SALEM HOME
704 S ASH STREET
HILLSBORO, KS, 67063
6209471429
CCN: 175484
4
Overall4
Health4
Staffing4
QualitySpecial FocusAbuse IconOwnership Changed (12mo)Inspection OverdueOIG ExcludedUnder CIA
Ownership
| Name | Role | % |
|---|---|---|
| ENSEY, LAURA | CORPORATE DIRECTOR | NOT APPLICABLE |
| HERBEL, DELAYNE | CORPORATE DIRECTOR | NOT APPLICABLE |
| JOST, JARED | CORPORATE DIRECTOR | NOT APPLICABLE |
| KOSLOWSKY, THOMAS | CORPORATE DIRECTOR | NOT APPLICABLE |
| LANCASTER, MARY | CORPORATE DIRECTOR | NOT APPLICABLE |
| WIEBE, HENRY | CORPORATE DIRECTOR | NOT APPLICABLE |
| CROCKER, HEATHER | CORPORATE OFFICER | NOT APPLICABLE |
| MUNGAI, PETER | CORPORATE OFFICER | NOT APPLICABLE |
| CROCKER, HEATHER | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| ZARAGOZA, ANGIE | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| DONAHUE, LISA | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| HAMM, JODIE | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| HAMM, MICHAEL | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| MUNGAI, PETER | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| REEH, MICHAEL | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| WEBER, VIRGILENE | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| WILLIAMS, ANGELA | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
Health Deficiencies (10)
2024-08-07 · Health
F
F851 · Administration Deficiencies
Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
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
F804 · Nutrition and Dietary Deficiencies
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
E
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.
2022-12-13 · Health
J
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
F550 · Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
2021-04-27 · Health
D
F757 · Pharmacy Service Deficiencies
Ensure each resident’s drug regimen must be free from unnecessary drugs.
D
F756 · Pharmacy Service Deficiencies
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
D
F686 · Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
D
F684 · Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Staffing
MetricThis FacilityNational Avg
Total Nurse Hrs/Resident/Day3.68
4.44
RN Hrs/Resident/Day0.54
0.52
LPN Hrs/Resident/Day0.81
0.45
CNA Hrs/Resident/Day2.33
3.47
PT Hrs/Resident/Day0.12
0.01
Data as of 2026-03-01