Facility profile · CCN 235174
Marshall Nursing And Rehabilitation Community
72 federal citations on record , including 1 at the Immediate Jeopardy level, and 4 federal enforcement actions totaling $105,860.
Record summary
Federal record · Q1 202672
Total citations
70
Last 3 years
3
Actual harm+
4
Federal penalties
$105,860
Total fines
1
Overall ★ rating
Most common violation categories here
Most common F-tags at this facility
Citation history
72 on record| Survey | F-Tag | Violation | Severity | Source |
|---|---|---|---|---|
| Sep 8, 2025 | F921 | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | E | Standard |
| Sep 8, 2025 | F887 | Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status. | D | Standard |
| Sep 8, 2025 | F883 | Develop and implement policies and procedures for flu and pneumonia vaccinations. | D | Standard |
| Sep 8, 2025 | F880 | Provide and implement an infection prevention and control program. | F | Standard |
| Sep 8, 2025 | F865 | Have a plan that describes the process for conducting QAPI and QAA activities. | E | Standard |
| Sep 8, 2025 | F812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | Standard |
| Sep 8, 2025 | F791 | Provide or obtain dental services for each resident. | D | Standard |
| Sep 8, 2025 | F761 | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | Standard |
| Sep 8, 2025 | F756 | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures. | E | Standard |
| Sep 8, 2025 | F686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | Standard |
| Sep 8, 2025 | F684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | Standard |
| Sep 8, 2025 | F680 | Ensure the activities program is directed by a qualified professional. | E | Standard |
| Sep 8, 2025 | F679 | Provide activities to meet all resident's needs. | E | Standard |
| Sep 8, 2025 | F677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | Standard |
| Sep 8, 2025 | F641 | Ensure each resident receives an accurate assessment. | D | Standard |
| Sep 8, 2025 | F637 | Assess the resident when there is a significant change in condition | D | Standard |
| Sep 8, 2025 | F628 | Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. | D | Standard |
| Sep 8, 2025 | F578 | Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | D | Standard |
| Aug 20, 2025 | F684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | Complaint |
| May 29, 2025 | F761 | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | Complaint |
| May 29, 2025 | F684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | Complaint |
| Feb 12, 2025 | F880 | Provide and implement an infection prevention and control program. | E | Complaint |
| Feb 12, 2025 | F755 | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | F | Complaint |
| Sep 20, 2024 | F921 | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | F | Standard |
| Sep 20, 2024 | F867 | Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action. | E | Standard |
| Sep 20, 2024 | F849 | Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services. | D | Standard |
| Sep 20, 2024 | F814 | Dispose of garbage and refuse properly. | F | Standard |
| Sep 20, 2024 | F812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | Standard |
| Sep 20, 2024 | F806 | Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | D | Standard |
| Sep 20, 2024 | F804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | Standard |
| Sep 20, 2024 | F761 | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | E | Standard |
| Sep 20, 2024 | F759 | Ensure medication error rates are not 5 percent or greater. | D | Standard |
| Sep 20, 2024 | F700 | Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail. | D | Standard |
| Sep 20, 2024 | F698 | Provide safe, appropriate dialysis care/services for a resident who requires such services. | D | Standard |
| Sep 20, 2024 | F697 | Provide safe, appropriate pain management for a resident who requires such services. | G | Standard |
| Sep 20, 2024 | F695 | Provide safe and appropriate respiratory care for a resident when needed. | D | Standard |
| Sep 20, 2024 | F692 | Provide enough food/fluids to maintain a resident's health. | D | Standard |
| Sep 20, 2024 | F688 | Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. | D | Standard |
| Sep 20, 2024 | F686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | G | Standard |
| Sep 20, 2024 | F655 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | D | Standard |
| Sep 20, 2024 | F641 | Ensure each resident receives an accurate assessment. | D | Standard |
| Sep 20, 2024 | F623 | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | F | Standard |
| Sep 20, 2024 | F584 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | D | Standard |
| Aug 30, 2024 | F880 | Provide and implement an infection prevention and control program. | D | Complaint |
| May 24, 2024 | F949 | Provide behavior health training consistent with the requirements and as determined by a facility assessment. | D | Complaint |
| May 24, 2024 | F947 | Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention. | D | Complaint |
| May 24, 2024 | F940 | Develop, implement, and/or maintain an effective training program for all new and existing staff members. | D | Complaint |
| May 24, 2024 | F730 | Observe each nurse aide's job performance and give regular training. | D | Complaint |
| May 24, 2024 | F726 | Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. | E | Complaint |
| May 24, 2024 | F676 | Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. | D | Complaint |
| May 24, 2024 | F607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | F | Complaint |
| Mar 14, 2024 | F686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | Complaint |
| Mar 14, 2024 | F684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | Complaint |
| Mar 14, 2024 | F656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | Complaint |
| Mar 14, 2024 | F600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | D | Complaint |
| Oct 11, 2023 | F921 | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | E | Complaint |
| Oct 11, 2023 | F725 | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | F | Complaint |
| Oct 11, 2023 | F695 | Provide safe and appropriate respiratory care for a resident when needed. | D | Complaint |
| Oct 11, 2023 | F684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | Complaint |
| Oct 11, 2023 | F678 | Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives. | J | Complaint |
| Aug 2, 2023 | F881 | Implement a program that monitors antibiotic use. | D | Complaint |
| Aug 2, 2023 | F880 | Provide and implement an infection prevention and control program. | D | Complaint |
| Aug 2, 2023 | F842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | Standard |
| Aug 2, 2023 | F812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | Standard |
| Aug 2, 2023 | F761 | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | Standard |
| Aug 2, 2023 | F758 | Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. | D | Standard |
| Aug 2, 2023 | F698 | Provide safe, appropriate dialysis care/services for a resident who requires such services. | D | Standard |
| Aug 2, 2023 | F690 | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | D | Standard |
| Aug 2, 2023 | F658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | Standard |
| Aug 2, 2023 | F583 | Keep residents' personal and medical records private and confidential. | D | Standard |
| Apr 5, 2023 | F684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | Complaint |
| Apr 5, 2023 | F655 | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | D | Complaint |
Federal enforcement history
Federal regulators have imposed 4 enforcement actions against this facility, including 2 civil money penalties totaling $105,860 and 2 payment-denial actions spanning 55 days.
| Date | Type | Fine | Payment denial |
|---|---|---|---|
| Aug 30, 2024 | Fine | $52,007 | — |
| Aug 30, 2024 | Payment Denial | — | Oct 18, 2024 · 33 days |
| Oct 11, 2023 | Fine | $53,853 | — |
| Oct 11, 2023 | Payment Denial | — | Nov 1, 2023 · 22 days |
About this record
A citation is a finding by a state survey team working under federal contract. It is not a court
judgment. The description above is drawn verbatim from federal public datasets. Facilities have
the right to appeal findings through an Informal Dispute Resolution (IDR/IIDR) process.
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