Harbor Post Acute Center
2060 Health Drive, Wyoming, MI 49519 · Kent County · 65 certified beds · avg 61 residents/day · certified since Aug 1, 2018
Part of chain: AVON HEALTHCARE (9 facilities, chain avg rating 2.2★)
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★★☆☆☆2/5 · CMS overall rating: 3/5
The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and self-reported quality measures.
Most serious findings (actual harm or immediate jeopardy)
▲ Actual harm, one-off · Oct 8, 2024 · F-0686
The facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving.
Why it matters: Bedsores are painful, can become deeply infected, and in serious cases can be life-threatening.
Severity (G): One or a few residents were actually harmed — physically or emotionally — though not put in immediate danger of serious injury or death.
Corrected: Feb 10, 2025 (Deficient, Provider has date of correction)
All citations in the current public record (43)
CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.
| Date | Severity | What the facility was cited for |
|---|---|---|
| Jul 1, 2026 | E · Potential for harm, repeated | The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · from a complaint |
| Jan 14, 2026 | D · Potential for harm, one-off | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint |
| Dec 4, 2025 | E · Potential for harm, repeated | The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock. |
| Dec 4, 2025 | D · Potential for harm, one-off | The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines. · from a complaint |
| Dec 4, 2025 | D · Potential for harm, one-off | The facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own. · from a complaint |
| Dec 4, 2025 | D · Potential for harm, one-off | The facility did not provide appropriate care related to bladder and bowel needs — including care for residents who use catheters and steps to prevent urinary tract infections. |
| Dec 4, 2025 | D · Potential for harm, one-off | The facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist. |
| Oct 8, 2024 | ▲ G · Actual harm, one-off | The facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving. |
| Oct 8, 2024 | F · Potential for harm, facility-wide | The facility provided care that did not meet professional standards of quality — the accepted standards that nurses and other clinicians are expected to follow. |
| Oct 8, 2024 | F · Potential for harm, facility-wide | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. |
| Oct 8, 2024 | E · Potential for harm, repeated | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. |
| Oct 8, 2024 | E · Potential for harm, repeated | The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it. |
| Oct 8, 2024 | E · Potential for harm, repeated | The facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist. |
| Oct 8, 2024 | D · Potential for harm, one-off | The facility did not allow residents to take their own medications when a clinical review showed they could do so safely. Residents have this right if their care team determines it's appropriate. |
| Oct 8, 2024 | D · Potential for harm, one-off | The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. |
| Oct 8, 2024 | D · Potential for harm, one-off | The facility did not try to gradually reduce doses of mood- and mind-altering medications or use non-drug approaches first, as required, or used 'as needed' psychiatric drugs without proper limits. |
| Oct 8, 2024 | D · Potential for harm, one-off | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. |
| May 21, 2024 | F · Potential for harm, facility-wide | The facility did not give residents important notices in a format and language they can understand — for example, translated documents or accessible formats for those with vision or hearing loss. · from a complaint |
| May 21, 2024 | F · Potential for harm, facility-wide | The facility required residents to give up Medicare or Medicaid benefits or pay privately as a condition of moving in, or failed to tell residents which types of care it does not provide. Both practices are against the rules. · from a complaint |
| May 21, 2024 | F · Potential for harm, facility-wide | The facility transferred or discharged a resident without a valid reason, or failed to provide the required documentation and information when moving a resident out. · from a complaint |
| May 21, 2024 | F · Potential for harm, facility-wide | The facility did not give residents (and their representatives and the ombudsman, a state advocate for residents) proper advance notice before a transfer or discharge, including information about their right to appeal. · from a complaint |
| May 21, 2024 | F · Potential for harm, facility-wide | The facility did not give the resident or their representative written notice of how long it would hold the resident's bed during a hospital stay or approved leave. · from a complaint |
| May 21, 2024 | D · Potential for harm, one-off | The facility did not allow a resident's chosen representative — often a family member or someone with power of attorney — to exercise the resident's rights on their behalf. When a resident can't speak for themselves, their representative steps into that role. · from a complaint |
| May 21, 2024 | D · Potential for harm, one-off | The facility did not give residents information about how to apply for and use Medicare and Medicaid benefits. · from a complaint |
| May 21, 2024 | D · Potential for harm, one-off | The facility did not let a resident return after a hospital stay or approved leave that lasted longer than the facility's bed-hold policy allowed. Residents generally have the right to come back to the next available bed. · from a complaint |
| May 21, 2024 | D · Potential for harm, one-off | The facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving. · from a complaint |
| Jan 17, 2024 | D · Potential for harm, one-off | The facility did not treat residents with dignity and respect, or did not honor their rights to make their own decisions and communicate freely. This is one of the most fundamental resident rights. · from a complaint |
| Oct 6, 2023 | F · Potential for harm, facility-wide | The facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock. |
| Oct 6, 2023 | F · Potential for harm, facility-wide | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. |
| Oct 6, 2023 | F · Potential for harm, facility-wide | The facility did not electronically submit complete and accurate staffing information to the government, based on payroll and other verifiable records. |
| Oct 6, 2023 | E · Potential for harm, repeated | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. |
| Oct 6, 2023 | D · Potential for harm, one-off | The facility did not honor residents' rights to request, refuse, or stop treatment, to decline participation in medical research, or to make an advance directive — a written statement of their wishes for future medical care. |
| Oct 6, 2023 | D · Potential for harm, one-off | The facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation. |
| Oct 6, 2023 | D · Potential for harm, one-off | The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines. |
| Oct 6, 2023 | D · Potential for harm, one-off | The facility did not develop a resident's complete plan of care within 7 days of the full assessment, or the plan wasn't prepared, reviewed, and updated by a team of health professionals as required. |
| Oct 6, 2023 | D · Potential for harm, one-off | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. |
| Oct 6, 2023 | D · Potential for harm, one-off | The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it. |
| Oct 6, 2023 | D · Potential for harm, one-off | The facility did not have a licensed pharmacist review each resident's complete medication regimen and medical chart every month, or did not follow its own rules for reporting medication problems. |
| Oct 6, 2023 | D · Potential for harm, one-off | The facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards. |
| Oct 6, 2023 | D · Potential for harm, one-off | The facility did not have a working call system — the button or cord residents use to summon help — in each resident's bathroom and bathing area. |
| Sep 21, 2023 | D · Potential for harm, one-off | The facility did not honor residents' right to voice complaints without discrimination or retaliation, or did not have a working complaint process that resolves issues promptly. · from a complaint |
| Sep 21, 2023 | D · Potential for harm, one-off | The facility did not respond appropriately to alleged violations, such as reports of abuse, neglect, or mistreatment. Facilities must investigate every allegation and protect residents while they do. · from a complaint |
| Sep 21, 2023 | D · Potential for harm, one-off | The facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist. · from a complaint |
Inspection trend by year
Citations from standard inspections decreased between the last two inspection cycles (10 → 5).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 16 | 0 | F |
| 2024 | 20 | 1 | G ▲ |
| 2025 | 5 | 0 | E |
| 2026 | 2 | 0 | E |
Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.
Fines and enforcement (last 3 years)
20 fines totaling $112,195, plus 1 Medicare payment denial period.
| Date | Type | Amount / length |
|---|---|---|
| Oct 8, 2024 | Payment Denial | 96 days from Nov 6, 2024 |
| Feb 20, 2024 | Fine | $4,938 |
| Feb 12, 2024 | Fine | $4,938 |
| Jan 22, 2024 | Fine | $14,814 |
| Jan 8, 2024 | Fine | $4,938 |
| Jan 2, 2024 | Fine | $4,587 |
| Dec 11, 2023 | Fine | $13,762 |
| Nov 20, 2023 | Fine | $4,587 |
| Nov 13, 2023 | Fine | $4,587 |
| Nov 6, 2023 | Fine | $4,587 |
| Oct 30, 2023 | Fine | $4,587 |
| Oct 23, 2023 | Fine | $4,587 |
| Oct 17, 2023 | Fine | $4,587 |
| Oct 10, 2023 | Fine | $4,587 |
| Oct 2, 2023 | Fine | $4,587 |
| Sep 25, 2023 | Fine | $4,587 |
| Sep 18, 2023 | Fine | $4,587 |
| Sep 11, 2023 | Fine | $4,587 |
| Sep 5, 2023 | Fine | $4,587 |
| Aug 28, 2023 | Fine | $4,587 |
| Aug 21, 2023 | Fine | $4,587 |
Nurse staffing (from payroll records, adjusted for how much care residents need)
| Measure | This facility | Michigan avg | U.S. avg | Where it stands |
|---|---|---|---|---|
| Total nurse staffing (hours per resident per day) | 4.54 | 4.32 | 3.95 | top 27% in Michigan; top 22% in the U.S. |
| Registered Nurse hours | 1.04 | 0.84 | 0.69 | top 22% in Michigan; top 14% in the U.S. |
| Weekend total nurse staffing | 3.85 | 3.79 | 3.50 | top 34% in Michigan; top 28% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.83 | 0.49 | 0.48 | top 10% in Michigan; top 10% in the U.S. |
| Total nursing staff turnover (%) | 58.9 | 44.1 | 45.8 | bottom 12% in Michigan; bottom 18% in the U.S. |
| RN turnover (%) | 50.0 | 39.2 | 42.9 | bottom 32% in Michigan; bottom 39% in the U.S. |
Hours are per resident per day, case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 4.75, RN 1.09, weekend 4.03. Staffing rating: 4/5.
Self-reported quality measures
Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.
Quality measures rating: 5/5 · long-stay residents: 5/5 · short-stay residents: 5/5
Who owns this facility
For profit - Corporation
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Gottlieb, Moshe | Individual | 5% or Greater Indirect Ownership Interest | 48% | 05/01/2025 |
| Hpac Mi LLC | Organization | 5% or Greater Direct Ownership Interest | 100% | 05/01/2025 |
| 2060 Health Drive LLC | Organization | ADP of the SNF | NOT APPLICABLE | 05/01/2025 |
| Bowers, Bryanna | Individual | Operational/Managerial Control | NOT APPLICABLE | 06/11/2025 |
| Bowers, Bryanna | Individual | ADP of the SNF | NOT APPLICABLE | 06/11/2025 |
| Freund, Eliyahu | Individual | Managing Control - Governing Body | NOT APPLICABLE | 05/01/2025 |
| Freund, Eliyahu | Individual | ADP of the SNF | NOT APPLICABLE | 05/01/2025 |
| Gottlieb, Moshe | Individual | ADP of the SNF | NOT APPLICABLE | 05/01/2025 |
| Harbor Avon Management | Organization | Operational/Managerial Control | NOT APPLICABLE | 05/01/2025 |
| Harbor Avon Management | Organization | ADP of the SNF | NOT APPLICABLE | 05/01/2025 |
| Harbor Post Acute Realty | Organization | ADP of the SNF | NOT APPLICABLE | 05/01/2025 |
| Miller, Erin | Individual | Operational/Managerial Control | NOT APPLICABLE | 08/21/2024 |
| Wiltrakis, Michael | Individual | Operational/Managerial Control | NOT APPLICABLE | 12/01/2021 |
| Wiltrakis, Michael | Individual | ADP of the SNF | NOT APPLICABLE | 07/23/2025 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "How do you prevent bedsores for residents who can't move themselves, and how often are at-risk residents repositioned?"
- "How do you make sure each resident's care follows the doctor's orders, and what changed after this citation?"
- "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
- "Can you show me how medications are stored and secured on the units, including controlled drugs?"
- "Can you show me an example care plan, and how are families included when it's created and updated?"
- "How many aides are on each shift, and how do you make sure every resident gets timely help with bathing, dressing, and meals?"
- "How do you care for residents with incontinence or catheters, and what do you do to prevent urinary tract infections?"
- "How does your pharmacist review residents' medications, and how quickly can you fill new or urgent prescriptions?"
- "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
- "Can I see the results and plan of correction from your most recent state inspection?"
Nearby facilities (within 20 miles)
| Facility | Distance | City | Overall | Inspection | Flags |
|---|---|---|---|---|---|
| Optalis Health & Rehabilitation of Wyoming | 1.2 mi | Wyoming, MI | ★☆☆☆☆ | 1/5 | |
| Medilodge of Wyoming | 2.6 mi | Wyoming, MI | ★★★★★ | 5/5 | |
| Mission Point Nursing & Physical Rehabilitation Ce | 2.9 mi | Grandville, MI | ★☆☆☆☆ | 1/5 | |
| Corewell Health Rehabilitation & Nursing Center - | 4.1 mi | Grand Rapids, MI | ★★★★★ | 4/5 | |
| Optalis Health and Rehabilitation of Grand Rapids | 4.3 mi | Grand Rapids, MI | ★☆☆☆☆ | 1/5 | abuseSFF |
| Mary Free Bed Sub-Acute Rehabilitation | 4.9 mi | Grand Rapids, MI | ★★★★☆ | 4/5 | |
| Clark Retirement Community | 5.0 mi | Grand Rapids, MI | ★★☆☆☆ | 2/5 | |
| Covenant Village of the Great Lakes | 5.0 mi | Grand Rapids, MI | ★★★★☆ | 4/5 | |
| Holland Home Breton Rehabilitation & Living Centre | 5.3 mi | Grand Rapids, MI | ★★★★★ | 5/5 | |
| Edison Christian Health Center | 5.7 mi | Grand Rapids, MI | ★★★★★ | 4/5 | |
| St Ann's Home | 5.9 mi | Grand Rapids, MI | ★★★★★ | 5/5 | |
| Holland Home - Raybrook Manor | 6.1 mi | Grand Rapids, MI | ★★★★★ | 4/5 |
Compare this facility with the 3 closest →
Facility data as of CMS processing date 2026-08-01. CCN 235723.