CMS Stars
RN hrs / day
Trust Index
Bounce-back
Long-stay residents , lower is better
Source: CMS MDS Quality Measures. Updated quarterly.
โญ Overall
4/5
๐ Health Inspection
3/5
๐ฉโโ๏ธ Staffing
4/5
๐ Quality Measures
5/5
RN / Resident / Day
58 min
State avg: 1h 2m ยท US avg: 41 min
LPN hrs/day
43 min
CNA hrs/day
2h 22m
Total Nurse / Resident / Day
4h 3m
State avg: 4h 30m ยท US avg: 3h 53m
PT / Resident / Day
2 min
State avg: 9 min ยท US avg: 4 min
RN Turnover Rate
36 per 100
State avg: 42 per 100 ยท US avg: 46 per 100
Weekend Staffing (PBJ Q3 2024)
RN Hours Weekday
1h 35m
RN Hours Weekend
1h 21m
Weekend vs. Weekday RN
85%above avg
US avg: 64%
Total Nurse Weekend
4h 13m
Federal Penalties
9 penalties ยท $427,869 total
| Date | Type | Fine | Denial Days |
|---|---|---|---|
| 1/23/2025 | Fine | $47,541 | - |
| 1/23/2025 | Fine | $47,541 | - |
| 1/23/2025 | Fine | $47,541 | - |
| 1/23/2025 | Fine | $47,541 | - |
| 1/23/2025 | Fine | $47,541 |
30-Day Readmission
18.1 per 100
State avg: 21.5 ยท US avg: 23.9
ED Visits (no readmit)
10.6 per 100
State avg: 11.2 ยท US avg: 12.0
VBP Performance Score
59/100
Incentive Payment
+1.45% bonus
Risk-Std Readmission
17.8 per 100
Healthcare-Assoc. Infections
6.4 per 100
Higher performance scores lead to payment bonuses. Lower scores indicate risk of readmission penalties.
Medicare Patients/Year
168
Avg Length of Stay
26.4 days
Avg Payment / Stay
$14,277.71
Patient Complexity
2.88 ร avg
Avg LOS 15-30 days is typical for short-term rehab ยท Patient complexity = HCC risk score (1.0 = national average; higher = sicker patient mix)
| - |
| 1/23/2025 | Fine | $47,541 | - |
| 1/23/2025 | Fine | $47,541 | - |
| 1/23/2025 | Fine | $47,541 | - |
| 1/23/2025 | Fine | $47,541 | - |
Inspection Citations
Survey: January 23, 2025(36 citations)
Survey: February 12, 2024(21 citations)
Survey: December 9, 2022(33 citations)
Falls w/ Major Injury
5.7 per 100
State avg: 3.2 ยท US avg: 3.3
Pressure Ulcers
7.4 per 100
State avg: 4.4 ยท US avg: 5.1
Antipsychotic Meds
3.7 per 100
State avg: 0.9 ยท US avg: 1.6
Flu Vaccination
95.4 per 100
State avg: 83.1 ยท US avg: 79.7
Discharge to Community
N/A
Functional Improvement
N/A
Rates shown per 100 patients ยท Green = better than average ยท Amber = average ยท Red = below average
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