01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-11-20 | 5 | 2025-11-20 | 1 |
| Cycle 2 | 2024-09-26 | 2 | 2024-09-26 | 2 |
| Cycle 3 | 2024-02-01 | 3 | 2024-02-01 | 4 |
CMS CCN 1653262026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Bloomfield Care Center
800 North Davis Street · Bloomfield, IA 52537 · Davis County
Certified beds91CMS provider file
Recent citation rows17current CMS citation release
Penalty rows0current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
17 rows in the current release
1 rows carry G–L scope/severity codes; 0 carry J–L. 2 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-06-25 · HEALTHF0760Severity G · isolated actual harm
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Correction field: Deficient, Provider has date of correction · 2026-07-08 · complaint2025-11-20 · FIREE0039Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Conduct testing and exercise requirements.
Correction field: Deficient, Provider has date of correction · 2025-12-102025-11-20 · HEALTHF0657Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Correction field: Deficient, Provider has date of correction · 2025-12-122025-11-20 · HEALTHF0658Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
Correction field: Deficient, Provider has date of correction · 2025-12-122025-11-20 · HEALTHF0689Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2025-12-12 · complaint2025-11-20 · HEALTHF0812Severity E · pattern; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2025-12-122025-06-19 · HEALTHF0627Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge.
Correction field: Deficient, Provider has date of correction · 2025-07-18 · complaint2025-06-19 · HEALTHF0628Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Correction field: Deficient, Provider has date of correction · 2025-07-18 · complaint2024-09-26 · FIREK0355Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Properly select, install, inspect, or maintain portable fire extinguishes.
Correction field: Deficient, Provider has date of correction · 2024-10-102024-09-26 · FIREK0918Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have generator or other power source capable of supplying service within 10 seconds.
Correction field: Deficient, Provider has date of correction · 2024-10-102024-02-01 · HEALTHF0656Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Correction field: Deficient, Provider has date of correction · 2024-03-012024-02-01 · HEALTHF0658Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
Correction field: Deficient, Provider has date of correction · 2024-03-012024-02-01 · HEALTHF0760Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Correction field: Deficient, Provider has date of correction · 2024-03-012024-02-01 · FIREK0321Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Correction field: Deficient, Provider has date of correction · 2024-02-082024-02-01 · FIREK0345Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Correction field: Deficient, Provider has date of correction · 2024-02-062024-02-01 · FIREK0363Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Install corridor and hallway doors that block smoke.
Correction field: Deficient, Provider has date of correction · 2024-02-072024-02-01 · FIREK0761Severity E · pattern; potential for more than minimal harm
Miscellaneous Deficiencies
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Correction field: Deficient, Provider has date of correction · 2024-02-0703 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| No penalty row appeared in the August 2026 penalties file. | |||
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- SHABAT, MENACHEMIndividual · CORPORATE OFFICERNOT APPLICABLE · since 08/15/2024
- LEGACY HEALTHCARE FINANCIAL SERVICES LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/15/2024
- BEASLEY, KARLAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/15/2024
- BEHOUNEK, LINSEYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/15/2024
- BORCHERDING, JENNYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/15/2024
- BURKEN, SHERIIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/15/2024
- CASE, JANELLEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 07/21/2025
- FRIEDENBERG, LAURAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/15/2024
- HEDBERG, JENNIFERIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/15/2024
- HEYING, LARINAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/15/2024
- HOUSTON, MINDYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/15/2024
- JAEGER, KRYSTLEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/15/2024
- KICE, TONYAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/15/2024
- LARSON, MELISSAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/15/2024
- MCCLURE, DOROTHYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/15/2024
- OTTERBECK, PATRICIAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/15/2024
- RAJCHENBACH, CHAIMIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/15/2024
- SHABAT, MENACHEMIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/15/2024
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours3.96per resident day
RN hours0.82per resident day
Weekend nurse hours3.55per resident day
Staff turnover31.8%CMS reported field
06 / LOCAL RECORDS
Open the Iowa ledger →Other published facilities nearby
No second facility in the same city met the directory rule.