5/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
5/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
The Willows at Howell is a 39-bed skilled nursing facility that provides short-term rehabilitation, memory care, independent living, and assisted living services. Located in a walkable urban neighborhood, the property handles brief post-acute recovery stays, resulting in a 46-day average length of stay. Admissions primarily focus on a mix of Medicare (46%) and private-pay (43%) clients. Business records indicate strong financial health, with the operation posting a $1.4 million profit and a 9.8% margin while routing 52.7% of its revenue into payroll to support on-site amenities like a courtyard, library, resident garden, and private dining rooms.
Public health tracking logs confirm an exceptional regulatory history paired with top-tier clinical outcomes despite a low local occupancy rate of 26%. Direct nursing care averages 3 hours and 44 minutes per resident daily, highlighted by weekend registered nurse coverage that runs 152% ahead of the Michigan state average, alongside physical therapy volumes that track 125% above the state baseline.
On the compliance side, the property has compiled just three total deficiencies since 2015, which sits 85% better than the state average, and carries zero history of federal financial penalties. Its most recent standard inspection in April 2024 flagged three minor, subsequently resolved documentation gaps regarding hospice roles and medication service plans. Clinical charts demonstrate high performance across both long-term and short-term metrics, documenting a zero percent rate for permanent resident pressure ulcers and a short-term community discharge success rate that beats the state norm by 36%.
Prospective representatives looking into premium post-acute physical rehabilitation or short-term recovery placements can analyze these public health profiles to evaluate the home’s baseline. Since the official tracking records low physical utilization alongside heavy weekend nurse staffing, high rehabilitation discharge numbers, and a near-flawless decade-long inspection track record, the documentation describes a highly capable and organized clinical environment.
The Overall CMS Rating combines results from health inspections, staffing levels and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Based on the results of the facility's three most recent standard inspections and any complaint investigations. CMS reviews the number, scope, and severity of deficiencies, with more recent findings weighted more heavily.
Measures average nursing staff hours per resident per day, including Registered Nurses (RNs) and total nursing staff. Ratings are adjusted based on the level of care residents require and are compared to state and national benchmarks.
Based on clinical and physical health indicators reported to CMS, such as hospital readmissions, falls, pressure ulcers, and improvements in mobility. These measures reflect how well residents' health needs are being managed.
Daily nursing hours per resident by staff type, reported to CMS. Higher is generally better — compare this facility to state and national averages to see where staffing stands.
Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
| Staff type | Hours / Day / Resident | vs state avg |
|---|---|---|
|
Registered Nurse (RN)
RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes.
| 1h 22m per day | ▲ 78% State avg: 46m per day · National avg: 41m per day |
|
LPN / LVN
Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care.
| 39m per day | ▼ 27% State avg: 53m per day · National avg: 52m per day |
|
Nurse Aide
Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life.
| 1h 54m per day | ▼ 20% State avg: 2h 23m per day · National avg: 2h 20m per day |
|
Weekend Total Nursing
Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours.
| 3h 49m per day | ▲ 9% State avg: 3h 31m per day · National avg: 3h 26m per day |
|
Physical Therapist
Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation.
| 7m per day | ▲ 78% State avg: 4m per day · National avg: 4m per day |
|
Weekend RN
Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent.
| 1h 13m per day | ▲ 151% State avg: 29m per day · National avg: 28m per day |
Average number of days residents stay at this facility, based on CMS cost report data. Shorter stays often reflect post-acute or rehab care; longer stays reflect long-term care.
Higher than the Michigan average: 75.8%In Michigan, the Department of Licensing and Regulatory Affairs (LARA) conducts unannounced inspections and investigations to ensure long-term care facilities comply with state health codes.
This scorecard compares key inspection, deficiency, and complaint metrics at this facility against the Michigan state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.
Deficiencies
| This Facility | MI Average | vs. MI Avg |
|---|---|---|---|
|
Total deficiencies
Formal regulatory issues recorded by inspectors across all inspection types.
| 25 | 8 | This facility has 213% more total deficiencies than a typical Michigan assisted living residence (25 vs. MI avg 8).↑ 213% worse |
|
Deficiencies per year
Average deficiencies per year since 2015.
| 2.3 | 0.7 | This facility has 229% more deficiencies per year than a typical Michigan assisted living residence (2.3 vs. MI avg 0.7).↑ 229% worse |
An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.
State average N/A
Last Health inspection on Jan 2025
State average N/A
State average N/A
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
15 of 20 citations resulted from standard inspections; 2 of 20 resulted from complaint investigations; and 3 of 20 came from combined inspections (standard and complaint).
In line with State averageState average: N/A
In line with State averageState average: N/A
Corrected
Corrected
Corrected
Corrected
Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.
0% compared with State averageState average ratio: 0 : 0
0% compared with State averageState average: 0 hours
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Manages medical care and health needs.
All 18 RN Staff are full-time employees. No contractors work on this role.
18
Average shift length. Calculated as total hours divided by days worked and average staff per day.
7.7 hoursAssists with medical care and medications.
All 7 LPN Staff are full-time employees. No contractors work on this role.
7
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.8 hoursHelps with daily care and mobility.
All 34 CNA Staff are full-time employees. No contractors work on this role.
34
Average shift length. Calculated as total hours divided by days worked and average staff per day.
7.4 hours
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors
3,059 contractor hours this quarter
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
| Certified Nursing Assistant | 34 | 0 | 34 | 9,487 | 92 | 100% | 7.4 |
| Registered Nurse | 18 | 0 | 18 | 5,246 | 92 | 100% | 7.7 |
| Licensed Practical Nurse | 7 | 0 | 7 | 2,767 | 92 | 100% | 9.8 |
| Other Dietary Services Staff | 9 | 0 | 9 | 2,039 | 92 | 100% | 8.3 |
| Clinical Nurse Specialist | 6 | 0 | 6 | 1,075 | 88 | 96% | 8.9 |
| Physical Therapy Assistant | 0 | 3 | 3 | 900 | 80 | 87% | 6.5 |
| Speech Language Pathologist | 0 | 3 | 3 | 778 | 66 | 72% | 6.3 |
| Respiratory Therapy Technician | 0 | 3 | 3 | 596 | 77 | 84% | 5.7 |
| Nurse Practitioner | 1 | 0 | 1 | 510 | 64 | 70% | 8 |
| Dietitian | 1 | 0 | 1 | 508 | 64 | 70% | 7.9 |
| Administrator | 1 | 0 | 1 | 504 | 63 | 68% | 8 |
| Physical Therapy Aide | 0 | 2 | 2 | 487 | 66 | 72% | 5.8 |
| RN Director of Nursing | 1 | 0 | 1 | 463 | 48 | 52% | 9.7 |
| Qualified Social Worker | 0 | 2 | 2 | 299 | 64 | 70% | 4.7 |
| Nurse Aide in Training | 1 | 0 | 1 | 38 | 5 | 5% | 7.7 |
| Occupational Therapy Assistant | 2 | 0 | 2 | 36 | 55 | 60% | 0.6 |
Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.
Source: CMS Penalties Database
No penalties in the past 3 years
No civil money penalties or payment denials were reported in the last 3 years.
These measures show how residents usually do over time at this home, based on health outcomes and preventive care.
A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline.
6.8
19% better than State averageState average: 8.4
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
17.2
6% worse than State averageState average: 16.3
CMS star rating based on long-stay quality measure performance. 5 stars = significantly above average, 1 star = significantly below average.
Percent of long-stay residents whose need for help with daily activities has increased
12.0%
In line with State averageState average: 12.5%
Percent of long-stay residents whose ability to move independently worsened
12.6%
18% better than State averageState average: 15.3%
Percent of low risk long-stay residents who lose control of their bowels or bladder
27.1%
29% worse than State averageState average: 21.0%
Percent of long-stay residents experiencing one or more falls with major injury
2.6%
19% better than State averageState average: 3.2%
Percent of long-stay high risk residents with pressure ulcers
0.0%
100% better than State averageState average: 5.7%
Percent of long-stay residents with a urinary tract infection
0.9%
48% better than State averageState average: 1.7%
Percent of long-stay residents who lose too much weight
6.9%
21% worse than State averageState average: 5.7%
Percent of long-stay residents who have depressive symptoms
2.9%
24% better than State averageState average: 3.9%
Percent of long-stay residents who received an antipsychotic medication
10.6%
29% better than State averageState average: 15.0%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
100.0%
5% better than State averageState average: 94.9%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
100.0%
5% better than State averageState average: 95.0%
Number of hospitalizations per 1,000 long-stay resident days.
2.54
46% worse than State averageState average: 1.74
Number of outpatient emergency department visits per 1,000 long-stay resident days.
2.99
94% worse than State averageState average: 1.54
CMS star rating based on short-stay quality measure performance. 5 stars = much above average, 1 star = much below average.
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
98.6%
19% better than State averageState average: 82.5%
Percent of short-stay residents who newly received an antipsychotic medication
0.0%
100% better than State averageState average: 1.4%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
99.0%
24% better than State averageState average: 79.5%
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
17.7%
27% better than State averageState average: 24.2%
Percentage of short-stay residents who had an outpatient emergency department visit.
7.4%
36% better than State averageState average: 11.5%
Percentage of SNF residents who experience falls with major injury during their stay.
0.0%
100% better than State averageState average: 0.8%
Percentage of residents at or above expected ability to care for themselves at discharge.
62.8%
17% better than State averageState average: 53.7%
Rate of successful return to home or community from a skilled nursing facility.
68.6%
36% better than State averageState average: 50.6%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
46% of new residents, usually for short-term rehab.
43% of new residents, often for short stays.
12% of new residents, often for long-term daily care.
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
55Residents meet regularly to discuss policies, care quality, and activities
Family members meet regularly to discuss policies, care quality, and activities
Organized group of family members that meets regularly to discuss facility policies, resident care, and activities.
Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.
Data sourced from CMS Long-Term Care Facility Characteristics quarterly report. Payer mix reflects the current resident census by primary payment source.
Historical financial and operational data for The Willows at Howell from 2016–2023, based on CMS SNF Cost Reports.
Key figures below are for fiscal year ending in 12/2023.
Based on CMS SNF Cost Report for fiscal year ending in 12/2023.
Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
Money the home earns outside of resident care — such as investments, grants, rentals and other non-operating sources (CMS cost report, Worksheet G-3). It is tracked separately from net patient revenue: it is not part of that figure, and it is not included in net patient income.
Staff salaries plus wage-related costs — benefits such as payroll taxes, health insurance and retirement — from the home's own accounting records (CMS cost report, Worksheet A). Contract or agency labor is counted separately, under other operating costs.
Rank #60 / 141Payroll — State benchmarkedThis home is ranked 60th out of 141 homes in Michigan for Payroll. Shows total annual staff payroll benchmarked to the Michigan average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.Facilities with the same value for a metric share the same rank. Rankings are based only on facilities in Michigan that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Payroll as a share of revenue: staff salaries and wage-related benefits divided by net patient revenue. A higher figure means more of each revenue dollar goes to staff pay.
Rank #28 / 141Payroll % — State benchmarkedThis home is ranked 28th out of 141 homes in Michigan for Payroll %. Shows payroll as a percentage of revenue versus the Michigan average. Well-run Michigan facilities typically land around 47–58% — the top third Statewide. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings.Facilities with the same value for a metric share the same rank. Rankings are based only on facilities in Michigan that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Everything it costs to run the home apart from payroll — food, utilities, supplies, maintenance, contract labor and administration. Calculated as total operating expense minus payroll (staff salaries and wage-related benefits).
The home's total operating expense for the year — all the costs of running it, salaries included (CMS cost report, Worksheet G-3).
Pets Allowed
Most residents typically stay for a few weeks or months before returning home or moving on.
New residents most often arrive under Medicare (46% of admissions), and a typical Medicare stay runs around 20 days.
Coverage residents most often arrive under.
Coverage residents most often leave under.
0.0 miles from city center
Estimated distance in miles from Howell's city center to The Willows at Howell's address, calculated via Google Maps.
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The information below is reported by the Michigan Department of Licensing and Regulatory Affairs (LARA).
| Chelsea Retirement Community | NH AL IL MC SNF | Chelsea | - | 172 | - | 13 | Studio / 1 Bed / 2 Bed / Cottage |
| Lourdes Senior Community | NH AL HOS IL MC SNF | Waterford Twp (Watkins-Pontiac Estates) | - | 80 | - | 8 | Studio / 1 Bed / 2 Bed |
| Bay Bluffs Emmet County Medical Care Facility | NH HOS MC SNF | Harbor Springs | - | 120 | - | 29 | - |
| Michigan Masonic Home | NH AL IL MC PC RC SNF | Alma | - | 124 | A+ | 67 | - |
| The Willows at Howell | NH ADC AL IL MC SNF | Howell | - | 39 | - | 78 | - |
The Willows at Howell is legally operated by Trilogy Healthcare of Livingston, LLC.
The Willows at Howell has a walk score of 78. Very walkable. Most errands can be accomplished on foot, and many essentials are within a short walk.
According to MI state health department records, The Willows at Howell's license number is AH470342721.
According to MI state health department records, The Willows at Howell's license expires on July 31, 2026.
The Willows at Howell's occupancy is 100%.
Yes, The Willows at Howell allows residents to bring their pets.
The Willows at Howell is registered as a for-profit in MI.
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