Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record

WINDSOR HOUSE

HUNTSVILLE, AL · 117 certified beds · Last Life Safety survey May 29, 2021

CMS Certification Number 015397 · first certified October 1987

Ownership

Operated by DIVERSICARE HEALTHCARE · For profit - Corporation

No change of ownership on CMS record since January 1, 2016, when the records begin.

4
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
0
Tags cited more than once
Across separate surveys
2
Inspection & testing records
Of the citations on file

Position within AL

4 citations — more than 11% of the 224 certified nursing homes in AL. Compared within AL rather than nationally because which state a facility is in explains about 30% of the variation in citation counts between facilities, while bed count explains under 1%. State survey agencies differ far more than the buildings do. How this is calculated

Improvingfewer citations at the latest survey than at its earlier surveys in the window.

The latest survey found 0 citations; the earlier surveys in the window averaged 2. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

Well past the typical window (June 2022 to October 2022), and past the point by which nine in ten US facilities have been surveyed. This facility’s last Life Safety survey was May 2021. Nursing homes nationally are typically surveyed 12–17 months after the last one (median 14), measured over 19,385 consecutive surveys in the last two years of CMS records. AL has too few recent surveys to measure on its own, so the national interval is used.

A range the record supports, not a prediction of a date. State agencies vary widely — from about 11 months in Pennsylvania to three years in Maryland. How the window is measured

Get an email about WINDSOR HOUSE

One email when it happens. No account; stop it any time with one click.

Which alerts

Physical environment (health survey)

6 physical-environment citations on the health survey. Cited by the health surveyors under Appendix PP, not the Life Safety Code surveyor: equipment in safe operating condition, the call system, bed rails, pest control, hazards, the environment. Counted separately from the 4 Life Safety citations above. The Physical Environment Index

  • F-0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
  • F-0584 Honor 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.
  • F-0880 Provide and implement an infection prevention and control program.

How that compares

Citations on file over three years

Compared with the median facility in AL, and nationally. Surveyors differ markedly between states, so the AL figure is the meaningful one.

This facility4AL median9National median11
Citations on file over three years, compared
MeasureCitations
This facility4
Median facility in AL9
Median facility nationally11

Survey history

Citations at each Life Safety survey
32018-0412019-0302021-05
Citations at each Life Safety survey
Survey dateCitations
April 5, 20183
March 7, 20191
May 29, 20210

Most-cited tags

Most-cited tags at this facility
K-03551K-02811K-03531K-03211
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0355Properly select, install, inspect, or maintain portable fire extinguishes.12018-04-05
K-0281Install proper backup exit lighting.12018-04-05
K-0353Inspect, test, and maintain automatic sprinkler systems.12019-03-07
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.12018-04-05

What the citations cover

Citations by CMS category
  • Smoke Deficiencies 3
  • Egress Deficiencies 1
Citations by CMS category
CategoryCitations
Smoke Deficiencies3
Egress Deficiencies1

Every citation on file

As published by CMS, newest survey first. Descriptions are CMS’s own wording.

March 7, 2019 — 1 citation

Citations issued on March 7, 2019
TagWhat the surveyor checksStatus
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (April 17, 2019)

April 5, 2018 — 3 citations

Citations issued on April 5, 2018
TagWhat the surveyor checksStatus
K-0281Install proper backup exit lighting.Deficient, Provider has date of correction (May 10, 2018)
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.Deficient, Provider has date of correction (May 10, 2018)
K-0355Properly select, install, inspect, or maintain portable fire extinguishes.Deficient, Provider has date of correction (May 10, 2018)

Reflects the CMS posting of August 1, 2026. Surveys conducted in the last few months may not appear yet.