Nursing Care Index

Abode Health And Wellness Center

Independence, Jackson County, Missouri · CCN 265456 · Non-profit (Corporation) · part of Blue Sky Basin, LLC (5 facilities, chain average 1.4 stars)

CMS rates Abode Health And Wellness Center 1 of 5 overall as of August 2026. 118 certified beds, 55 residents a day on average. 80 citations on record from the current inspection cycles, 1 at immediate jeopardy; 21 fines totalling $246,540 and 1 payment denial.

On record

CMS’s ratings

The Five-Star Quality Rating System, as CMS publishes it. Where CMS gives no rating, the reason CMS gives is printed instead.

Overall★☆☆☆☆ 1 of 5
Health inspections★☆☆☆☆ 1 of 5
Staffing★☆☆☆☆ 1 of 5
Quality measures★☆☆☆☆ 1 of 5
Quality: long-stay / short-stay1 / — of 5

Staffing

Total nurse staffing4.20858 hours per resident per day
Registered nurses0.28029 hours per resident per day
Weekend total4.02921 hours per resident per day

Citations from health inspections

Each is a finding by a state surveyor on the date shown, in CMS’s words. The severity is CMS’s scope-and-severity grid, spelled out: harm on the left, how widespread on the right.

SurveyFindingSeverityStatus
2026-05-14
complaint survey
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0600
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-06-16
2026-05-14
complaint survey
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0609
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-06-16
2026-05-14
complaint survey
Respond appropriately to all alleged violations.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0610
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-06-16
2026-01-23
complaint survey
Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.
Resident Rights Deficiencies · tag F0569
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2026-02-17
2025-12-19
complaint survey
Protect each resident from the wrongful use of the resident's belongings or money.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0602
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2026-02-02
2025-12-19
complaint survey
Ensure that residents are free from significant medication errors.
Pharmacy Service Deficiencies · tag F0760
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2026-02-02
2025-05-14
complaint survey
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies · tag F0684
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-06-15
2025-05-14
complaint survey
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · tag F0689
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-06-15
2025-02-19
complaint survey
Respond appropriately to all alleged violations.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0610
J Immediate jeopardy to resident health or safety; isolated Deficient, Provider has date of correction
2025-02-24
2025-02-19 Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
Nursing and Physician Services Deficiencies · tag F0727
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2025-04-05
2025-02-19 Have a plan that describes the process for conducting QAPI and QAA activities.
Administration Deficiencies · tag F0865
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2025-04-05
2025-02-19 Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Administration Deficiencies · tag F0867
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2025-04-05
2025-02-19
complaint survey
Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2025-06-15
2025-02-19 Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
Infection Control Deficiencies · tag F0882
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2025-04-05
2025-02-19 Honor the resident's right to manage his or her financial affairs.
Resident Rights Deficiencies · tag F0567
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-04-05
2025-02-19 Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.
Resident Rights Deficiencies · tag F0568
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-04-05
2025-02-19 Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Resident Rights Deficiencies · tag F0582
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-04-05
2025-02-19
complaint survey
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.
Resident Rights Deficiencies · tag F0584
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-04-05
2025-02-19 Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning Deficiencies · tag F0641
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-04-05
2025-02-19 Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Resident Assessment and Care Planning Deficiencies · tag F0657
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-04-05
2025-02-19
complaint survey
Provide care and assistance to perform activities of daily living for any resident who is unable.
Quality of Life and Care Deficiencies · tag F0677
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-04-05
2025-02-19 Ensure the activities program is directed by a qualified professional.
Quality of Life and Care Deficiencies · tag F0680
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-04-05
2025-02-19
complaint survey
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies · tag F0684
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-06-15
2025-02-19 Provide safe and appropriate respiratory care for a resident when needed.
Quality of Life and Care Deficiencies · tag F0695
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-04-05
2025-02-19
complaint survey
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Nursing and Physician Services Deficiencies · tag F0725
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-04-05
2025-02-19 Post nurse staffing information every day.
Nursing and Physician Services Deficiencies · tag F0732
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-04-05
2025-02-19 Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Nutrition and Dietary Deficiencies · tag F0804
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-04-05
2025-02-19 Implement a program that monitors antibiotic use.
Infection Control Deficiencies · tag F0881
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-04-05
2025-02-19 Develop and implement policies and procedures for flu and pneumonia vaccinations.
Infection Control Deficiencies · tag F0883
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-04-05
2025-02-19 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.
Infection Control Deficiencies · tag F0887
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-04-05
2025-02-19 Keep all essential equipment working safely.
Environmental Deficiencies · tag F0908
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-04-05
2025-02-19 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.
Resident Rights Deficiencies · tag F0578
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-05
2025-02-19
complaint survey
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Resident Rights Deficiencies · tag F0580
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-05
2025-02-19
complaint survey
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0609
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-02-24
2025-02-19 Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Resident Rights Deficiencies · tag F0623
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-05
2025-02-19 Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
Resident Rights Deficiencies · tag F0625
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-05
2025-02-19 Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Resident Assessment and Care Planning Deficiencies · tag F0655
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-05
2025-02-19 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies · tag F0656
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-05
2025-02-19 Ensure services provided by the nursing facility meet professional standards of quality.
Resident Assessment and Care Planning Deficiencies · tag F0658
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-06-15
2025-02-19 Provide activities to meet all resident's needs.
Quality of Life and Care Deficiencies · tag F0679
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-05
2025-02-19 Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Quality of Life and Care Deficiencies · tag F0686
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-06-15
2025-02-19
complaint survey
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · tag F0689
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-05
2025-02-19 Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
Quality of Life and Care Deficiencies · tag F0693
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-06-15
2025-02-19 Provide safe, appropriate pain management for a resident who requires such services.
Quality of Life and Care Deficiencies · tag F0697
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-06-15
2025-02-19 Provide medically-related social services to help each resident achieve the highest possible quality of life.
Quality of Life and Care Deficiencies · tag F0745
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-05
2025-02-19 Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Pharmacy Service Deficiencies · tag F0755
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-05
2025-02-19 Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Pharmacy Service Deficiencies · tag F0756
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-05
2025-02-19 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.
Pharmacy Service Deficiencies · tag F0761
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-05
2025-02-19
complaint survey
Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.
Nutrition and Dietary Deficiencies · tag F0800
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-05
2024-11-21
complaint survey
Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.
Resident Rights Deficiencies · tag F0569
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-01-05
2024-11-21
complaint survey
Protect each resident from the wrongful use of the resident's belongings or money.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0602
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-01-05
2024-04-22
complaint survey
Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
Resident Rights Deficiencies · tag F0557
D No actual harm, with potential for more than minimal harm; isolated Past Non-Compliance
2024-04-15
2024-02-13
complaint survey
Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-03-25
2024-02-13
complaint survey
Implement a program that monitors antibiotic use.
Infection Control Deficiencies · tag F0881
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-03-25
2023-06-05 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.
Nursing and Physician Services Deficiencies · tag F0726
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2023-07-14
2023-06-05 Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
Administration Deficiencies · tag F0851
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2023-07-14
2023-06-05 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2023-07-14
2023-06-05 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies · tag F0656
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-07-14
2023-06-05 Provide care and assistance to perform activities of daily living for any resident who is unable.
Quality of Life and Care Deficiencies · tag F0677
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-07-14
2023-06-05 Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Quality of Life and Care Deficiencies · tag F0686
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-07-31
2023-06-05 Provide safe and appropriate respiratory care for a resident when needed.
Quality of Life and Care Deficiencies · tag F0695
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-07-14
2023-06-05 Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Nutrition and Dietary Deficiencies · tag F0804
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-07-14
2023-06-05 Honor the resident's right to manage his or her financial affairs.
Resident Rights Deficiencies · tag F0567
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-07-14
2023-06-05 Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.
Resident Rights Deficiencies · tag F0568
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-07-14
2023-06-05 Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.
Resident Rights Deficiencies · tag F0569
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-07-14
2023-06-05 Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0604
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-07-27
2023-06-05 Respond appropriately to all alleged violations.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0610
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-07-14
2023-06-05 Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
Resident Rights Deficiencies · tag F0625
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-07-14
2023-06-05 Assess the resident when there is a significant change in condition
Resident Assessment and Care Planning Deficiencies · tag F0637
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-07-14
2023-06-05 PASARR screening for Mental disorders or Intellectual Disabilities
Resident Assessment and Care Planning Deficiencies · tag F0645
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-07-14
2023-06-05 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · tag F0689
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-07-14
2023-06-05 Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Quality of Life and Care Deficiencies · tag F0690
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-07-14
2023-06-05 Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Pharmacy Service Deficiencies · tag F0756
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-07-14
2023-06-05 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.
Pharmacy Service Deficiencies · tag F0761
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-07-31
2023-06-05 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · tag F0812
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-07-14
2021-08-09 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2021-09-23
2021-08-09 Keep all essential equipment working safely.
Environmental Deficiencies · tag F0908
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2021-09-23
2021-08-09 Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Quality of Life and Care Deficiencies · tag F0690
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2021-09-23
2021-08-09 Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Pharmacy Service Deficiencies · tag F0756
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2021-09-23
2021-08-09 Post nurse staffing information every day.
Nursing and Physician Services Deficiencies · tag F0732
C No actual harm, with potential for minimal harm; widespread Deficient, Provider has date of correction
2021-09-23

Fines and payment denials

DatePenaltyAmount
2025-02-19Payment denial for 75 days from 2025-04-01
2025-02-19Fine$134,345
2024-02-20Fine$4,938
2024-02-12Fine$4,938
2024-01-22Fine$14,814
2024-01-08Fine$4,938
2024-01-02Fine$4,587
2023-12-11Fine$13,762
2023-11-20Fine$4,587
2023-11-13Fine$4,587
2023-11-06Fine$4,587
2023-10-30Fine$4,587
2023-10-23Fine$4,587
2023-10-17Fine$4,587
2023-10-10Fine$4,587
2023-10-02Fine$4,587
2023-09-25Fine$4,587
2023-09-18Fine$4,587
2023-09-11Fine$4,587
2023-09-05Fine$4,587
2023-08-28Fine$4,587
2023-08-21Fine$4,587

Who owns and runs it

Every owner, officer and manager CMS lists, as filed. These are the names in CMS’s ownership record; anyone named in the ownership record can ask about it on the about page.

NameRoleShareSince
Independence Opco Holdings, LLC
Organization
5% or greater direct ownership interest100%2025-07-01
Blue Sky Basin LLC
Organization
adp of the snf2025-07-01
Bsb Independence Realty, LLC
Organization
adp of the snf2025-07-01
Compliance Consulting Group LLC
Organization
adp of the snf2025-07-01
Forvis Mazars, LLP
Organization
adp of the snf2025-07-01
Independence Realty Holdings, LLC
Organization
adp of the snf2025-07-01
Prime Advisory, LLC
Organization
adp of the snf2025-07-01
Saul N Friedman & Company
Organization
adp of the snf2025-07-01
Sloans Lake Trust
Organization
adp of the snf2025-07-01
Dkdp Missouri LLC
Organization
indirect ownership interest2025-07-01
Dkyh Missouri LLC
Organization
indirect ownership interest2025-07-01
Cicero, Steven
Individual
adp of the snf2025-07-01
Short, David
Individual
adp of the snf2025-10-29
Berger, Eliot
Individual
indirect ownership interest2025-07-01
Kleiner, David
Individual
indirect ownership interest2025-07-01
Perlow, Bernard
Individual
indirect ownership interest2025-07-01
Perlow, Bernard
Individual
managing control - governing body2025-07-01
Berger, Eliot
Individual
operational/managerial control2025-07-01
Cicero, Steven
Individual
operational/managerial control2025-07-01
O'Guin, Laura
Individual
operational/managerial control2025-10-29
Perlow, Bernard
Individual
operational/managerial control2025-07-01
Short, David
Individual
operational/managerial control2025-10-29

What changed

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Source: Centers for Medicare & Medicaid Services, Provider Data Catalog (public domain), files dated 2026-08-01. Ratings are CMS’s; citations are state surveyors’ findings; nothing here is estimated or a recommendation. Every nursing home in Jackson County.