Maple Valley Nursing Home
1086 W. Burdickville Road, Maple Valley, MI 49664 · CCN 235588
Ratings
- Overall
- ★☆☆☆☆ 1
- Health inspection
- ★☆☆☆☆ 1
- Quality measures
- ★★☆☆☆ 2
- Staffing
- ★★★★☆ 4
Facility
- Ownership type
- For profit - Corporation
- Certified beds
- 25
- Avg residents/day
- 19.4
- Phone
- 2312285895
Inspection history vs Michigan & national averages
Cycle 1 is the most recent standard health inspection. Lower total deficiency counts are better.
| Cycle | Inspection date | This facility | Michigan avg | National avg | vs state |
|---|---|---|---|---|---|
| 1 | 2025-04-10 | 9 | 9.9 | 9.5 | -0.9 better |
| 2 | 2024-04-25 | 29 | 11.4 | 9.8 | +17.6 worse |
| 3 | 2023-02-17 | 24 | 12.0 | 9.3 | +12.0 worse |
Cycle 1 deficiencies by category
| Category | Deficiencies |
|---|---|
| Quality of life and care | 2 |
| Resident assessment and care planning | 1 |
| Resident rights | 1 |
| Nutrition and dietary | 1 |
| Pharmacy service | 2 |
| Infection control | 2 |
Staffing (hours per resident per day)
| Metric | This facility | Turnover |
|---|---|---|
| Total nurse staffing (reported) | 4.05 | 65.4% |
| RN staffing (reported) | 1.26 | 75.0% |
| Total nurse staffing (adjusted) | 5.45 | — |
Fines & penalties
- Total fines
- $119,265
- Number of fines
- 2
- Number of penalties
- 3
- Payment denials
- 1
Inspection citations (62)2 immediate jeopardy6 actual harm
- DF0550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.2025-04-10 · Health · corrected 2025-05-19
Potential for more than minimal harm
- DF0658Ensure services provided by the nursing facility meet professional standards of quality.2025-04-10 · Health · corrected 2025-05-19
Potential for more than minimal harm
- DF0678Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.2025-04-10 · Health · corrected 2025-05-19
Potential for more than minimal harm
- DF0684Provide appropriate treatment and care according to orders, resident’s preferences and goals.2025-04-10 · Health · corrected 2025-05-19
Potential for more than minimal harm
- DF0756Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.2025-04-10 · Health · corrected 2025-05-19
Potential for more than minimal harm
- DF0760Ensure that residents are free from significant medication errors.2025-04-10 · Health · corrected 2025-05-19
Potential for more than minimal harm
- FF0812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.2025-04-10 · Health · corrected 2025-05-19
Potential for more than minimal harm
- FF0880Provide and implement an infection prevention and control program.2025-04-10 · Health · corrected 2025-05-19
Potential for more than minimal harm
- DF0883Develop and implement policies and procedures for flu and pneumonia vaccinations.2025-04-10 · Health · corrected 2025-05-19
Potential for more than minimal harm
- DF0684Provide appropriate treatment and care according to orders, resident’s preferences and goals.2025-01-22 · Health · corrected 2025-02-10
Potential for more than minimal harm
- GF0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.2024-08-20 · Health · corrected 2024-08-29
Actual harm
- JF0600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.2024-04-25 · Health · corrected 2024-06-30
Immediate jeopardy
- DF0604Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.2024-04-25 · Health · corrected 2024-07-19
Potential for more than minimal harm
- DF0609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.2024-04-25 · Health · corrected 2024-06-03
Potential for more than minimal harm
- DF0610Respond appropriately to all alleged violations.2024-04-25 · Health · corrected 2024-06-03
Potential for more than minimal harm
- DF0623Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.2024-04-25 · Health · corrected 2024-06-03
Potential for more than minimal harm
- DF0625Notify 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.2024-04-25 · Health · corrected 2024-06-03
Potential for more than minimal harm
- DF0638Assure that each resident’s assessment is updated at least once every 3 months.2024-04-25 · Health · corrected 2024-06-03
Potential for more than minimal harm
- DF0645PASARR screening for Mental disorders or Intellectual Disabilities2024-04-25 · Health · corrected 2024-06-03
Potential for more than minimal harm
- DF0656Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.2024-04-25 · Health · corrected 2024-06-03
Potential for more than minimal harm
- EF0657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.2024-04-25 · Health · corrected 2024-07-19
Potential for more than minimal harm
- DF0684Provide appropriate treatment and care according to orders, resident’s preferences and goals.2024-04-25 · Health · corrected 2024-06-03
Potential for more than minimal harm
- GF0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.2024-04-25 · Health · corrected 2024-06-03
Actual harm
- DF0699Provide care or services that was trauma informed and/or culturally competent.2024-04-25 · Health · corrected 2024-06-12
Potential for more than minimal harm
- DF0700Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.2024-04-25 · Health · corrected 2024-06-03
Potential for more than minimal harm
- DF0740Ensure each resident must receive and the facility must provide necessary behavioral health care and services.2024-04-25 · Health · corrected 2024-06-03
Potential for more than minimal harm
- DF0755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.2024-04-25 · Health · corrected 2024-06-03
Potential for more than minimal harm
- EF0756Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.2024-04-25 · Health · corrected 2024-07-19
Potential for more than minimal harm
- FF0812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.2024-04-25 · Health · corrected 2024-07-19
Potential for more than minimal harm
- FF0835Administer the facility in a manner that enables it to use its resources effectively and efficiently.2024-04-25 · Health · corrected 2024-06-03
Potential for more than minimal harm
- DF0842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.2024-04-25 · Health · corrected 2024-06-03
Potential for more than minimal harm
- DF0880Provide and implement an infection prevention and control program.2024-04-25 · Health · corrected 2024-06-03
Potential for more than minimal harm
- FF0882Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.2024-04-25 · Health · corrected 2024-06-03
Potential for more than minimal harm
- DF0883Develop and implement policies and procedures for flu and pneumonia vaccinations.2024-04-25 · Health · corrected 2024-06-03
Potential for more than minimal harm
- EF0942Ensure that staff members are educated on resident rights and facility responsibilities to properly care for its residents.2024-04-25 · Health · corrected 2024-07-19
Potential for more than minimal harm
- DF0943Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.2024-04-25 · Health · corrected 2024-07-19
Potential for more than minimal harm
- EF0945Include as part of its infection prevention and control program, mandatory training that includes written standards, policies, and procedures for the program.2024-04-25 · Health · corrected 2024-07-19
Potential for more than minimal harm
- GF0600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.2024-03-13 · Health · corrected 2024-06-30
Actual harm
- EF0550Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.2023-02-17 · Health · corrected 2023-03-28
Potential for more than minimal harm
- DF0582Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.2023-02-17 · Health · corrected 2023-03-28
Potential for more than minimal harm
- FF0606Not hire anyone with a finding of abuse, neglect, exploitation, or theft.2023-02-17 · Health · corrected 2023-03-15
Potential for more than minimal harm
- EF0657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.2023-02-17 · Health · corrected 2023-03-28
Potential for more than minimal harm
- GF0677Provide care and assistance to perform activities of daily living for any resident who is unable.2023-02-17 · Health · corrected 2023-03-13
Actual harm
- DF0679Provide activities to meet all resident's needs.2023-02-17 · Health · corrected 2023-03-28
Potential for more than minimal harm
- GF0684Provide appropriate treatment and care according to orders, resident’s preferences and goals.2023-02-17 · Health · corrected 2023-03-28
Actual harm
- EF0688Provide 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.2023-02-17 · Health · corrected 2023-06-01
Potential for more than minimal harm
- FF0689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.2023-02-17 · Health · corrected 2023-06-01
Potential for more than minimal harm
- DF0690Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.2023-02-17 · Health · corrected 2023-03-28
Potential for more than minimal harm
- DF0692Provide enough food/fluids to maintain a resident's health.2023-02-17 · Health · corrected 2023-03-28
Potential for more than minimal harm
- DF0695Provide safe and appropriate respiratory care for a resident when needed.2023-02-17 · Health · corrected 2023-03-28
Potential for more than minimal harm
- CF0732Post nurse staffing information every day.2023-02-17 · Health · corrected 2023-03-28
Potential for minimal harm
- EF0755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.2023-02-17 · Health · corrected 2023-03-28
Potential for more than minimal harm
- EF0761Ensure 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.2023-02-17 · Health · corrected 2023-03-28
Potential for more than minimal harm
- FF0803Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.2023-02-17 · Health · corrected 2023-03-28
Potential for more than minimal harm
- JF0805Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.2023-02-17 · Health · corrected 2023-03-28
Immediate jeopardy
- FF0806Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.2023-02-17 · Health · corrected 2023-03-28
Potential for more than minimal harm
- GF0825Provide or get specialized rehabilitative services as required for a resident.2023-02-17 · Health · corrected 2023-03-28
Actual harm
- FF0835Administer the facility in a manner that enables it to use its resources effectively and efficiently.2023-02-17 · Health · corrected 2023-03-28
Potential for more than minimal harm
- EF0842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.2023-02-17 · Health · corrected 2023-03-28
Potential for more than minimal harm
- CF0851Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.2023-02-17 · Health · corrected 2023-03-28
Potential for minimal harm
- EF0908Keep all essential equipment working safely.2023-02-17 · Health · corrected 2023-03-28
Potential for more than minimal harm
- EF0921Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.2023-02-17 · Health · corrected 2023-03-28
Potential for more than minimal harm
Ownership
| Owner | Type | Role | Percent | Since |
|---|---|---|---|---|
| KASBEN, DONNA | Individual | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 50% | 1996-03-08 |
| KASBEN, JOHN | Individual | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 50% | 1996-03-08 |
| CLEMENS GRAY, MICHELLE | Individual | OPERATIONAL/MANAGERIAL CONTROL | — | 2024-04-03 |
| DYKSTRA, SANTIAGO | Individual | OPERATIONAL/MANAGERIAL CONTROL | — | 2023-09-24 |
| HULBERT, AMY | Individual | OPERATIONAL/MANAGERIAL CONTROL | — | 2022-01-30 |
| HULBERT, RICHARD | Individual | OPERATIONAL/MANAGERIAL CONTROL | — | 2023-11-13 |
| KASBEN, JENNIFER | Individual | OPERATIONAL/MANAGERIAL CONTROL | — | 2019-07-29 |
| KASBEN, JOHN | Individual | OPERATIONAL/MANAGERIAL CONTROL | — | 1996-03-08 |
| KASBEN, SERENA | Individual | OPERATIONAL/MANAGERIAL CONTROL | — | 1997-10-15 |
| LANGLOIS, MARK | Individual | OPERATIONAL/MANAGERIAL CONTROL | — | 2020-02-01 |
| MOORE, KENDRA | Individual | OPERATIONAL/MANAGERIAL CONTROL | — | 2024-10-20 |
| PORTER, MISTY | Individual | OPERATIONAL/MANAGERIAL CONTROL | — | 2023-01-01 |
| KASBEN, DONNA | Individual | CORPORATE OFFICER | — | 1996-03-08 |
| KASBEN, JOHN | Individual | CORPORATE OFFICER | — | 1996-03-08 |
Other facilities in Maple Valley
| Name | Overall | Beds |
|---|
Source: CMS Provider Data Catalog, Nursing Home Care Compare files (processed 2026-03-01). Citations show the 3 most recent inspection cycles.