Holland Home - Raybrook Manor
2121 Raybrook SE
Grand Rapids, MI, 49546
6162355702
CCN: 235440
4
Overall2
Health5
Staffing5
QualitySpecial FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
Ownership
| Name | Role | % |
|---|---|---|
| DUEMLER, RONALD | CONTRACTED MANAGING EMPLOYEE | NOT APPLICABLE |
| FARR, PAUL | CORPORATE DIRECTOR | NOT APPLICABLE |
| HIDALGO, CARLOS | CORPORATE DIRECTOR | NOT APPLICABLE |
| JOHNSON, MARK | CORPORATE DIRECTOR | NOT APPLICABLE |
| KNIBBE, DAVID | CORPORATE DIRECTOR | NOT APPLICABLE |
| MALBURG, GARY | CORPORATE DIRECTOR | NOT APPLICABLE |
| NAGELKERK, JEAN | CORPORATE DIRECTOR | NOT APPLICABLE |
| SANCHEZ, NELSON | CORPORATE DIRECTOR | NOT APPLICABLE |
| SEGOVIA, GILBERT | CORPORATE DIRECTOR | NOT APPLICABLE |
| SMITH, DAVID | CORPORATE DIRECTOR | NOT APPLICABLE |
| THOLE, NICK | CORPORATE DIRECTOR | NOT APPLICABLE |
| URSUL, MARY | CORPORATE DIRECTOR | NOT APPLICABLE |
| VOGEL-VANDERSON, SUSAN | CORPORATE DIRECTOR | NOT APPLICABLE |
| VUGTEVEEN, TROY | CORPORATE DIRECTOR | NOT APPLICABLE |
| WATSON, SAM | CORPORATE DIRECTOR | NOT APPLICABLE |
| KINDER, ADAM | CORPORATE OFFICER | NOT APPLICABLE |
| VUGTEVEEN, TROY | CORPORATE OFFICER | NOT APPLICABLE |
| CHRISTIAN LIVING SERVICES | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| MATRO, PHILIP | W-2 MANAGING EMPLOYEE | NOT APPLICABLE |
| MYERS, TIMOTHY | W-2 MANAGING EMPLOYEE | NOT APPLICABLE |
Penalties (1)
| Date | Type | Amount |
|---|---|---|
| 2025-02-05 | Payment Denial | 10 days |
Health Deficiencies (23)
2025-12-23 · Health
D
F761 · 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.
D
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
2025-02-05 · Health
D
F880 · Infection Control Deficiencies
Provide and implement an infection prevention and control program.
F
F812 · Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
D
F810 · Nutrition and Dietary Deficiencies
Provide special eating equipment and utensils for residents who need them and appropriate assistance.
G
F689 · Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
F657 · 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.
D
F609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
D
F585 · Resident Rights Deficiencies
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
F
F583 · Resident Rights Deficiencies
Keep residents' personal and medical records private and confidential.
D
F550 · Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
2024-01-26 · Health
D
F883 · Infection Control Deficiencies
Develop and implement policies and procedures for flu and pneumonia vaccinations.
D
F761 · 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.
B
F726 · Nursing and Physician Services Deficiencies
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
D
F658 · Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
D
F644 · Resident Assessment and Care Planning Deficiencies
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
D
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
2023-11-29 · Health
E
F689 · Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
D
F684 · Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
E
F610 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
2023-01-11 · Health
D
F813 · Nutrition and Dietary Deficiencies
Have a policy regarding use and storage of foods brought to residents by family and other visitors.
F
F812 · Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
E
F689 · Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day3.68
4.79
RN Hrs/Resident/Day0.54
0.94
LPN Hrs/Resident/Day0.81
0.78
CNA Hrs/Resident/Day2.33
3.07
PT Hrs/Resident/Day0.12
0.06
Data as of 2026-03-01