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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.
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.
This home is ranked 103rd out of 133 homes in Michigan 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.
| 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 |
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, citation, 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 nursing home (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 nursing home (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.
Michigan average 6.5
Last Health inspection on Jan 2025
Michigan average 33.5
Michigan average 5.18
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).
100% better than Michigan averageMichigan average: 0.3
100% better than Michigan averageMichigan average: 1.9
Corrected
Corrected
Corrected
Corrected
Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.
0% compared with Michigan average
0% compared with Michigan average
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 Michigan averageMichigan average: 8.4
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
17.2
6% worse than Michigan averageMichigan 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 Michigan averageMichigan average: 12.5%
Percent of long-stay residents whose ability to move independently worsened
12.6%
18% better than Michigan averageMichigan average: 15.3%
Percent of low risk long-stay residents who lose control of their bowels or bladder
27.1%
29% worse than Michigan averageMichigan average: 21.0%
Percent of long-stay residents experiencing one or more falls with major injury
2.6%
19% better than Michigan averageMichigan average: 3.2%
Percent of long-stay high risk residents with pressure ulcers
0.0%
100% better than Michigan averageMichigan average: 5.7%
Percent of long-stay residents with a urinary tract infection
0.9%
48% better than Michigan averageMichigan average: 1.7%
Percent of long-stay residents who lose too much weight
6.9%
21% worse than Michigan averageMichigan average: 5.7%
Percent of long-stay residents who have depressive symptoms
2.9%
24% better than Michigan averageMichigan average: 3.9%
Percent of long-stay residents who received an antipsychotic medication
10.6%
29% better than Michigan averageMichigan average: 15.0%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
100.0%
5% better than Michigan averageMichigan average: 94.9%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
100.0%
5% better than Michigan averageMichigan average: 95.0%
Number of hospitalizations per 1,000 long-stay resident days.
2.54
46% worse than Michigan averageMichigan average: 1.74
Number of outpatient emergency department visits per 1,000 long-stay resident days.
2.99
94% worse than Michigan averageMichigan 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 Michigan averageMichigan average: 82.5%
Percent of short-stay residents who newly received an antipsychotic medication
0.0%
100% better than Michigan averageMichigan average: 1.4%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
99.0%
24% better than Michigan averageMichigan average: 79.5%
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
17.7%
27% better than Michigan averageMichigan average: 24.2%
Percentage of short-stay residents who had an outpatient emergency department visit.
7.4%
36% better than Michigan averageMichigan average: 11.5%
Percentage of SNF residents who experience falls with major injury during their stay.
0.0%
100% better than Michigan averageMichigan average: 0.8%
Percentage of residents at or above expected ability to care for themselves at discharge.
62.8%
17% better than Michigan averageMichigan average: 53.7%
Rate of successful return to home or community from a skilled nursing facility.
68.6%
36% better than Michigan averageMichigan 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 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 #54 / 134Payroll — State benchmarkedThis home is ranked 54th out of 134 homes in Michigan. 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.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.
Most residents typically stay for a few weeks or months before returning home or moving on.
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.
Add your location
The Willows at Howell is located in Howell, Michigan.
Here are the financial assistance programs available to residents in Michigan.
The information below is reported by the Michigan Department of Licensing and Regulatory Affairs (LARA).
| Friendship Village – Kalamazoo |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
IL Independent Living Lifestyle-focused communities for older adults offering dining, activities, and transportation with minimal personal care. Best for active, independent seniors who want community without medical support. | Kalamazoo | 57
Facility
57
MI AVG
75
Rank
#255 / 435 | - | - | 5.72
Facility
5.72
MI AVG
4.30
Rank
#7 / 133 | +80% | +33% | $0
Facility
$0
MI AVG
$87.6k
Rank
#1 / 136 | 21
Facility
21
MI AVG
33.5
Rank
#47 / 135 | 5.3
Facility
5.3
MI AVG
5.2
Rank
#76 / 135 | - | 50 | A+ |
7
Facility
7
MI AVG
39
Rank
#636 / 703 | Timothy Cain | $27.0M
Facility
$27.0M
MI AVG
$15.8M
Rank
#25 / 134 | $13.5M
Facility
$13.5M
MI AVG
$5.6M
Rank
#13 / 134 | 50.2%
Facility
50.2%
MI AVG
39%
Rank
#33 / 134 | 235248 | ||||
| The Willows at Howell |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Howell | 39
Facility
39
MI AVG
75
Rank
#298 / 435 |
100.0%
Facility
100.0%
MI AVG
75.8%
Rank
#1 / 386 | +32% | 3.73
Facility
3.73
MI AVG
4.30
Rank
#103 / 133 | +87% | -13% | $0
Facility
$0
MI AVG
$87.6k
Rank
#1 / 136 | 20
Facility
20
MI AVG
33.5
Rank
#40 / 135 | 4.0
Facility
4.0
MI AVG
5.2
Rank
#42 / 135 | - | 54 | - |
78
Facility
78
MI AVG
39
Rank
#36 / 703 | Jamie Scott | $14.5M
Facility
$14.5M
MI AVG
$15.8M
Rank
#75 / 134 | $7.6M
Facility
$7.6M
MI AVG
$5.6M
Rank
#54 / 134 | 52.7%
Facility
52.7%
MI AVG
39%
Rank
#25 / 134 | 235707 | ||||
| Allegria Village |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
IL Independent Living Lifestyle-focused communities for older adults offering dining, activities, and transportation with minimal personal care. Best for active, independent seniors who want community without medical support.
MC Memory Care Secured, specialized care for people living with Alzheimer's or dementia. Staff trained in cognitive impairment, with higher staff-to-resident ratios and an environment designed to reduce confusion and wandering risk. | Dearborn | 132
Facility
132
MI AVG
75
Rank
#55 / 435 |
53.0%
Facility
53.0%
MI AVG
75.8%
Rank
#176 / 386 | -30% | 4.72
Facility
4.72
MI AVG
4.30
Rank
#31 / 133 | -20% | +10% | $0
Facility
$0
MI AVG
$87.6k
Rank
#1 / 136 | 16
Facility
16
MI AVG
33.5
Rank
#28 / 135 | 3.2
Facility
3.2
MI AVG
5.2
Rank
#28 / 135 | 1 | 81 | D- |
52
Facility
52
MI AVG
39
Rank
#201 / 703 | Firo Operator LLC | $35.3M
Facility
$35.3M
MI AVG
$15.8M
Rank
#8 / 134 | $17.0M
Facility
$17.0M
MI AVG
$5.6M
Rank
#8 / 134 | 48.2%
Facility
48.2%
MI AVG
39%
Rank
#45 / 134 | 235593 | ||||
| Lynwood Manor |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
IL Independent Living Lifestyle-focused communities for older adults offering dining, activities, and transportation with minimal personal care. Best for active, independent seniors who want community without medical support.
MC Memory Care Secured, specialized care for people living with Alzheimer's or dementia. Staff trained in cognitive impairment, with higher staff-to-resident ratios and an environment designed to reduce confusion and wandering risk. | Adrian (Kimole Lane) | 84
Facility
84
MI AVG
75
Rank
#175 / 435 |
77.4%
Facility
77.4%
MI AVG
75.8%
Rank
#91 / 386 | +2% | 3.62
Facility
3.62
MI AVG
4.30
Rank
#111 / 133 | +5% | -16% | $23.8k
Facility
$23.8k
MI AVG
$87.6k
Rank
#92 / 136 | 40
Facility
40
MI AVG
33.5
Rank
#93 / 135 | 6.7
Facility
6.7
MI AVG
5.2
Rank
#97 / 135 | 1 | 70 | A+ |
12
Facility
12
MI AVG
39
Rank
#594 / 703 | Crg Lynwood Holdings LLC | $10.2M
Facility
$10.2M
MI AVG
$15.8M
Rank
#114 / 134 | $4.3M
Facility
$4.3M
MI AVG
$5.6M
Rank
#117 / 134 | 41.9%
Facility
41.9%
MI AVG
39%
Rank
#67 / 134 | 235182 | ||||
| Brittany Manor |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
IL Independent Living Lifestyle-focused communities for older adults offering dining, activities, and transportation with minimal personal care. Best for active, independent seniors who want community without medical support.
MC Memory Care Secured, specialized care for people living with Alzheimer's or dementia. Staff trained in cognitive impairment, with higher staff-to-resident ratios and an environment designed to reduce confusion and wandering risk. | Midland (East Ashman Street) | 138
Facility
138
MI AVG
75
Rank
#44 / 435 |
54.8%
Facility
54.8%
MI AVG
75.8%
Rank
#172 / 386 | -28% | 4.27
Facility
4.27
MI AVG
4.30
Rank
#44 / 133 | +26% | -1% | $0
Facility
$0
MI AVG
$87.6k
Rank
#1 / 136 | 20
Facility
20
MI AVG
33.5
Rank
#40 / 135 | 2.9
Facility
2.9
MI AVG
5.2
Rank
#14 / 135 | 4 | 91 | A+ |
13
Facility
13
MI AVG
39
Rank
#582 / 703 | Shannon Robinson | $21.9M
Facility
$21.9M
MI AVG
$15.8M
Rank
#44 / 134 | $7.3M
Facility
$7.3M
MI AVG
$5.6M
Rank
#62 / 134 | 33.2%
Facility
33.2%
MI AVG
39%
Rank
#111 / 134 | 235245 |
The legal owner and operator of The Willows at Howell is 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%.
The Willows at Howell has 39 beds.
Yes — there are 22 photos of The Willows at Howell in the photo gallery on this page.
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