01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-01-29 | 0 | 2026-01-29 | 4 |
| Cycle 2 | 2025-01-09 | 2 | 2025-01-09 | 3 |
| Cycle 3 | 2023-11-02 | 4 | 2023-11-02 | 0 |
CMS CCN 1656132026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Northridge Village
3300 George Washington Carver Avenue · Ames, IA 50010 · Story County
Certified beds38CMS provider file
Recent citation rows13current 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
13 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.
2026-01-29 · FIREK0133Severity F · widespread; potential for more than minimal harm
Construction Deficiencies
Install a two-hour-resistant firewall separation.
Correction field: Deficient, Provider has date of correction · 2026-02-062026-01-29 · FIREK0353Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2026-02-062026-01-29 · FIREK0372Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Correction field: Deficient, Provider has date of correction · 2026-02-062026-01-29 · 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 · 2026-02-092025-01-09 · 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 · 2025-01-142025-01-09 · HEALTHF0880Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2025-01-142025-01-09 · FIREK0353Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2025-01-162025-01-09 · FIREK0363Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Install corridor and hallway doors that block smoke.
Correction field: Deficient, Provider has date of correction · 2025-01-162025-01-09 · FIREK0923Severity D · isolated; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have proper medical gas storage and administration areas.
Correction field: Deficient, Provider has date of correction · 2025-01-162024-06-20 · HEALTHF0689Severity G · isolated actual 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: Past Non-Compliance · 2024-04-30 · complaint2023-11-02 · HEALTHF0698Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe, appropriate dialysis care/services for a resident who requires such services.
Correction field: Deficient, Provider has date of correction · 2023-11-072023-11-02 · HEALTHF0761Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2023-11-072023-11-02 · HEALTHF0880Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2023-11-0703 / 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
- SCENIC DEVELOPMENT LLCOrganization · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 09/01/2015
- SCENIC HOLDINGS LLCOrganization · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 12/31/2018
- 3RK, LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 01/01/2021
- 5 R CATTLE, LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 09/01/2015
- CADET INVESTMENT LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 09/01/2015
- LMRAY, LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 09/01/2015
- POKY - 5R LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 12/31/2018
- POKY FEEDERS INCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 09/01/2015
- WSG LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 09/01/2015
- ANDERSON, JORDANIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 10/01/2021
- ANDERSON, MARLENEIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 09/01/2015
- ANDERSON, WAYNEIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 09/01/2015
- GULLEDGE, SCOTTIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 09/01/2015
- GULLEDGE, TRAVISIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 10/01/2021
- HOWARD, STEVENIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 09/01/2015
- WOOD, GILBERTIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 09/01/2015
- PIVOTAL HEALTH CARE LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 09/01/2015
- SCENIC DEVELOPMENT LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 09/01/2015
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 hours4.37per resident day
RN hours0.92per resident day
Weekend nurse hours3.91per resident day
Staff turnover54.7%CMS reported field
06 / LOCAL RECORDS
Open the Ames ledger →