Nursing Care Index

Hearthstone Health And Rehabilitation

Sparks, Washoe County, Nevada · CCN 295044 · For-profit (LLC) · part of The Ensign Group (342 facilities, chain average 3.2 stars)

CMS rates Hearthstone Health And Rehabilitation 1 of 5 overall as of August 2026. 125 certified beds, 110 residents a day on average. 59 citations on record from the current inspection cycles, 1 at immediate jeopardy; 1 fine totalling $48,721.

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★★★★☆ 4 of 5
Quality measures★★★★☆ 4 of 5
Quality: long-stay / short-stay5 / 3 of 5

Staffing

Total nurse staffing3.80534 hours per resident per day
Registered nurses0.69967 hours per resident per day
Weekend total3.24529 hours per resident per day
Nursing staff turnover34.7% (registered nurses 23.1%)
Administrators who left1

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
2026-03-05 Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Resident Rights Deficiencies · tag F0628
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2026-04-17
2026-03-05 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
2026-04-17
2026-03-05 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
2026-04-17
2026-03-05 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
2026-04-17
2026-03-05 Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning Deficiencies · tag F0641
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-04-17
2026-03-05 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
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-04-17
2026-03-05 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
2026-04-17
2026-03-05 Provide care and assistance to perform activities of daily living for any resident who is unable.
Quality of Life and Care Deficiencies · tag F0677
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-04-17
2026-03-05 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
2026-04-17
2026-03-05 Provide safe and appropriate respiratory care for a resident when needed.
Quality of Life and Care Deficiencies · tag F0695
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-04-17
2026-03-05 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-04-17
2025-03-03 Provide safe, appropriate dialysis care/services for a resident who requires such services.
Quality of Life and Care Deficiencies · tag F0698
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2025-04-05
2025-03-03
complaint survey
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies · tag F0550
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-05
2025-03-03 Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning Deficiencies · tag F0641
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-05
2025-03-03 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
2025-03-03 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
2025-04-05
2025-03-03 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
2025-04-05
2025-03-03 Observe each nurse aide's job performance and give regular training.
Nursing and Physician Services Deficiencies · tag F0730
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-05
2025-03-03 Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
Quality of Life and Care Deficiencies · tag F0740
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-05
2025-03-03 Administer the facility in a manner that enables it to use its resources effectively and efficiently.
Administration Deficiencies · tag F0835
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-05
2025-03-03 Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Resident Assessment and Care Planning Deficiencies · tag F0842
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-05
2025-03-03 Have a plan that describes the process for conducting QAPI and QAA activities.
Administration Deficiencies · tag F0865
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-05
2025-03-03 Ensure that staff members are educated on resident rights and facility responsibilities to properly care for its residents.
Resident Rights Deficiencies · tag F0942
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-05
2025-03-03 Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.
Administration Deficiencies · tag F0944
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-05
2025-03-03 Provide training in compliance and ethics.
Administration Deficiencies · tag F0946
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-04-05
2025-03-03 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
2025-04-05
2024-03-25 Ensure that residents are fully informed and understand their health status, care and treatments.
Resident Rights Deficiencies · tag F0552
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2024-04-30
2024-03-25 Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
Resident Rights Deficiencies · tag F0561
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2024-04-30
2024-03-25 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
2024-04-30
2024-03-25 Dispose of garbage and refuse properly.
Nutrition and Dietary Deficiencies · tag F0814
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2024-04-30
2024-03-25 Administer the facility in a manner that enables it to use its resources effectively and efficiently.
Administration Deficiencies · tag F0835
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2024-04-30
2024-03-25 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
2024-04-30
2024-03-25 Ensure services provided by the nursing facility meet professional standards of quality.
Resident Assessment and Care Planning Deficiencies · tag F0658
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-04-30
2024-03-25 Keep residents' personal and medical records private and confidential.
Resident Rights Deficiencies · tag F0583
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-04-30
2024-03-25
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
2024-04-30
2024-03-25 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
2024-04-30
2024-03-25 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
2024-04-30
2024-03-25 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
2024-04-30
2024-03-25 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
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-04-30
2024-03-25 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
2024-04-30
2024-03-25 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.
Quality of Life and Care Deficiencies · tag F0688
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-04-30
2024-03-25 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
2024-04-30
2024-03-25 Provide safe, appropriate dialysis care/services for a resident who requires such services.
Quality of Life and Care Deficiencies · tag F0698
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-04-30
2024-03-25 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
2024-04-30
2024-03-25 Ensure each resident’s drug regimen must be free from unnecessary drugs.
Pharmacy Service Deficiencies · tag F0757
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-04-30
2024-03-25 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
2024-04-30
2024-03-25 Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
Nutrition and Dietary Deficiencies · tag F0806
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-04-30
2024-03-25 Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Resident Assessment and Care Planning Deficiencies · tag F0842
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-04-30
2024-03-25 Develop and implement policies and procedures for flu and pneumonia vaccinations.
Infection Control Deficiencies · tag F0883
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-04-30
2024-03-25 Develop, implement, and/or maintain an effective training program for all new and existing staff members.
Administration Deficiencies · tag F0940
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-04-30
2024-01-24
complaint survey
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies · tag F0550
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-02-05
2023-11-16
complaint survey
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies · tag F0684
J Immediate jeopardy to resident health or safety; isolated Deficient, Provider has date of correction
2024-01-08
2023-11-16
complaint survey
Honor each resident's preferences, choices, values and beliefs.
Quality of Life and Care Deficiencies · tag F0675
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-12-22
2023-11-16
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
2023-12-22
2023-11-16
complaint survey
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
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-12-22
2023-11-16
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
2023-12-22
2023-11-16
complaint survey
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
2023-12-22
2023-11-16
complaint survey
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Resident Assessment and Care Planning Deficiencies · tag F0842
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-12-22
2023-11-16
complaint survey
Ensure that the resident and his/her doctor meet face-to-face at all required visits.
Nursing and Physician Services Deficiencies · tag F0712
C No actual harm, with potential for minimal harm; widespread Deficient, Provider has date of correction
2023-12-22

Fines and payment denials

DatePenaltyAmount
2023-11-16Fine$48,721

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
Milestone Healthcare LLC
Organization
5% or greater direct ownership interest100%2023-10-20
Magluilo, Susan
Individual
adp of the snf2025-04-04
Miller, Denver
Individual
adp of the snf2025-04-04
Farnsworth, Stephen
Individual
corporate director2024-01-01
Burnam, Soon
Individual
corporate officer2023-10-20
Fitch, Craig
Individual
corporate officer2023-10-20
Hoopes, Tyler
Individual
corporate officer2024-01-01
Sato, Ami
Individual
corporate officer2024-09-09
Magluilo, Susan
Individual
operational/managerial control2024-01-01

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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 Washoe County.