01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-11-17 | 3 | 2025-11-17 | 3 |
| Cycle 2 | 2024-09-12 | 7 | 2024-09-12 | 4 |
| Cycle 3 | 2023-08-30 | 5 | 2023-08-30 | 6 |
CMS CCN 2750492026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Polson Health & Rehabilitation Center
9 14Th Ave W · Polson, MT 59860 · Lake County
Certified beds70CMS provider file
Recent citation rows28current CMS citation release
Penalty rows1current 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
28 rows in the current release
1 rows carry G–L scope/severity codes; 0 carry J–L. 4 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-11-17 · HEALTHF0580Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Correction field: Deficient, Provider has date of correction · 2025-11-192025-11-17 · HEALTHF0602Severity E · pattern; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from the wrongful use of the resident's belongings or money.
Correction field: Past Non-Compliance · 2025-09-21 · complaint2025-11-17 · HEALTHF0609Severity E · pattern; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Correction field: Past Non-Compliance · 2025-09-21 · complaint2025-11-17 · FIREK0211Severity D · isolated; potential for more than minimal harm
Egress Deficiencies
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Correction field: Deficient, Provider has date of correction · 2025-12-092025-11-17 · FIREK0271Severity E · pattern; potential for more than minimal harm
Egress Deficiencies
Have exits that are accessible at all times.
Correction field: Deficient, Provider has date of correction · 2025-12-092025-11-17 · FIREK0355Severity F · widespread; 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 · 2025-12-092024-09-12 · HEALTHF0578Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2024-10-142024-09-12 · 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 · 2024-10-142024-09-12 · HEALTHF0675Severity E · pattern; potential for more than minimal harm
Quality of Life and Care Deficiencies
Honor each resident's preferences, choices, values and beliefs.
Correction field: Deficient, Provider has date of correction · 2024-10-142024-09-12 · HEALTHF0692Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide enough food/fluids to maintain a resident's health.
Correction field: Deficient, Provider has date of correction · 2024-10-142024-09-12 · HEALTHF0695Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Correction field: Deficient, Provider has date of correction · 2024-10-142024-09-12 · HEALTHF0732Severity C · widespread; potential for minimal harm
Nursing and Physician Services Deficiencies
Post nurse staffing information every day.
Correction field: Deficient, Provider has date of correction · 2024-10-142024-09-12 · HEALTHF0742Severity G · isolated actual harm
Quality of Life and Care Deficiencies
Provide the appropriate treatment and services to a resident who displays or is diagnosed with mental disorder or psychosocial adjustment difficulty, or who has a history of trauma and/or post-traumatic stress disorder.
Correction field: Deficient, Provider has date of correction · 2024-10-142024-09-12 · FIREK0271Severity E · pattern; potential for more than minimal harm
Egress Deficiencies
Have exits that are accessible at all times.
Correction field: Deficient, Provider has date of correction · 2024-10-152024-09-12 · FIREK0353Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2024-10-152024-09-12 · 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 · 2024-10-152024-09-12 · FIREK0911Severity E · pattern; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Meet requirements for the installation and maintenance of electrical systems.
Correction field: Deficient, Provider has date of correction · 2024-10-152024-05-20 · HEALTHF0609Severity E · pattern; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Correction field: Deficient, Provider has date of correction · 2024-06-20 · complaint2024-05-20 · HEALTHF0812Severity F · widespread; 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 · 2024-06-20 · complaint2023-11-06 · HEALTHF0655Severity E · pattern; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Correction field: Deficient, Provider has date of correction · 2023-12-06 · complaint2023-08-30 · HEALTHF0554Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Allow residents to self-administer drugs if determined clinically appropriate.
Correction field: Deficient, Provider has date of correction · 2023-09-292023-08-30 · HEALTHF0758Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Correction field: Deficient, Provider has date of correction · 2023-09-292023-08-30 · FIREK0211Severity D · isolated; potential for more than minimal harm
Egress Deficiencies
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Correction field: Deficient, Provider has date of correction · 2023-09-292023-08-30 · FIREK0271Severity E · pattern; potential for more than minimal harm
Egress Deficiencies
Have exits that are accessible at all times.
Correction field: Deficient, Provider has date of correction · 2023-09-2903 / 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 |
|---|---|---|---|
| 2024-09-12 | Fine | $17,404 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- PACIFIC NORTHWEST 12 LEASED OPERATIONS HOLDINGS LLCOrganization · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 08/31/2023
- POLSON SNF OPERATIONS LLCOrganization · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 08/31/2023
- CH PNW 12 HOLDINGS LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 08/31/2023
- WITZCORP PNW 12 LLCOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 08/31/2023
- CHEEKS, DONALDIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 08/31/2023
- HERZKA, YISROELIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 08/31/2023
- YENOWITZ, YITZCHOKIndividual · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 08/31/2023
- CHEEKS, DONALDIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 08/31/2023
- HOHN, JAMESIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 08/31/2023
- SPIELMAN, SHIMONIndividual · CORPORATE OFFICERNOT APPLICABLE · since 08/31/2023
- YENOWITZ, YITZCHOKIndividual · CORPORATE OFFICERNOT APPLICABLE · since 08/31/2023
- COUVE FINANCIAL SERVICES LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/31/2023
- COUVE HEALTHCARE CONSULTING LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/31/2023
- PNW 12 OPCO MANAGEMENT LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/31/2023
- PNW 12 SNF CONSULTING LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/31/2023
- POLSON SNF OPERATIONS LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/31/2023
- CHEEKS, DONALDIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/31/2023
- ENSUNCHO, JOANNIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/31/2023
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 hours3.13per resident day
RN hours1.00per resident day
Weekend nurse hours2.64per resident day
Staff turnover50.0%CMS reported field
06 / LOCAL RECORDS
Open the Montana ledger →Other published facilities nearby
No second facility in the same city met the directory rule.