Starfile

Starfile / Michigan

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.

CycleInspection dateThis facilityMichigan avgNational avgvs state
12025-04-1099.99.5-0.9 better
22024-04-252911.49.8+17.6 worse
32023-02-172412.09.3+12.0 worse

Cycle 1 deficiencies by category

CategoryDeficiencies
Quality of life and care2
Resident assessment and care planning1
Resident rights1
Nutrition and dietary1
Pharmacy service2
Infection control2

Staffing (hours per resident per day)

MetricThis facilityTurnover
Total nurse staffing (reported)4.0565.4%
RN staffing (reported)1.2675.0%
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

  1. 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

  2. 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

  3. 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

  4. 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

  5. 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

  6. DF0760Ensure that residents are free from significant medication errors.2025-04-10 · Health · corrected 2025-05-19

    Potential for more than minimal harm

  7. 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

  8. FF0880Provide and implement an infection prevention and control program.2025-04-10 · Health · corrected 2025-05-19

    Potential for more than minimal harm

  9. 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

  10. 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

  11. 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

  12. 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

  13. 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

  14. 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

  15. DF0610Respond appropriately to all alleged violations.2024-04-25 · Health · corrected 2024-06-03

    Potential for more than minimal harm

  16. 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

  17. 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

  18. 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

  19. DF0645PASARR screening for Mental disorders or Intellectual Disabilities2024-04-25 · Health · corrected 2024-06-03

    Potential for more than minimal harm

  20. 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

  21. 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

  22. 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

  23. 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

  24. 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

  25. 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

  26. 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

  27. 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

  28. 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

  29. 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

  30. 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

  31. 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

  32. DF0880Provide and implement an infection prevention and control program.2024-04-25 · Health · corrected 2024-06-03

    Potential for more than minimal harm

  33. 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

  34. 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

  35. 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

  36. 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

  37. 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

  38. 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

  39. 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

  40. 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

  41. 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

  42. 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

  43. 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

  44. DF0679Provide activities to meet all resident's needs.2023-02-17 · Health · corrected 2023-03-28

    Potential for more than minimal harm

  45. GF0684Provide appropriate treatment and care according to orders, resident’s preferences and goals.2023-02-17 · Health · corrected 2023-03-28

    Actual harm

  46. 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

  47. 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

  48. 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

  49. DF0692Provide enough food/fluids to maintain a resident's health.2023-02-17 · Health · corrected 2023-03-28

    Potential for more than minimal harm

  50. 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

  51. CF0732Post nurse staffing information every day.2023-02-17 · Health · corrected 2023-03-28

    Potential for minimal harm

  52. 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

  53. 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

  54. 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

  55. 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

  56. 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

  57. GF0825Provide or get specialized rehabilitative services as required for a resident.2023-02-17 · Health · corrected 2023-03-28

    Actual harm

  58. 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

  59. 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

  60. 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

  61. EF0908Keep all essential equipment working safely.2023-02-17 · Health · corrected 2023-03-28

    Potential for more than minimal harm

  62. 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

OwnerTypeRolePercentSince
KASBEN, DONNAIndividual5% OR GREATER DIRECT OWNERSHIP INTEREST50%1996-03-08
KASBEN, JOHNIndividual5% OR GREATER DIRECT OWNERSHIP INTEREST50%1996-03-08
CLEMENS GRAY, MICHELLEIndividualOPERATIONAL/MANAGERIAL CONTROL2024-04-03
DYKSTRA, SANTIAGOIndividualOPERATIONAL/MANAGERIAL CONTROL2023-09-24
HULBERT, AMYIndividualOPERATIONAL/MANAGERIAL CONTROL2022-01-30
HULBERT, RICHARDIndividualOPERATIONAL/MANAGERIAL CONTROL2023-11-13
KASBEN, JENNIFERIndividualOPERATIONAL/MANAGERIAL CONTROL2019-07-29
KASBEN, JOHNIndividualOPERATIONAL/MANAGERIAL CONTROL1996-03-08
KASBEN, SERENAIndividualOPERATIONAL/MANAGERIAL CONTROL1997-10-15
LANGLOIS, MARKIndividualOPERATIONAL/MANAGERIAL CONTROL2020-02-01
MOORE, KENDRAIndividualOPERATIONAL/MANAGERIAL CONTROL2024-10-20
PORTER, MISTYIndividualOPERATIONAL/MANAGERIAL CONTROL2023-01-01
KASBEN, DONNAIndividualCORPORATE OFFICER1996-03-08
KASBEN, JOHNIndividualCORPORATE OFFICER1996-03-08

Other facilities in Maple Valley

NameOverallBeds

Source: CMS Provider Data Catalog, Nursing Home Care Compare files (processed 2026-03-01). Citations show the 3 most recent inspection cycles.