Derby Health & Rehabilitation, LLC
Derby, Kansas · CCN 175514
16 surveys since 2010. The first finding at harm level was recorded in 2021.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
- Citations on record
- 84
- Surveys
- 16
- Harm or worse
- 1
- Immediate jeopardy
- 1
Findings at the most serious level CMS records.
Older surveys no longer in CMS’s monthly file or on Care Compare. They are shown here.
The facility
- Certified beds
- 74
- Ownership
- For profit - Corporation
- Chain
- Independent
- County
- Sedgwick
- Medicare-certified since
- 2010
CMS ratings
- Overall
- 5
- Health inspection
- 5
- Staffing
- 4
- Quality measures
- 5
CMS’s own Five-Star ratings.
Compared with similar facilities
Not shown for this facility: too few citations in window (n=15, floor 20).
Last survey on record
Mar 11, 2026
243 days ago.
Counts surveys with at least one finding. A clean survey leaves no record here, so the real gap may be shorter.
Staffing
| Measure | This facility | Peer median |
|---|---|---|
| Nurse hours per resident day | 4.99 | 3.56 |
| Registered-nurse hours per resident day | 0.59 | — |
| Annual nurse turnover | 60.7% | 52.1% |
As reported by the facility to CMS, beside the peer-group median.
Enforcement
No fines, payment denials or special-focus designation on the current CMS record.
Severity of recent findings
| Severity | Isolated | Pattern | Widespread |
|---|---|---|---|
| Immediate jeopardy | J— | K— | L— |
| Actual harm | G— | H— | I— |
| No harm, potential for more than minimal | D1178.6% | E214.3% | F— |
| No harm, potential for minimal | A— | B— | C17.1% |
Most frequently cited here
In CMS’s current monthly file.
- F6893×
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- F5821×
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
- F6021×
Protect each resident from the wrongful use of the resident's belongings or money.
- F6281×
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
- F6841×
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
In the surveyor’s words
From the most serious findings on record at Derby Health & Rehabilitation, LLC, in the surveyor’s own words.
- Immediate jeopardy, patternF678Mar 10, 2021
The facility reported a census of 64 residents, with three residents sampled for cardiopulmonary resuscitation (CPR, emergency medical procedure for restoring normal heartbeat and breathing to victims of heart failure, drowning, etc.). The facility identified 31 residents with full code status, indicating the residents wishes for life saving measures to be utilized in emergent situations, to include CPR. Based on interview and record review, the facility staff failed to implement CPR on a non-responsive full-code hospice Resident (R1) on [DATE] at 06:00 AM, when staff found the resident without respirations and pulseless. […]
- No harm, potential for more than minimal, patternF689Apr 30, 2024
The facility had a census of 61 residents. The sample included 15 residents. Based on observation, interview, and record review the facility failed to ensure hazardous chemicals were stored safely. This placed the five residents identified by the facility as cognitively impaired and independently mobile at risk for accidents and hazard-related injuries. Findings included: - On 04/24/24 at 08:13 AM, observation in the 300-household revealed an unlocked housekeeping closet with the following hazardous items with Keep out of reach of children instructions stored on a waist-high shelf: One small can of fiberglass resin. One quart bottle of tile sealer. One spray bottle of ant killer. One spray can of ant and roach killer. […]
- No harm, potential for more than minimal, patternF812Apr 30, 2024
The facility had a census of 61 residents. Based on observation, interview, and record review the facility failed to store, prepare, and serve food in a sanitary manner for residents in two of four kitchens and dining rooms. This deficient practice placed residents at risk for food-borne illness. Findings included: - On 04/24/24 at 09:07 AM, observation in the 100-household kitchen freezer revealed a bag of chicken tenders, undated, and a box of hamburger patties opened, and the plastic bag torn leaving the patties open to air. On 04/24/24 at 12:17 PM, observation in the 300-household dining room revealed Certified Nurse Aide (CNA) M served plated food to residents. […]
- No harm, potential for more than minimal, isolatedF628Mar 11, 2026
The facility identified a census of 61 residents. The sample included 15 residents with three residents reviewed for hospitalization. Based on observation, record review, and interviews, the facility failed to provide a written notification of transfer for facility-initiated transfers to Resident (R) 22, R77, and R78 and/or their representative for all applicable transfers/discharges. The facility further failed to notify the State Long Term Care Ombudsman (LTCO) of transfers/discharges for R22, R77, and R78. Findings included:- R22 admitted to the facility on [DATE], the facility transferred him to the hospital on [DATE], and he re-admitted to the facility on [DATE]. R77 admitted to the facility on [DATE], and the facility transferred her to the hospital on [DATE]. […]
- No harm, potential for more than minimal, isolatedF684Mar 11, 2026
The facility reported a census of 61 residents; the sample included five residents reviewed unnecessary medications. Based on observation, interview, and record review revealed the facility failed to obtain physician-ordered orthostatic blood pressures as part of an evaluation following complaints of dizziness and lightheadedness. Findings included:- R45's Electronic Medical Record (EMR) revealed the following diagnoses: anxiety (mental or emotional reaction characterized by apprehension, uncertainty, and irrational fear) and hypotension (low blood pressure). R45's 02/18/26 admission Minimum Data Set (MDS) documented a Brief Interview for Mental Status (BIMS) of 14, indicating intact cognition. […]
Read 20 findings in full →The most serious and the most recent: 20 of 84 on record.
Every survey on record
FindingsAt actual harm or above
- Mar 11, 2026Standard2 findings
- Apr 29, 2025Complaint1 finding
- Apr 30, 2024Standard and complaint7 findings
- Nov 8, 2022Standard4 findings
- Mar 10, 2021Complaint1 finding · 1 harm
- Apr 26, 2017Complaint2 findings
- Sep 26, 2016Standard and complaint5 findings
- Apr 10, 2015Standard5 findings
Show the 8 earlier surveys
- Jan 8, 2014—2 findings
- Dec 19, 2013—19 findings
- Dec 19, 2012—1 finding
- Sep 7, 2012—5 findings
- Sep 7, 2011—1 finding
- Jul 19, 2011Standard2 findings
- May 19, 2011Standard and complaint26 findings
- Sep 9, 2010—1 finding
Surveys that found no deficiencies are not in CMS’s files and do not appear here.
Comparable facilities
The nearest facilities to this one in the same peer group, by weighted findings.
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