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 3P Partners, LLC, Twin Rivers Health and Rehabilitation is a nursing home in Arkadelphia, Arkansas, owned by Christina Avery and administered by Nicolai Murusiak. The facility is located on Twin Rivers Drive in a highly walkable area with a Walk Score of 75, where most errands can be handled on foot and nearby services are easily accessible. The home has been operating for 41 years.
The facility has 112 beds and currently serves 73 residents. Residents stay an average of 136 days. There’s a mix of short-term rehabilitation residents and those receiving longer-term skilled nursing care. Medicaid, Medicare, and private pay are accepted, giving families several options when arranging coverage for rehabilitation stays and ongoing care.
Rehabilitation services are a central part of the home’s care model. Respite care is available as well. Around-the-clock staffing and on-site physician support are part of daily operations.
Residents receive an average of 4 hours and 34 minutes of nursing care each day. That total includes about 2 hours and 45 minutes of nursing aide care, 34 minutes of registered nurse care, and 50 minutes of licensed practical or vocational nursing support. Outpatient services are also available for residents with ongoing recovery needs.
The location is one of the facility’s notable features. Family members visiting regularly can reach many nearby services while walking. The surrounding neighborhood offers convenient access to local amenities, so visitors can stay close to the community.
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.
| 34m 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.
| 50m 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 45m 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 33m 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 | |
|
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.
| 26m 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.
Lower than the Arkansas average: 71.3%Twin Rivers Health and Rehabilitation is legally operated by 3P Partners, LLC, and administered by Nicolai Murusiak.
Key information about the people who lead and staff this community.
State average N/A
Last Health inspection on Aug 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.
19 of 21 citations resulted from standard inspections; and 2 of 21 resulted from complaint investigations.
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 6 RN Staff are full-time employees. No contractors work on this role.
6
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.2 hoursAssists with medical care and medications.
All 11 LPN Staff are full-time employees. No contractors work on this role.
11
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.6 hoursHelps with daily care and mobility.
All 39 CNA Staff are full-time employees. No contractors work on this role.
39
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.1 hours
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors
2,316 contractor hours this quarter
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
| Certified Nursing Assistant | 39 | 0 | 39 | 13,399 | 92 | 100% | 8.1 |
| Nurse Aide in Training | 18 | 0 | 18 | 4,091 | 92 | 100% | 7 |
| Licensed Practical Nurse | 11 | 0 | 11 | 3,714 | 92 | 100% | 9.6 |
| Registered Nurse | 6 | 0 | 6 | 2,064 | 92 | 100% | 9.2 |
| RN Director of Nursing | 3 | 0 | 3 | 1,589 | 73 | 79% | 8.2 |
| Clinical Nurse Specialist | 5 | 4 | 9 | 1,029 | 88 | 96% | 7.2 |
| Nurse Practitioner | 4 | 0 | 4 | 557 | 67 | 73% | 7.4 |
| Dietitian | 1 | 0 | 1 | 514 | 63 | 68% | 8.2 |
| Mental Health Service Worker | 1 | 0 | 1 | 500 | 65 | 71% | 7.7 |
| Administrator | 1 | 0 | 1 | 488 | 61 | 66% | 8 |
| Speech Language Pathologist | 0 | 1 | 1 | 483 | 64 | 70% | 7.5 |
| Physical Therapy Aide | 0 | 1 | 1 | 437 | 62 | 67% | 7.1 |
| Qualified Social Worker | 0 | 2 | 2 | 330 | 54 | 59% | 6.1 |
| Physical Therapy Assistant | 0 | 1 | 1 | 291 | 61 | 66% | 4.8 |
| Respiratory Therapy Technician | 0 | 2 | 2 | 242 | 51 | 55% | 4.8 |
| Medication Aide/Technician | 2 | 0 | 2 | 94 | 11 | 12% | 7.2 |
| Occupational Therapy Aide | 0 | 1 | 1 | 9 | 3 | 3% | 3 |
| Occupational Therapy Assistant | 0 | 1 | 1 | 9 | 3 | 3% | 2.8 |
| Medical Director | 0 | 1 | 1 | 6 | 3 | 3% | 2 |
Includes penalties issued in 2025
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)
52% lower than State averageState average: $26K
32% fewer fines than State averageState average: 1.5
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
0
100% fewer payment denials than State averageState average: 0.2
Penalties are imposed by CMS for violations of federal nursing home regulations.
1 penalty in the past 3 years
Aug 28, 2025 · $12K
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Aug 28, 2025Last 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.
6.3
18% better than State averageState average: 7.7
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
16.5
23% worse than State averageState average: 13.3
Percent of long-stay residents whose need for help with daily activities has increased
12.4%
8% worse than State averageState average: 11.5%
Percent of long-stay residents whose ability to move independently worsened
8.7%
35% better than State averageState average: 13.4%
Percent of low risk long-stay residents who lose control of their bowels or bladder
28.2%
87% worse than State averageState average: 15.1%
Percent of long-stay residents experiencing one or more falls with major injury
3.6%
9% better than State averageState average: 3.9%
Percent of long-stay high risk residents with pressure ulcers
5.6%
19% worse than State averageState average: 4.7%
Percent of long-stay residents with a urinary tract infection
0.8%
38% better than State averageState average: 1.3%
Percent of long-stay residents who lose too much weight
1.3%
74% better than State averageState average: 5.0%
Percent of long-stay residents who have depressive symptoms
1.8%
13% worse than State averageState average: 1.5%
Percent of long-stay residents who received an antipsychotic medication
0.4%
96% better than State averageState average: 10.5%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
98.8%
5% better than State averageState average: 94.4%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
100.0%
In line with State averageState average: 96.2%
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
96.4%
19% better than State averageState average: 80.9%
Percent of short-stay residents who newly received an antipsychotic medication
0.0%
100% better than State averageState average: 1.5%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
87.9%
13% better than State averageState average: 77.7%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
45% of new residents, usually for short-term rehab.
50% of new residents, often for short stays.
5% of new residents, often for long-term daily care.
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
72Residents 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 Twin Rivers Health and Rehabilitation from 2011–2023, 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.
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).
This home supports both short-term rehab and long-term care, with residents staying for a wide range of durations.
Most new residents arrive under private pay (50% of admissions), and a typical private pay 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 Arkadelphia's city center to Twin Rivers Health and Rehabilitation's address, calculated via Google Maps.
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The information below is reported by the Arkansas Department of Human Services, Office of Long Term Care.
| Indian Rock Village | NH | Fairfield Bay | - | 55 | - | 11 | Studio / 1 Bed / 2 Bed |
| Legacy Heights Nursing Home | NH RC SNF | Russellville (West 12Th Street) | - | 107 | A+ | 24 | - |
| Arkansas State Veterans Home | NH AL IL MC | North Little Rock (North Oaks) | - | 96 | - | 16 | - |
| Wood-Lawn Heights | NH AL IL PC SNF | Batesville (College Heights Addition) | - | 159 | - | 34 | - |
| Twin Rivers Health and Rehabilitation | NH RC SNF | Arkadelphia | - | 112 | A+ | 75 | - |
Twin Rivers Health and Rehabilitation is legally operated by 3P Partners, LLC, and administered by Nicolai Murusiak.
Twin Rivers Health and Rehabilitation has a walk score of 75. Very walkable. Most errands can be accomplished on foot, and many essentials are within a short walk.
Twin Rivers Health and Rehabilitation's occupancy is 65%.
Twin Rivers Health and Rehabilitation is registered as a for-profit in AR.
Nicolai Murusiak is the administrator of Twin Rivers Health and Rehabilitation.
Twin Rivers Health and Rehabilitation has 112 beds.
Yes — there are 3 photos of Twin Rivers Health and Rehabilitation in the photo gallery on this page.
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