Map showing the location of MAJESTIC CARE OF MIDDLETOWN LLC in MIDDLETOWN, Ohio
6898 HAMILTON MIDDLETOWN ROAD, MIDDLETOWN, OH, 45044

Overall Score

CMS Five-Star Quality Rating
2/5Below averageCMS Five-Star overall rating
  1. Much below average
  2. Below average
  3. Average
  4. Above average
  5. Much above average

Where it ranks

  • OhioAbove only 10% of peers911 rated homes · average 3.2★
  • Butler CountyAbove only 4% of peers24 rated homes · average 3.8★
  • United StatesAbove only 20% of peers14,574 rated homes · average 3.0★

How the rating is built

  • Health inspectionsStarting point1★−1.8 vs OH avg
  • StaffingCan add or remove a star1★−1.4 vs OH avg
  • Quality measuresCan add or remove a star5★+0.6 vs OH avg

CMS starts from the health inspection stars, then adds or subtracts a star for staffing and for quality measures. Stars are assigned relative to other facilities in the same state.

Ratings & measures

Tap a row to see what it means
Health inspection ratingCMS stars from the last three on-site inspection cycles1★Lowest tier among peersOH avg2.8★U.S. avg2.8★
What is health inspection rating?

Stars assigned from the last three standard surveys and every complaint investigation in that window, weighted toward the most recent and the most serious findings. CMS assigns these stars relative to other facilities in the same state.

Why it matters

It carries the most weight in the overall rating and is the only domain based on what trained inspectors saw on site rather than what the facility reported.

Staffing ratingCMS stars from payroll-reported hours and turnover1★Lowest tier among peersOH avg2.4★U.S. avg2.9★
What is staffing rating?

Nurse and aide hours per resident day from payroll records CMS collects every quarter, adjusted for how much care residents need, plus staff turnover and weekend coverage.

Why it matters

More hours and lower turnover are the strongest predictors of fewer falls, pressure sores, and avoidable hospital stays.

Quality measures ratingCMS stars from clinical outcomes and resident assessments5★Above only 43% of peersOH avg4.4★U.S. avg3.6★
What is quality measures rating?

Clinical outcomes from resident assessments and Medicare claims: falls with injury, pressure ulcers, hospitalizations, antipsychotic use, and more, for both short-stay and long-stay residents.

Why it matters

It shows whether care is working, but part of it comes from the facility’s own assessments, so read it alongside the inspection results.

Total nurse hoursPer resident per day, all nursing staff3.58hrsAbove 50% of peersOH avg3.73Benchmark4.10
What is total nurse hours?

All licensed nurse and aide hours worked, divided by the number of residents, on an average day. Reported from payroll, not self-reported.

Why it matters

Federal research links 4.1 hours a day to fewer avoidable harms. Below about 3 hours, residents wait longer for help with basics like toileting and repositioning.

RN hoursPer resident per day, registered nurses only0.29hrsAbove only 3% of peersOH avg0.63Benchmark0.75
What is rn hours?

Registered nurse hours only. RNs assess residents, manage medications, and catch changes in condition; LPNs and aides deliver most hands-on care.

Why it matters

RN coverage is the staffing measure most tied to fewer hospital transfers and infections, and it is where thinly staffed facilities cut first.

Nursing staff turnoverShare of nursing staff who left within a year · lower is better57%Above only 30% of peersOH avg50%RN turnover82%
What is nursing staff turnover?

The share of nursing staff who left within the past year, from the same payroll data.

Why it matters

High turnover means residents are cared for by people who do not know them, and it is one of the strongest predictors of inspection problems.

Fines in the last three yearsCivil money penalties imposed by CMS · lower is better$108,164Above only 7% of peersOH avg$23,502Fines · denials1 · 2
What is fines in the last three years?

Civil money penalties CMS imposed after serious or uncorrected deficiencies, and denials of Medicare payment for new admissions.

Why it matters

Penalties follow the worst inspection findings. A recent fine is the clearest sign that inspectors found real harm.

Inspection history

Last three inspection cycles
61citations
13inspection dates
1actual harm (G–I)
1immediate jeopardy (J–L)
Jun 5, 2025most recent

Citations by monthJul 2019 – Jun 2025

  • No actual harm (D–F)
  • Actual harm (G–I)
  • Immediate jeopardy (J–L)
  • $Fine or payment denial

Click a month or a year to filter the findings below. Arrow keys move between months; Esc clears.

Jun 5, 20256 citationsCycle 1worst F · no actual harm
  1. F761Ensure 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.Pharmacy ServiceD · isolatedCorrected Aug 5, 2025
  2. F880Provide and implement an infection prevention and control program.Infection ControlF · widespreadCorrected Aug 5, 2025
  3. F756Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.Pharmacy ServiceD · isolatedCorrected Aug 5, 2025
  4. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryF · widespreadCorrected Aug 5, 2025
  5. F584Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.Resident RightsD · isolatedCorrected Aug 5, 2025
  6. F677Provide care and assistance to perform activities of daily living for any resident who is unable.Quality of Life and CareD · isolatedCorrected Aug 5, 2025
Feb 4, 20251 citationCycle 1worst D · no actual harm
  1. F691Provide appropriate colostomy, urostomy, or ileostomy care/services for a resident who requires such services.Quality of Life and CareD · isolatedCorrected Mar 12, 2025
Jan 17, 20251 citationCycle 2worst E · no actual harm
  1. F558Reasonably accommodate the needs and preferences of each resident.Resident RightsE · patternCorrected Mar 12, 2025
Jan 6, 20254 citationsCycle 2worst D · no actual harm
  1. F580Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.Resident RightsD · isolatedCorrected Mar 12, 2025
  2. F880Provide and implement an infection prevention and control program.Infection ControlD · isolatedCorrected Mar 12, 2025
  3. F760Ensure that residents are free from significant medication errors.Pharmacy ServiceD · isolatedCorrected Mar 12, 2025
  4. F657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.Resident Assessment and Care PlanningD · isolatedCorrected Mar 12, 2025
May 29, 20243 citationsCycle 2worst E · no actual harm
  1. F804Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.Nutrition and DietaryD · isolatedCorrected Jun 19, 2024
  2. F580Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.Resident RightsD · isolatedCorrected Jun 19, 2024
  3. F690Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.Quality of Life and CareE · patternCorrected Jun 19, 2024
Apr 29, 20243 citationsCycle 2worst J · immediate jeopardy
  1. F580Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.Resident RightsD · isolatedCorrected Jun 19, 2024
  2. F698Provide safe, appropriate dialysis care/services for a resident who requires such services.Quality of Life and CareJ · isolatedCorrected Jun 19, 2024
  3. F600Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Jun 19, 2024
Mar 18, 20248 citationsCycle 2worst G · actual harm
  1. F726Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.Nursing and Physician ServicesE · patternCorrected Jun 19, 2024
  2. F883Develop and implement policies and procedures for flu and pneumonia vaccinations.Infection ControlD · isolatedCorrected Jun 19, 2024
  3. F880Provide and implement an infection prevention and control program.Infection ControlD · isolatedCorrected Jun 19, 2024
  4. F645PASARR screening for Mental disorders or Intellectual DisabilitiesResident Assessment and Care PlanningD · isolatedCorrected Jun 19, 2024
  5. F657Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.Resident Assessment and Care PlanningE · patternCorrected Jun 19, 2024
  6. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareG · isolatedCorrected Jun 19, 2024
  7. F692Provide enough food/fluids to maintain a resident's health.Quality of Life and CareE · patternCorrected Jun 19, 2024
  8. F755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.Pharmacy ServiceD · isolatedCorrected Jun 19, 2024
Feb 14, 20244 citationsCycle 2worst D · no actual harm$108,164, payment denial
  1. F677Provide care and assistance to perform activities of daily living for any resident who is unable.Quality of Life and CareD · isolatedCorrected Jun 19, 2024
  2. F580Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.Resident RightsD · isolatedCorrected Jun 19, 2024
  3. Provide appropriate treatment and care according to orders, resident’s preferences and goals.Quality of Life and CareD · isolatedCorrected Jun 19, 2024
  4. F690Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.Quality of Life and CareD · isolatedCorrected Jun 19, 2024
Nov 16, 20234 citationsCycle 3worst E · no actual harm
  1. F694Provide for the safe, appropriate administration of IV fluids for a resident when needed.Quality of Life and CareE · patternCorrected Dec 11, 2023
  2. F755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.Pharmacy ServiceE · patternCorrected Dec 11, 2023
  3. F837Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility.AdministrationE · patternCorrected Dec 11, 2023
  4. F842Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.Resident Assessment and Care PlanningD · isolatedCorrected Dec 11, 2023
Aug 24, 20232 citationsCycle 3worst D · no actual harm
  1. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareD · isolatedCorrected Sep 13, 2023
  2. F690Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.Quality of Life and CareD · isolatedCorrected Sep 13, 2023
Mar 29, 202315 citationsCycle 2worst F · no actual harm
  1. F677Provide care and assistance to perform activities of daily living for any resident who is unable.Quality of Life and CareD · isolatedCorrected May 10, 2023
  2. F679Provide activities to meet all resident's needs.Quality of Life and CareD · isolatedCorrected May 10, 2023
  3. F687Provide appropriate foot care.Quality of Life and CareD · isolatedCorrected May 10, 2023
  4. F692Provide enough food/fluids to maintain a resident's health.Quality of Life and CareD · isolatedCorrected May 10, 2023
  5. F791Provide or obtain dental services for each resident.Quality of Life and CareD · isolatedCorrected May 10, 2023
  6. F803Ensure 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.Nutrition and DietaryE · patternCorrected May 10, 2023
  7. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryF · widespreadCorrected Jun 1, 2023
  8. F825Provide or get specialized rehabilitative services as required for a resident.Quality of Life and CareD · isolatedCorrected May 10, 2023
  9. F584Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.Resident RightsE · patternCorrected May 10, 2023
  10. F567Honor the resident's right to manage his or her financial affairs.Resident RightsD · isolatedCorrected May 10, 2023
  11. F569Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.Resident RightsD · isolatedCorrected May 10, 2023
  12. F609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected May 10, 2023
  13. F610Respond appropriately to all alleged violations.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected May 10, 2023
  14. F645PASARR screening for Mental disorders or Intellectual DisabilitiesResident Assessment and Care PlanningD · isolatedCorrected May 10, 2023
  15. F661Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.Resident Assessment and Care PlanningD · isolatedCorrected May 10, 2023
Feb 22, 20233 citationsCycle 3worst D · no actual harmpayment denial
  1. Provide appropriate treatment and care according to orders, resident’s preferences and goals.Quality of Life and CareD · isolatedCorrected Mar 23, 2023
  2. F692Provide enough food/fluids to maintain a resident's health.Quality of Life and CareD · isolatedCorrected May 10, 2023
  3. F694Provide for the safe, appropriate administration of IV fluids for a resident when needed.Quality of Life and CareD · isolatedCorrected Mar 23, 2023
Jul 11, 20197 citationsCycle 3worst E · no actual harm
  1. F677Provide care and assistance to perform activities of daily living for any resident who is unable.Quality of Life and CareD · isolatedCorrected Aug 13, 2019
  2. F761Ensure 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.Pharmacy ServiceE · patternCorrected Aug 13, 2019
  3. F582Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.Resident RightsD · isolatedCorrected Aug 13, 2019
  4. F607Develop and implement policies and procedures to prevent abuse, neglect, and theft.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Aug 13, 2019
  5. F609Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Aug 13, 2019
  6. F610Respond appropriately to all alleged violations.Freedom from Abuse, Neglect, and ExploitationD · isolatedCorrected Aug 13, 2019
  7. F685Assist a resident in gaining access to vision and hearing services.Quality of Life and CareD · isolatedCorrected Aug 13, 2019

Staffing

From quarterly payroll reports

Hours per resident per day

  • All nursing staffRNs, LPNs and aides combined3.58hrsAbove 50% of peers−0.15 vs OH avg
  • Registered nursesRN hours only0.29hrsAbove only 3% of peers−0.34 vs OH avg
  • Licensed practical nursesLPN hours1.57hrs
  • Nurse aidesCNA hours1.72hrs
  • Weekend nursingAll staff on Saturdays and Sundays3.15hrs
  • Ohio average
  • Research benchmark (4.10 total, 0.75 RN)

Turnover & capacity

  • Nursing staff turnoverShare who left within a year · lower is better57%Above only 30% of peersOH avg 50%
  • RN turnoverRegistered nurses only82%Not ranked by CMS
  • Administrators who leftIn the past year1Leadership changed
  • Occupancy200 certified beds · ~133 residents a day66%Above only 8% of peersOH avg 83%

Fines & penalties

Roughly the past three years

Enforcement summary

  • $108,164In fines
  • 1Fine
  • 2Payment denials
  • $23,502OH avg in fines
Above only 7% of peersFewer fines than 7% of rated homes in Ohio

Actions on record

  1. Feb 14, 2024Civil money penalty$108,164
  2. Feb 14, 2024Denial of payment for new admissionsfrom Apr 16, 2024
  3. Feb 22, 2023Denial of payment for new admissionsfrom May 22, 2023

Ownership

As filed with CMS

Structure

Ownership type
For profit - Limited Liability company
Chain
Majestic Care33 facilities in the chain2.6★ chain average
Certification
Medicare and Medicaid
Location type
Urban
Ownership change
None in the last 12 months

People and entities on file

Direct owners (5%+)
  • Rb SNF Operations Holdings LLC
Indirect owners (5%+)
  • David Marx
Operational or managerial control
  • 6898 Hamilton Middletown Road SNF Realty LLC
  • Majestic Management LLC
  • Margaret Chamberlain
  • David Marx
  • Paul Pruitt
  • Angela Rewa
  • Robert Russell
  • Anzhelika Shatrov
  • +2 more

Person Organization

Sources & notes

Public data, updated quarterly

Data sources

  • CMS Care Compare · Provider InformationStar ratings, staffing hours, turnover, penalties and flags · processed February 2026.
  • CMS Health CitationsEvery deficiency from the last three inspection cycles, with scope, severity and inspection cycle.
  • CMS Penalties and Ownership filesCivil money penalties, payment denials, and the owners and managers on file.

Notes

  • CMS Certification Number 365209 · 6898 HAMILTON MIDDLETOWN ROAD, MIDDLETOWN, OH, 45044.
  • Percentiles compare this facility with every rated nursing home in Ohio and Butler County. Turnover and fines are inverted so a high percentile is always good.
  • This is an informational summary of public data, not medical, legal, or placement advice. Facilities cannot pay to change it; a facility that believes a record is wrong can dispute it with CMS.

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