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
4/5
๐ฉโโ๏ธ Staffing
4/5
๐ Quality Measures
3/5
RN / Resident / Day
48 min
State avg: 47 min ยท US avg: 41 min
LPN hrs/day
54 min
CNA hrs/day
1h 58m
Total Nurse / Resident / Day
3h 40m
State avg: 3h 54m ยท US avg: 3h 53m
PT / Resident / Day
6 min
State avg: 6 min ยท US avg: 4 min
RN Turnover Rate
41 per 100
State avg: 47 per 100 ยท US avg: 46 per 100
Weekend Staffing (PBJ Q3 2024)
RN Hours Weekday
47 min
RN Hours Weekend
36 min
Weekend vs. Weekday RN
77%above avg
US avg: 64%
Total Nurse Weekend
3h 51m
Federal Penalties
No federal penalties in the past 3 years.
โ No penalty records on file
Inspection Citations
Survey: February 7, 2025(12 citations)
30-Day Readmission
26.4 per 100
State avg: 23.1 ยท US avg: 23.9
ED Visits (no readmit)
6.6 per 100
State avg: 9.8 ยท US avg: 12.0
VBP Performance Score
32/100
Incentive Payment
-1.34% penalty
Risk-Std Readmission
21.9 per 100
Healthcare-Assoc. Infections
7.0 per 100
Higher performance scores lead to payment bonuses. Lower scores indicate risk of readmission penalties.
Medicare Patients/Year
157
Avg Length of Stay
19.7 days
Avg Payment / Stay
$11,026.94
Patient Complexity
2.35 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)
Survey: March 7, 2024(21 citations)
Survey: March 23, 2023(18 citations)
Falls w/ Major Injury
0.7 per 100
State avg: 3.2 ยท US avg: 3.3
Pressure Ulcers
3.5 per 100
State avg: 5.3 ยท US avg: 5.1
Antipsychotic Meds
1.2 per 100
State avg: 1.5 ยท US avg: 1.6
Flu Vaccination
86.7 per 100
State avg: 68.7 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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