment for Resident with Mental Health Needs
Penalty
Summary
The facility failed to ensure the accuracy of a Pre-Admission Screening and Resident Review (PASRR) assessment for a resident, which is crucial for identifying mental health needs and determining appropriate nursing home placement. The resident in question, who had complex medical diagnoses including dementia, anxiety, and schizophrenia, was receiving antipsychotic medication for acute psychosis. However, the Level 1 PASRR assessment inaccurately identified the resident's serious mental illness indicator as only anxiety and failed to update the assessment to reflect the resident's psychosis and schizophrenia diagnoses. Additionally, the PASRR assessment inaccurately recorded the resident's primary language as English, despite staff identifying it as Vietnamese during the admission assessment. The Social Service Director acknowledged the importance of accurate PASRR assessments for determining the need for Level 2 evaluations and ensuring residents' success in the facility. The director also confirmed that the Level 1 PASRR should have been updated to include the correct diagnoses and primary language, highlighting a lapse in the facility's adherence to its policy and regulatory requirements.
Failure to Implement Comprehensive Care Plans
Penalty
Summary
The facility failed to develop and implement comprehensive care plans for four residents, leading to unmet care needs and a decreased quality of life. Resident 60, who was admitted with paralysis on the left side of their body, had a physician order for bilateral bed rails, but this was not documented in their care plan. The resident was not informed about the risks and benefits of the bed rails, nor was their consent obtained. Staff C, a Registered Nurse Manager, acknowledged the oversight in care planning for the bed rails. Resident 39, who had multiple diagnoses including brain damage and pressure ulcers, had an indwelling urinary catheter that was not documented in their care plan. The resident's representative expressed a desire to have the catheter removed, but was informed by staff that it was necessary until the resident's wounds healed. Staff C admitted that the catheter should have been included in the care plan to ensure proper care. Resident 58, with a history of stroke and difficulty swallowing, was receiving nutrition via a feeding tube, but the care plan was not updated after the resident transitioned to oral intake. Staff AA, a dietician, confirmed that the care plan was outdated. Resident 1, who had conditions including stroke and aphasia, had a care plan that did not address their refusal of care. Observations noted poor hygiene and refusal of care, and staff interviews revealed a lack of documentation and communication regarding refusals, which was acknowledged by the Director of Nursing.
Failure to Follow Physician's Orders and Document Care
Penalty
Summary
The facility failed to provide nursing care within professional standards by not adhering to physician's orders for pain medication administration for two residents. Resident 34, who experienced occasional pain affecting sleep and daily activities, was given opioid pain medication for pain levels below the prescribed threshold on multiple occasions. Similarly, Resident 20, diagnosed with chronic pain, received incorrect dosages of opioid pain medication for pain levels that did not meet the physician's specified parameters. These actions were confirmed by the Registered Nurse Manager, who acknowledged the importance of following physician-provided parameters for as-needed pain medications. Additionally, the facility did not clarify physician orders or accurately document the completion of tasks for two other residents. Resident 25 had a topical pain patch applied without proper documentation of its removal, and staff incorrectly signed the MAR indicating the patch was applied when it was not. Resident 52's orders for a pain patch were not followed as the MAR did not direct staff to remove the patch after the prescribed 12 hours. The Director of Nursing confirmed the need for clarification of pain patch orders for these residents.
Deficiencies in ADL Assistance for Residents
Penalty
Summary
The facility failed to provide necessary assistance with Activities of Daily Living (ADLs) for several residents, leading to deficiencies in care. Resident 58, who required substantial assistance due to a history of stroke and partial paralysis, was observed multiple times in bed despite orders to be up in a wheelchair daily. Staff interviews revealed that aides were expected to follow care plans, but Resident 58 remained in bed, expressing a preference to get up. Resident 52, who was dependent on staff for personal hygiene, was observed with long fingernails and facial hair, despite orders for regular nail care and shaving. The resident reported that staff did not offer to cut their fingernails as ordered and placed their electric razor out of reach, preventing self-care. Staff interviews confirmed that nail care should be offered as ordered, and refusals should be documented, but this was not consistently done. Resident 60, admitted with paralysis and no memory impairment, also experienced neglect in personal hygiene care. The resident reported not receiving nail care since admission, and staff interviews indicated a lack of documentation for refusals of nail care. Additionally, Resident 1, who required maximum assistance for various ADLs, was observed with greasy hair and long fingernails, despite scheduled bed baths. Staff interviews highlighted a failure to provide care even when residents refused, and a lack of documentation for care provided.
Deficiencies in Hospice Care Coordination and Documentation
Penalty
Summary
The facility failed to provide necessary end-of-life care and services for two residents receiving hospice care, compromising their quality of life. Resident 1, who had multiple medical conditions including stroke and paralysis, was observed with greasy hair and body odor over several days, indicating a lack of personal hygiene care. Despite the care plan specifying cooperation with hospice services to meet the resident's needs, staff interviews revealed that Resident 1 frequently refused bathing, and there was a lack of communication and coordination between the facility and hospice to address these refusals. Additionally, there was a discrepancy in medication management for Resident 1. The facility's records showed that a high blood pressure medication was discontinued in June, but hospice orders in September still included the medication. This inconsistency highlighted a failure in coordinating medication orders between the facility and hospice services, as confirmed by the Director of Nursing. For Resident 7, who had complex medical diagnoses including cancer, there was a lack of documentation and physician orders for hospice services in the resident's records. Despite being admitted to hospice services in early July, there were no hospice notes or logged visits in the resident's records from late July to early September. Staff interviews confirmed the absence of hospice documentation, indicating a failure in maintaining accurate and complete records of hospice care provided to the resident.
Failure to Implement Restorative Program for Resident with Mobility Limitations
Penalty
Summary
The facility failed to provide a restorative program for a resident with mobility limitations, as identified by staff and reviewed for Range of Motion (ROM). The resident, who had a history of stroke with muscle weakness and functional limitations in ROM, was discharged from physical therapy with recommendations for a restorative nursing program (RNP) to maintain ROM and positioning. However, the facility did not implement the recommended RNP after the discharge from therapy, as confirmed by staff interviews and record reviews. Observations revealed that the resident was not wearing a knee brace and was not on a restorative program, despite the physical therapy discharge summary and referral form recommending specific interventions. Interviews with facility staff, including the Registered Nurse Manager and the Director of Rehabilitation, confirmed that the RNP was not established within the expected timeframe after the referral. The Director of Nursing also acknowledged that the RNP should have been implemented promptly to prevent a decline in the resident's function.
Failure to Monitor Resident Weight During Transition from Tube Feeding
Penalty
Summary
The facility failed to adequately monitor the weight of a resident, identified as Resident 58, who was transitioning from tube feeding to oral intake. According to the facility's policy, weights should be collected monthly or more frequently as needed. Resident 58, who had a history of stroke, partial paralysis, and swallowing difficulties, was receiving over half of their calories via a feeding tube. A physician's order from May 2024 directed that Resident 58 be weighed monthly. However, there was a significant gap in weight monitoring, with the resident not being weighed for over a month prior to the discontinuation of tube feeding and not for two weeks after the transition to oral intake. The dietician, Staff AA, confirmed the importance of monitoring weight during such transitions to ensure adequate nutritional intake. Despite the policy and the physician's order, Resident 58's weight was not measured since mid-August 2024. The September Medication Administration Record noted that the resident refused to be weighed, and there was no space to document a weight after the refusal, which may have contributed to the oversight. This failure to monitor weights as ordered placed the resident at risk for weight loss and other negative health outcomes.
Failure to Provide Prompt Dental Services
Penalty
Summary
The facility failed to provide prompt dental services for two residents, leading to oral discomfort and a diminished quality of life. Resident 52, who had intact mental processing abilities and was dependent on staff for denture care, experienced mouth and facial pain due to ill-fitting upper dentures. Despite a recommendation for new dentures from a dental consult in February 2024, no follow-up appointments were scheduled, and the resident was not seen by a dentist since that time. The resident expressed the need for bottom dentures and reported an incident where they waited for a dental appointment that was never fulfilled due to overbooking. Resident 37, who required substantial assistance for oral hygiene, had issues with loose-fitting upper dentures, causing difficulty in chewing and discomfort. Despite multiple dental visits and recommendations for denture realignment, no follow-up appointments were scheduled. The resident expressed a desire to wear their dentures if they fit properly, indicating the ongoing issue with loose dentures. Staff interviews revealed that the referral for denture adjustment was overlooked, and no pending appointments were scheduled since June 2024. The facility's policy required coordination of dental care and transportation as needed, but these actions were not executed for the residents in question. Staff members, including the Medical Records Supervisor and the Director of Nursing, acknowledged the oversight in scheduling necessary dental appointments, which was contrary to the facility's expectations and policies.
Infection Control Deficiencies in LTC Facility
Penalty
Summary
The facility failed to maintain proper infection control practices, as evidenced by several observations and interviews. Staff did not adhere to Enhanced Barrier Precautions (EBP) for residents requiring such measures. For instance, two nurse's aides were observed repositioning a resident with an infectious immune disease without wearing gowns, despite signage indicating the need for gowns and gloves. This oversight was confirmed by the Licensed Practical Nurse responsible for infection control, who acknowledged the importance of following precaution signs to minimize disease transmission. Hand hygiene practices were also inadequate. A Certified Nursing Assistant (CNA) was observed performing incontinence care for a resident without changing gloves or performing hand hygiene between tasks, leading to potential cross-contamination. Another CNA similarly failed to change gloves during incontinence care, touching clean items with soiled gloves. These actions were contrary to the facility's expectations, as stated by the infection control nurse, who emphasized the need for hand hygiene after glove removal. Additionally, the facility did not provide catheter care in accordance with professional standards. A resident with a history of urinary tract infections and a catheter was observed with their catheter drainage bag lying on the floor, which is against infection control protocols. Staff interviews confirmed that the catheter bag should not be on the floor to prevent infection. Furthermore, the facility had uncleanable surfaces, such as worn toilet seats and damaged wheelchair armrests, which could harbor bacteria and contribute to cross-contamination, as noted by the infection control nurse.
Failure in Antibiotic Stewardship Program
Penalty
Summary
The facility failed to implement an effective Antibiotic Stewardship Program, which led to inappropriate and unnecessary use of antibiotics for three residents. Resident 223 was prescribed antibiotics for a urinary tract infection (UTI) that did not meet the criteria for treatment. The facility did not follow physician orders to collect a urinalysis to confirm the UTI, and there was no documentation of a culture and sensitivity report to ensure the appropriate prescription of antibiotics. Staff interviews revealed that the necessary steps to confirm the infection and appropriate antibiotic use were not followed. Resident 224 was treated with antibiotics for pneumonia, but the facility failed to communicate the chest X-ray results to the provider in a timely manner, resulting in a delay in treatment. Similarly, Resident 38 was treated with multiple antibiotics for pneumonia, despite a chest X-ray showing no diagnosis of pneumonia. The staff did not review the antibiotic medications appropriately. These failures in communication and adherence to the facility's antibiotic stewardship policy placed residents at risk for adverse outcomes associated with inappropriate antibiotic use.
Inadequate Supervision Leads to Resident Altercations
Penalty
Summary
The facility failed to provide adequate supervision to prevent resident-to-resident altercations, specifically between two residents. Resident 1, who had a history of a right hip fracture with surgical repair, anxiety, and insomnia, reported multiple incidents involving Resident 2. These incidents included Resident 2 entering Resident 1's room, consuming their snacks, wearing their clothes, and leaving feces on their bed sheets. On one occasion, Resident 2 sat on Resident 1's leg, causing discomfort and pain, especially given Resident 1's recent hip surgery and existing knee issues. Despite Resident 1 informing the staff about these incidents, there was no documentation of staff response or intervention until Resident 2 was moved to another room. Resident 2, who had a history of dementia, psychotic disorder, and insomnia, was admitted to the facility without a proper assessment for wandering risk. The facility's policies required such assessments and care plans to address wandering behaviors, but these were not implemented for Resident 2. Staff documented Resident 2's behaviors, such as attempting to get out of bed, using fecal matter inappropriately, and wandering around the room, but there was no evidence of actions taken to manage these behaviors or ensure the safety of both residents. Interviews with staff revealed a lack of communication and documentation regarding the incidents and the necessary interventions. The Director of Nursing Services did not recall reviewing Resident 2's admission referral, and there was no care plan in place for Resident 2's wandering risk. The facility's investigation confirmed that staff were aware of the issues but did not take appropriate actions to address them, leading to a delay in moving Resident 2 to a different room and ensuring the safety and well-being of both residents.
Failure to Initiate Timely CPR for Residents
Penalty
Summary
The facility failed to ensure that basic life support, including CPR, was initiated immediately for two residents who experienced unexpected deaths. For Resident 1, the facility's staff did not promptly initiate CPR despite the resident being designated as a Full Code. The resident's family member alerted staff to the emergency, but there was a delay in initiating CPR as staff were unsure of the resident's code status and required additional personnel to move the resident to the floor. The absence of a Code Blue Emergency Recorder form further complicated the documentation of the sequence of events. In the case of Resident 2, the facility again failed to initiate CPR in a timely manner. Although the resident was found unresponsive with weak breathing and pulse, staff did not immediately begin CPR. Instead, there was a delay as staff communicated with each other and called 911. The facility's investigation revealed that the staff member who first assessed the resident did not initiate CPR due to a back injury, and CPR was only started after another staff member returned from making the emergency call. The facility's lack of a clear and immediate response to these medical emergencies placed additional residents at risk, as there were 35 other residents with current physician orders to receive CPR. The absence of proper documentation and adherence to emergency response protocols contributed to the deficiencies observed in these incidents.
Removal Plan
- Audited the records of all residents
- Audited the Physician Order for Life Sustaining Treatment (POLST) binders
- Educated staff on the facility's Medical Emergency Response Policy and Code Blue Emergency Recorder process during CPR
- Performed CPR drills
- Implemented a plan of correction to sustain ongoing compliance
Inadequate In-Service Training for Nursing Assistants
Penalty
Summary
The facility failed to develop, implement, and maintain an in-service training program that ensured nursing assistants received the required 12 hours of annual training and education. This deficiency was identified through observation, interviews, and record reviews, which revealed that three nursing assistants did not receive the necessary training. The facility's assessment indicated that in-service training should include dementia management, communication, resident rights, cultural competency, and identification of changes in resident conditions. However, the facility could not provide documentation to confirm that the required training was completed for the nursing assistants reviewed. Additionally, the facility lacked documentation of staff training on the use of an Automated External Defibrillator (AED) and the facility's Medical Emergency Response policy. Interviews with the facility's administrator and corporate consultant revealed that there was an in-service training calendar, but it was not followed by the previous staff development coordinator. The Vice President of Operations acknowledged the absence of a system to ensure the required training was provided to each nursing aide, further contributing to the deficiency.
Deficiency in POLST Form Management
Penalty
Summary
The facility failed to ensure the availability and completeness of Physician Orders for Life-Sustaining Treatment (POLST) forms for two residents, which are crucial for honoring residents' medical treatment preferences during emergencies. For Resident 3, the facility did not have a POLST form accessible in the medical records, despite an order indicating the resident was a Full Code and wanted CPR. Staff interviews confirmed the absence of the POLST form, with suggestions that it might have been sent to the hospital with the resident. For Resident 4, the POLST form was initiated and signed by the resident but was incomplete as it lacked the facility provider's signature, indicating that the information was not discussed with the resident or their representative. This deficiency was noted after Resident 4 was found unresponsive and CPR was performed. Staff confirmed the form remained unsigned by the physician until after the resident's death.
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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 Renton
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Cedar River Healthcare Center | 2.6 mi | ★★★★★ | 1 | 0 |
| Valley View Skilled Nursing And Rehabilitation | 3 mi | ★★★★★ | 22 | 0 |
| Caroline Kline Galland Home | 4.3 mi | ★★★★★ | 27 | 0 |
| Kin On Health Care Center | 5.7 mi | ★★★★★ | 1 | 0 |
| Benson Heights Rehabilitation Center | 5.7 mi | ★★★★★ | 30 | 0 |
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