Ormsby Post Acute Rehabilitation
3050 N Ormsby Road · Carson City, NV · 89703 · 7758414646
120 certified beds For profit - Limited Liability company Chain: Evergreen Healthcare Group
Why this verdict
- On the federal Special Focus list of the most persistently poor performers.
- Carries CMS’s abuse warning icon.
- Inspection record is far worse than the national median (deficiency count and severity).
- Inspection results have improved across recent cycles.
The complete Safety Report — $19
Everything on this page plus the full citation-by-citation history with inspector findings, the complete penalty record, staffing vs benchmarks, side-by-side nearby comparisons, and the printable tour checklist. One PDF, emailed in minutes, yours to keep and share with family.
Red flags
Special Focus Facility
CMS has designated this facility one of the most persistently poor performers in the country — it is under increased inspection and enforcement.
CMS abuse warning
CMS flags this facility with its abuse icon: cited for abuse that caused harm in the past year, or potential harm in the past two years.
1 immediate-jeopardy citation in prior inspection cycles
Serious past findings — check whether the underlying problems were fixed and stayed fixed.
1 abuse-related citation at the actual-harm level
Inspectors cited failures in the abuse-prevention rules (F600–F610) that resulted in actual harm to a resident.
Medicare/Medicaid payments were denied
CMS refused payment for new admissions for a period — one of its strongest enforcement tools.
63% of nursing staff left within a year
High turnover disrupts continuity of care; the national median is 45%.
If someone you love was harmed at a facility with findings like these, you have options — read this.
Score breakdown
Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.
CMS ratings & staffing
Overall: not rated Inspections: not rated Staffing: not rated Quality measures: not rated
| Total nurse hours / resident-day | 3.54 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 0.82 | 0.55–0.75 |
| Weekend hours / resident-day | 3.01 | ≈ weekday level |
| Nursing turnover / year | 63% | median 45% |
| Fines (3-yr window) | 1 · $60,464 |
Inspection citations (96 in the current record)
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Potential for harm · D March 26, 2026 · found via complaint
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected April 30, 2026 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D March 26, 2026 · found via complaint
Respond appropriately to all alleged violations.
Corrected April 30, 2026 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D March 27, 2025
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Corrected April 14, 2025 · Resident Rights
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Potential for harm · D March 27, 2025
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
Corrected April 14, 2025 · Resident Assessment and Care Planning
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Potential for harm · D March 27, 2025
Ensure each resident receives an accurate assessment.
Corrected April 14, 2025 · Resident Assessment and Care Planning
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Potential for harm · D March 27, 2025
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected April 14, 2025 · Resident Assessment and Care Planning
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Potential for harm · D March 27, 2025
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Corrected April 14, 2025 · Pharmacy Service
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Potential for harm · D March 27, 2025
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.
Corrected April 14, 2025 · Pharmacy Service
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Potential for harm · F March 27, 2025
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected April 14, 2025 · Nutrition and Dietary
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Potential for harm · D March 27, 2025
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected April 14, 2025 · Resident Assessment and Care Planning
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Potential for harm · E March 27, 2025
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.
Corrected April 14, 2025 · Administration
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Potential for harm · D March 27, 2025 · found via complaint
Develop, implement, and/or maintain an effective training program for all new and existing staff members.
Corrected April 14, 2025 · Administration
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Potential for harm · D September 18, 2024 · found via complaint
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected November 3, 2024 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D September 18, 2024 · found via complaint
Protect each resident from the wrongful use of the resident's belongings or money.
Corrected November 3, 2024 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D September 18, 2024 · found via complaint
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected November 3, 2024 · Resident Assessment and Care Planning
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Potential for harm · D September 18, 2024 · found via complaint
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Corrected November 3, 2024 · Pharmacy Service
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Immediate jeopardy · J May 29, 2024 · found via complaint
Respond appropriately to all alleged violations.
Corrected July 24, 2024 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D May 29, 2024
Ensure that residents are fully informed and understand their health status, care and treatments.
Corrected July 24, 2024 · Resident Rights
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Potential for harm · D May 29, 2024
Reasonably accommodate the needs and preferences of each resident.
Corrected July 24, 2024 · Resident Rights
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Potential for harm · D May 29, 2024
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected July 24, 2024 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D May 29, 2024
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected July 24, 2024 · Resident Assessment and Care Planning
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Potential for harm · E May 29, 2024
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected July 24, 2024 · Resident Assessment and Care Planning
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Potential for harm · D May 29, 2024
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected July 24, 2024 · Quality of Life and Care
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Potential for harm · D May 29, 2024
Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.
Corrected July 24, 2024 · Quality of Life and Care
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Potential for harm · D May 29, 2024
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected July 24, 2024 · Quality of Life and Care
Showing the 25 most recent. The Safety Report includes every citation with full findings.
Federal penalties
| Date | Type | Amount / length |
|---|---|---|
| May 29, 2024 | Fine | $60,464 |
| May 29, 2024 | Payment Denial | 6 days |
Family & resident reviews — a separate signal, never mixed into the score
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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 295067 · certified since March 25, 1999. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.