4/5
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.
4/5
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.
Operated by Country Club Gardens, LLC under owner Amanda Levato and administrator Erica Wacaster, Lake Hamilton Health and Rehab is a skilled nursing facility in Hot Springs, Arkansas. The home accepts Medicare, Medicaid, and private pay, giving families several ways to cover both short-term rehabilitation and longer-term nursing care. The facility has 84 beds, with 89% occupancy, so there’s a substantial but manageable community.
Residents stay an average of about 136 days, including those receiving post-acute rehabilitation and ongoing nursing support. Rehabilitation services are a central part of the facility’s care model. A doctor is on staff, and a dedicated rehabilitation gym supports therapy programs.
Nurse staffing averages 4 hours and 43 minutes of nursing care each day. Also, there’s 24-hour staffing and around-the-clock physician services, which means clinical coverage is consistent and responsive.
Residents’ daily lives are about comfort and independence. Semi-private rooms include partial dividing walls, individual window access, and personal heating and air controls, giving residents and families a greater sense of privacy and choice.
Dining follows a restaurant-style approach with fine cuisine, fresh fruits and vegetables, and a variety of entrées and desserts prepared on site. Activities are built around residents’ interests rather than a fixed schedule. Housekeeping, laundry services, beauty salon services, and free wireless Internet are also available. The neighborhood’s Walk Score is 81, so the area is highly walkable for visiting family members and mobile residents.
Inspection records have highlighted issues related to infection control, medication safety practices, and staffing continuity. Families touring the facility should ask how those operational areas are managed as part of daily care. With rehabilitation services, ongoing nursing support, and amenities focused on resident comfort, Lake Hamilton is worth considering.
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.
|
16m per day | ▼ 32% State avg: 24m 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.
|
1h 13m per day | ▲ 28% State avg: 57m 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.
|
2h 42m per day | ■ Avg State avg: 2h 43m 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 9m per day | ▼ 9% State avg: 3h 29m 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.
|
2m per day | ▼ 19% State avg: 2m 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.
|
10m per day | ▼ 36% State avg: 16m per day · National avg: 28m per day |
Higher than the Arkansas average: 71.3%
Lake Hamilton Health and Rehab is legally operated by Country Club Gardens, LLC, and administered by Erica Wacaster.
In Arkansas, the Department of Human Services, Office of Long Term Care is authorized to conduct unannounced inspections and issue official quality of care reports for all senior living providers.
This scorecard compares key inspection, deficiency, and complaint metrics at this facility against the Arkansas state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.
Deficiencies
|
This Facility | AR Average | vs. AR Avg |
|---|---|---|---|
|
Total deficiencies
Formal regulatory issues recorded by inspectors across all inspection types.
|
22 | 21 | This facility has 5% more total deficiencies than a typical Arkansas nursing home (22 vs. AR avg 21).↑ 5% worse |
|
Deficiencies per year
Average deficiencies per year since 2023.
|
7.3 | 7 | This facility has 4% more deficiencies per year than a typical Arkansas nursing home (7.3 vs. AR avg 7).↑ 4% worse |
An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.
Arkansas average 4.2
Last Health inspection on May 2025
Arkansas average 21.8
Arkansas average 5.32
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
All 22 citations resulted from standard inspections.
100% better than Arkansas average
Arkansas average: 0.4
100% better than Arkansas average
Arkansas average: 0.2
Corrected
Corrected
Corrected
Corrected
Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.
10% more staff per resident than Arkansas average
0% compared with Arkansas average
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Manages medical care and health needs.
All 2 RN Staff are full-time employees. No contractors work on this role.
2
Average shift length. Calculated as total hours divided by days worked and average staff per day.
10.1 hours
Assists with medical care and medications.
All 19 LPN Staff are full-time employees. No contractors work on this role.
19
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.4 hours
Helps with daily care and mobility.
All 58 CNA Staff are full-time employees. No contractors work on this role.
58
Average shift length. Calculated as total hours divided by days worked and average staff per day.
7.7 hours
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors
2,318 contractor hours this quarter
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
| Certified Nursing Assistant | 58 | 0 | 58 | 15,799 | 92 | 100% | 7.7 |
| Licensed Practical Nurse | 19 | 0 | 19 | 6,764 | 92 | 100% | 9.4 |
| Medication Aide/Technician | 6 | 0 | 6 | 2,504 | 92 | 100% | 8.2 |
| RN Director of Nursing | 3 | 0 | 3 | 1,507 | 67 | 73% | 7.9 |
| Clinical Nurse Specialist | 4 | 1 | 5 | 1,206 | 88 | 96% | 7.6 |
| Physical Therapy Aide | 0 | 4 | 4 | 721 | 68 | 74% | 5.5 |
| Speech Language Pathologist | 0 | 7 | 7 | 581 | 71 | 77% | 4.2 |
| Occupational Therapy Aide | 1 | 1 | 2 | 567 | 66 | 72% | 7.3 |
| Administrator | 1 | 0 | 1 | 528 | 66 | 72% | 8 |
| Nurse Practitioner | 1 | 0 | 1 | 528 | 66 | 72% | 8 |
| Dental Services Staff | 1 | 0 | 1 | 505 | 63 | 68% | 8 |
| Dietitian | 1 | 0 | 1 | 445 | 57 | 62% | 7.8 |
| Qualified Social Worker | 0 | 1 | 1 | 292 | 63 | 68% | 4.6 |
| Respiratory Therapy Technician | 0 | 5 | 5 | 184 | 57 | 62% | 2.2 |
| Nurse Aide in Training | 3 | 0 | 3 | 148 | 14 | 15% | 7 |
| Registered Nurse | 2 | 0 | 2 | 131 | 13 | 14% | 10.1 |
| Other Dietary Services Staff | 1 | 0 | 1 | 65 | 10 | 11% | 6.5 |
| Physical Therapy Assistant | 0 | 4 | 4 | 52 | 35 | 38% | 1.3 |
| Occupational Therapy Assistant | 0 | 1 | 1 | 23 | 3 | 3% | 7.5 |
| Medical Director | 0 | 1 | 1 | 12 | 3 | 3% | 4 |
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.
7.5
In line with Arkansas average
Arkansas average: 7.7
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
15.9
19% worse than Arkansas average
Arkansas average: 13.3
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
7.0%
39% better than Arkansas average
Arkansas average: 11.5%
Percent of long-stay residents whose ability to move independently worsened
24.3%
82% worse than Arkansas average
Arkansas average: 13.4%
Percent of low risk long-stay residents who lose control of their bowels or bladder
16.3%
8% worse than Arkansas average
Arkansas average: 15.1%
Percent of long-stay residents experiencing one or more falls with major injury
2.1%
47% better than Arkansas average
Arkansas average: 3.9%
Percent of long-stay high risk residents with pressure ulcers
3.0%
36% better than Arkansas average
Arkansas average: 4.7%
Percent of long-stay residents with a urinary tract infection
0.4%
67% better than Arkansas average
Arkansas average: 1.3%
Percent of long-stay residents who lose too much weight
1.0%
80% better than Arkansas average
Arkansas average: 5.0%
Percent of long-stay residents who have depressive symptoms
0.0%
100% better than Arkansas average
Arkansas average: 1.5%
Percent of long-stay residents who received an antipsychotic medication
1.2%
88% better than Arkansas average
Arkansas average: 10.5%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
98.4%
In line with Arkansas average
Arkansas average: 94.4%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
100.0%
In line with Arkansas average
Arkansas average: 96.2%
Number of hospitalizations per 1,000 long-stay resident days.
1.50
24% better than Arkansas average
Arkansas average: 1.97
Number of outpatient emergency department visits per 1,000 long-stay resident days.
0.51
77% better than Arkansas average
Arkansas average: 2.18
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
99.5%
23% better than Arkansas average
Arkansas average: 80.9%
Percent of short-stay residents who newly received an antipsychotic medication
0.8%
51% better than Arkansas average
Arkansas average: 1.5%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
9.2%
88% worse than Arkansas average
Arkansas average: 77.7%
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
19.8%
21% better than Arkansas average
Arkansas average: 25.2%
Percentage of short-stay residents who had an outpatient emergency department visit.
7.0%
49% better than Arkansas average
Arkansas average: 13.8%
Percentage of SNF residents who experience falls with major injury during their stay.
0.0%
100% better than Arkansas average
Arkansas average: 0.8%
Percentage of residents at or above expected ability to care for themselves at discharge.
40.2%
25% worse than Arkansas average
Arkansas average: 53.7%
Rate of successful return to home or community from a skilled nursing facility.
51.7%
In line with Arkansas average
Arkansas average: 50.6%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
69% of new residents, usually for short-term rehab.
30% of new residents, often for short stays.
1% of new residents, often for long-term daily care.
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
72
Residents meet regularly to discuss policies, care quality, 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 Lake Hamilton Health and Rehab from 2012–2023, based on CMS SNF Cost Reports.
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.
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.
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).
Most residents typically stay for a few weeks or months before returning home or moving on.
Most new residents arrive under Medicare (69% of admissions), and a typical Medicare stay runs around 2 - 3 months.
Coverage residents most often arrive under.
Coverage residents most often leave under.
0.0 miles from city center
Estimated distance in miles from Hot Springs's city center to Lake Hamilton Health and Rehab's address, calculated via Google Maps.
Add your location
The information below is reported by the Arkansas Department of Human Services, Office of Long Term Care.
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|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Quapaw Care and Rehabilitation Center, LLC |
NH
RC
|
Hot Springs |
126
Facility
126
AR AVG
84
Rank
#50 / 330
| 81.0% | +14% | 5.72 | -67% | +22% | $0 | 25 | 8.3 | - | 92 | - |
81
Facility
81
AR AVG
34
Rank
#1 / 419
| Cindy Farmer | $12.0M | $5.5M | 45.6% | 45338 | ||||
| Lake Hamilton Health and Rehab |
NH
NC
|
Hot Springs |
84
Facility
84
AR AVG
84
Rank
#176 / 330
| 88.5% | +24% | 4.72 | -71% | +1% | $0 | 22 | 7.3 | - | 74 | - |
81
Facility
81
AR AVG
34
Rank
#1 / 419
| Amanda Levato | $9.9M | $3.6M | 37% | 45445 | ||||
| The Springs of Park Avenue |
NH
HC
MC
PC
|
Hot Springs |
95
Facility
95
AR AVG
84
Rank
#151 / 330
| 73.1% | +3% | 4.27 | +38% | -9% | $0 | 23 | 5.8 | - | 76 | - |
17
Facility
17
AR AVG
34
Rank
#307 / 419
| Stacy Luster | $9.4M | $3.4M | 36% | 45142 | ||||
| Lakewood Therapy and Living Center |
NH
|
Hot Springs |
80
Facility
80
AR AVG
84
Rank
#186 / 330
| 57.5% | -19% | 4.93 | -54% | +6% | $14.9k | 24 | 4.0 | 1 | 51 | A+ |
4
Facility
4
AR AVG
34
Rank
#373 / 419
| - | $4.4M | $2.1M | 47.1% | 45404 | ||||
| Belvedere Nursing and Rehabilitation Center, LLC |
NH
|
Hot Springs |
120
Facility
120
AR AVG
84
Rank
#59 / 330
| 95.0% | +33% | 4.66 | -74% | 0% | $206.9k | 25 | 5.0 | 3 | 118 | - |
0
Facility
0
AR AVG
34
Rank
#405 / 419
| Belvedere Nursing And Rehabilitation Center, LLC | $15.5M | $5.8M | 37.5% | 45463 |
Lake Hamilton Health and Rehab is located in Hot Springs, Arkansas.
Here are the financial assistance programs available to residents in Arkansas.
Lake Hamilton Health and Rehab is legally operated by Country Club Gardens, LLC, and administered by Erica Wacaster.
Lake Hamilton Health and Rehab has a walk score of 81. Very walkable. Most errands can be accomplished on foot, and many essentials are within a short walk.
Lake Hamilton Health and Rehab's occupancy is 89%.
Lake Hamilton Health and Rehab is registered as a for-profit in AR.
Erica Wacaster is the administrator of Lake Hamilton Health and Rehab.
Lake Hamilton Health and Rehab has 84 beds.
Yes — there are 4 photos of Lake Hamilton Health and Rehab in the photo gallery on this page.
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