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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.
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.
Managing 16 dementia units and 50 behavioral health units, The Seasons at Alexandria is a 66-bed nonprofit senior community that integrates skilled nursing, assisted living, and physical rehabilitation. The property serves a patient base that averages a 102-day length of stay, relying heavily on a combination of private-pay admissions (65%) and Medicare coverage (34%). While local building utilization stays stable at an 87% occupancy rate, commercial data points to immense operational stress. The business recorded a $3.7 million net operating loss in 2023 despite pulling in a high $35.7 million in gross revenue, with management keeping its payroll allocation down to just 36.1% of overall funding.
Critical front-line staffing shortages and serious historical regulatory fines stand out in public health databases, alongside mixed clinical outcomes. Daily direct nursing care lines average 1 hour and 11 minutes per resident, ranking the facility last out of 184 homes statewide across Kentucky, while weekend registered nurse hours drop slightly to 1 hour and 10 minutes. On the compliance side, state records note 17 total citations since 2019, featuring five critical and two serious deficiencies alongside a massive $226,000 federal financial penalty issued in June 2024.
A more recent August 2025 inspection logged four moderate, subsequently resolved points involving infection protocols, nutrition, and pharmacy tracking. While permanent resident files show solid skin care management, short-term post-acute recovery charts flag an elevated 1.7% major injury fall rate during active rehabilitation.
Prospective residents evaluating regional behavioral health options or short-term physical therapy placements can examine these state monitoring logs to weigh the provider’s current workloads. Since the public paperwork documents substantial historical financial penalties, low permanent-resident mobility preservation, and the thinnest daily nursing hours in the state alongside stable local building occupancy, the files outline a facility facing acute structural and care delivery challenges.
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.
This home is ranked 184th out of 184 homes in Kentucky for nurse hours. 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.
| 40m per day | ▼ 13% 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.
| 1h 5m per day | ▲ 33% State avg: 49m 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 56m per day | ▲ 20% State avg: 2h 26m 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.
| 4h 19m per day | ▲ 23% State avg: 3h 30m 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.
| 5m per day | ▲ 16% 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.
| 27m per day | ▼ 13% State avg: 31m per day · National avg: 28m per day |
Higher than the Kentucky average: 81.3%The Seasons at Alexandria is administrated by Reva Stroud.
In Kentucky, the Cabinet for Health and Family Services, Office of Inspector General is the regulatory authority that conducts inspections and investigates complaints in all long-term care homes.
This scorecard compares key inspection, citation, and complaint metrics at this facility against the Kentucky state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.
Deficiencies
| This Facility | KY Average | vs. KY Avg |
|---|---|---|---|
|
Total deficiencies
Formal regulatory issues recorded by inspectors across all inspection types.
| 19 | 6 | This facility has 217% more total deficiencies than a typical Kentucky nursing home (19 vs. KY avg 6).↑ 217% worse |
|
Deficiencies per year
Average deficiencies per year since 2019.
| 2.7 | 0.9 | This facility has 200% more deficiencies per year than a typical Kentucky nursing home (2.7 vs. KY avg 0.9).↑ 200% worse |
|
Deficiencies per inspection
Average deficiencies per inspection.
| 3.8 | 2 | This facility has 90% more deficiencies per inspection than a typical Kentucky nursing home (3.8 vs. KY avg 2).↑ 90% worse |
Inspections
| This Facility | KY Average | vs. KY Avg |
|---|---|---|---|
|
Total inspections
Combined count of all routine and focused inspections. Excludes complaint investigations.
| 5 | 3 | This facility has 67% more total inspections than a typical Kentucky nursing home (5 vs. KY avg 3).↑ 67% worse |
Kentucky average 2.9
Last Health inspection on Aug 2025
Kentucky average 13.5
Kentucky average 4.4
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
11 of 17 citations resulted from standard inspections; 5 of 17 resulted from complaint investigations; and 1 of 17 came from combined inspections (standard and complaint).
355% worse than Kentucky averageKentucky average: 1.1
233% worse than Kentucky averageKentucky average: 0.6
Corrected
Corrected
Corrected
Corrected
Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.
38% more staff per resident than Kentucky average
9% better than Kentucky average
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Manages medical care and health needs.
13 total: 12 full-time employees and 1 contractor.
13
Average shift length. Calculated as total hours divided by days worked and average staff per day.
11.7 hoursAssists with medical care and medications.
51 total: 22 full-time employees and 29 contractors.
51
Average shift length. Calculated as total hours divided by days worked and average staff per day.
11.4 hoursHelps with daily care and mobility.
120 total: 82 full-time employees and 38 contractors.
120
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.7 hours
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors
6,802 contractor hours this quarter
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
| Certified Nursing Assistant | 82 | 38 | 120 | 24,641 | 92 | 100% | 9.7 |
| Licensed Practical Nurse | 22 | 29 | 51 | 8,411 | 92 | 100% | 11.4 |
| Registered Nurse | 12 | 1 | 13 | 3,763 | 92 | 100% | 11.7 |
| Clinical Nurse Specialist | 5 | 0 | 5 | 1,788 | 87 | 95% | 8.9 |
| Medication Aide/Technician | 14 | 1 | 15 | 1,639 | 88 | 96% | 10.6 |
| RN Director of Nursing | 3 | 0 | 3 | 1,370 | 67 | 73% | 9 |
| Other Dietary Services Staff | 4 | 0 | 4 | 1,163 | 74 | 80% | 6.5 |
| Physical Therapy Aide | 0 | 6 | 6 | 891 | 87 | 95% | 6.2 |
| Physical Therapy Assistant | 0 | 3 | 3 | 733 | 70 | 76% | 5.8 |
| Respiratory Therapy Technician | 0 | 4 | 4 | 692 | 78 | 85% | 5 |
| Speech Language Pathologist | 0 | 3 | 3 | 501 | 70 | 76% | 6.4 |
| Administrator | 1 | 0 | 1 | 488 | 61 | 66% | 8 |
| Occupational Therapy Aide | 1 | 0 | 1 | 472 | 59 | 64% | 8 |
| Therapeutic Recreation Specialist | 0 | 1 | 1 | 455 | 60 | 65% | 7.6 |
| Nurse Practitioner | 1 | 0 | 1 | 448 | 56 | 61% | 8 |
| Qualified Social Worker | 0 | 2 | 2 | 356 | 64 | 70% | 5.6 |
| Occupational Therapy Assistant | 0 | 1 | 1 | 76 | 54 | 59% | 1.4 |
| Medical Director | 0 | 1 | 1 | 45 | 9 | 10% | 5 |
Includes penalties issued in 2024
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 (Data as of Jan 2026)
259% higher than Kentucky averageKentucky average: $63K
57% fewer fines than Kentucky averageKentucky average: 2.3
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
0
100% fewer payment denials than Kentucky averageKentucky average: 0.3
Penalties are imposed by CMS for violations of federal nursing home regulations.
1 penalty in the past 3 years
Jun 6, 2024 · $226K
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Jun 6, 2024Last updated: Jan 2026
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.
9.6
8% better than Kentucky averageKentucky average: 10.5
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
21.9
16% worse than Kentucky averageKentucky average: 18.9
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
19.1%
14% worse than Kentucky averageKentucky average: 16.8%
Percent of long-stay residents whose ability to move independently worsened
18.3%
7% better than Kentucky averageKentucky average: 19.6%
Percent of low risk long-stay residents who lose control of their bowels or bladder
28.3%
38% worse than Kentucky averageKentucky average: 20.5%
Percent of long-stay residents experiencing one or more falls with major injury
2.8%
24% better than Kentucky averageKentucky average: 3.8%
Percent of long-stay high risk residents with pressure ulcers
2.1%
63% better than Kentucky averageKentucky average: 5.8%
Percent of long-stay residents with a urinary tract infection
0.9%
54% better than Kentucky averageKentucky average: 1.9%
Percent of long-stay residents who lose too much weight
5.7%
16% better than Kentucky averageKentucky average: 6.8%
Percent of long-stay residents who have depressive symptoms
15.0%
5% worse than Kentucky averageKentucky average: 14.3%
Percent of long-stay residents who received an antipsychotic medication
18.7%
20% worse than Kentucky averageKentucky average: 15.6%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
99.7%
6% better than Kentucky averageKentucky average: 93.9%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
90.4%
6% worse than Kentucky averageKentucky average: 96.2%
Number of hospitalizations per 1,000 long-stay resident days.
2.01
7% worse than Kentucky averageKentucky average: 1.87
Number of outpatient emergency department visits per 1,000 long-stay resident days.
1.46
33% better than Kentucky averageKentucky average: 2.19
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
98.9%
18% better than Kentucky averageKentucky average: 83.7%
Percent of short-stay residents who newly received an antipsychotic medication
1.5%
20% better than Kentucky averageKentucky average: 1.9%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
98.7%
18% better than Kentucky averageKentucky average: 83.6%
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
15.2%
38% better than Kentucky averageKentucky average: 24.5%
Percentage of short-stay residents who had an outpatient emergency department visit.
9.3%
33% better than Kentucky averageKentucky average: 13.9%
Percentage of SNF residents who experience falls with major injury during their stay.
1.7%
117% worse than Kentucky averageKentucky average: 0.8%
Percentage of residents at or above expected ability to care for themselves at discharge.
47.4%
12% worse than Kentucky averageKentucky average: 53.7%
Rate of successful return to home or community from a skilled nursing facility.
60.7%
20% better than Kentucky averageKentucky average: 50.6%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
34% of new residents, usually for short-term rehab.
65% of new residents, often for short stays.
2% of new residents, often for long-term daily care.
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
99Residents 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 The Seasons at Alexandria based on CMS SNF Cost Reports.
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Rank #5 / 188Payroll — State benchmarkedThis home is ranked 5th out of 188 homes in Kentucky. Shows total annual staff payroll benchmarked to the Kentucky average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
Residents typically stay for brief periods, with frequent admissions and discharges throughout the year.
0.0 miles from city center
Estimated distance in miles from Alexandria's city center to The Seasons at Alexandria's address, calculated via Google Maps.
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The Seasons at Alexandria is located in ALEXANDRIA, Kentucky.
Here are the financial assistance programs available to residents in Kentucky.
The Seasons at Alexandria has a walk score of 50. Moderately walkable. Some errands can be accomplished on foot, with a mix of nearby amenities.
According to KY state health department records, The Seasons at Alexandria's license number is 100055.
According to KY state health department records, The Seasons at Alexandria's license expires on July 30, 2026.
The Seasons at Alexandria's occupancy is 100%.
Reva Stroud is the administrator of The Seasons at Alexandria.
The Seasons at Alexandria has 66 beds.
Yes — there are 7 photos of The Seasons at Alexandria in the photo gallery on this page.
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