Layhill Nursing and Rehabilitation Center, Silver Spring, Maryland

105
Citations from health inspectionsMaryland average: 52 a home: 3
Residents harmed or put in dangerMaryland average: 1.0 a home: $153,596
Fines from the federal governmentMaryland average: $21,934 a home: 1 out of 5
Overall rating in starsMaryland average: 3.2

The figures come from Medicare Care Compare files released October 8, 2026 by CMS, the federal Medicare agency. The citations span each home's three most recent inspection cycles plus their complaint visits, going back to March 2017 at the earliest; the fines span about three years, beginning September 2023. Browse the CMS files

Six inspection visits produced 105 citations. Residents were in immediate danger in one finding. Residents were found hurt in two cases. Federal fines came to $153,596 (two fines). Once, Medicare stopped paying for new admissions.

A candidate for Special Focus. For its list of nursing homes with past poor inspection results, CMS has named this home a candidate.

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Quick Look at the Record

The home's overall star rating: 1 out of 5
Rating for health inspections: 1 out of 5
Rating for staffing: 2 out of 5
Rating for quality of care: 4 out of 5
Nurse time for each resident: 3.46 hours each dayThe Maryland average is 3.87 hours
Time from registered nurses: 0.72 hours each dayThe Maryland average is 0.84 hours
Nursing staff who left during one year: 38.1%against the Maryland average of 40.2%
Beds that are certified: 129
Ownership: Limited Liability company (for profit)
Chain: Lifeworks Rehab, with 64 homes
Street address: 3227 Bel Pre Road, Silver Spring, Maryland 20906
County: Montgomery

Each inspection's citations

Every citation marks a federal rule inspectors found broken, along with its seriousness and the number of residents affected.

Two citations dated July 14, 2026

F697 Pain Management: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F684 Quality of Care: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.

15 citations dated Feb. 18, 2026

F921 A Safe, Clean Building: risk of harm, no one found hurt, one or a few residents.
F917 Adequate Room, Window, Bedding, Furniture, and Closet: risk of harm, no one found hurt, a pattern, several residents.
F880 Infection Prevention and Control: risk of harm, no one found hurt, one or a few residents.
F842 Medical Records and Privacy: risk of harm, no one found hurt, one or a few residents.
F812 Food Storage and Kitchen Safety: risk of harm, no one found hurt, widespread.
F759 Medication Error Rate of 5 Percent or More: risk of harm, no one found hurt, one or a few residents.
F756 Monthly Drug Regimen Review: risk of harm, no one found hurt, one or a few residents.
F658 Care That Meets Professional Standards: risk of harm, no one found hurt, one or a few residents.
F657 Updating the Care Plan on Time: risk of harm, no one found hurt, one or a few residents.
F656 A Complete Care Plan: risk of harm, no one found hurt, one or a few residents.
F628 Required Transfer Paperwork and Notices: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F604 Freedom From Physical Restraints: risk of harm, no one found hurt, a pattern, several residents.
F584 A Safe, Clean, Homelike Room: risk of harm, no one found hurt, one or a few residents.
F567 Right to Manage Own Finances: risk of harm, no one found hurt, a pattern, several residents.
F550 Dignity and Resident Rights: risk of harm, no one found hurt, one or a few residents.

11 citations dated Oct. 9, 2025

F755 Pharmacy Services: risk of harm, no one found hurt, a pattern, several residents, found on a complaint visit.
F711 Doctor Reviews Care and Writes Notes Each Visit: risk of harm, no one found hurt, a pattern, several residents, found on a complaint visit.
F689 Accident Hazards and Supervision: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F686 Pressure Ulcer (Bedsore) Care: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F684 Quality of Care: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F658 Care That Meets Professional Standards: risk of harm, no one found hurt, a pattern, several residents, found on a complaint visit.
F657 Updating the Care Plan on Time: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F628 Required Transfer Paperwork and Notices: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F609 Reporting Suspected Abuse: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F568 Properly Manage Resident Money Held by Facility: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F552 Keep Residents Informed About Health and Care: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.

46 citations dated Sept. 23, 2024

F941 Communication Training for Direct Care Staff: risk of harm, no one found hurt, widespread.
F921 A Safe, Clean Building: risk of harm, no one found hurt, one or a few residents.
F919 Working Call System in Bathrooms: risk of harm, no one found hurt, one or a few residents.
F909 Regular Safety Checks of Beds and Rails: risk of harm, no one found hurt, a pattern, several residents.
F908 Keep Essential Equipment Working Safely: risk of harm, no one found hurt, one or a few residents.
F880 Infection Prevention and Control: risk of harm, no one found hurt, one or a few residents.
F868 Quality Group Membership and Quarterly Meetings: risk of harm, no one found hurt, widespread.
F865 Written Quality Improvement Plan: risk of harm, no one found hurt, widespread.
F842 Medical Records and Privacy: risk of harm, no one found hurt, one or a few residents.
F812 Food Storage and Kitchen Safety: risk of harm, no one found hurt, one or a few residents.
F801 Qualified Kitchen and Dietitian Staff: risk of harm, no one found hurt, one or a few residents.
F800 Nutritious, Tasty, Balanced Meals: risk of harm, no one found hurt, a pattern, several residents.
F759 Medication Error Rate of 5 Percent or More: risk of harm, no one found hurt, one or a few residents.
F758 Psychotropic Drugs and PRN Orders: risk of harm, no one found hurt, one or a few residents.
F757 Unnecessary Drugs: risk of harm, no one found hurt, a pattern, several residents.
F756 Monthly Drug Regimen Review: risk of harm, no one found hurt, one or a few residents.
F740 Behavioral Health Care and Services: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F732 Post Daily Nurse Staffing Information: risk of harm, no one found hurt, widespread.
F700 Safe Use of Bed Rails: risk of harm, no one found hurt, a pattern, several residents.
F697 Pain Management: risk of harm, no one found hurt, a pattern, several residents.
F693 Feeding Tube Care: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F692 Enough Food and Fluids: risk of harm, no one found hurt, one or a few residents.
F689 Accident Hazards and Supervision: risk of harm, no one found hurt, one or a few residents.
F688 Range of Motion and Mobility: risk of harm, no one found hurt, one or a few residents.
F686 Pressure Ulcer (Bedsore) Care: risk of harm, no one found hurt, one or a few residents.
F679 Activities That Meet Every Resident's Needs: risk of harm, no one found hurt, a pattern, several residents.
F678 CPR and Basic Life Support: immediate danger to residents, a pattern, several residents.
F677 Help With Daily Living: risk of harm, no one found hurt, one or a few residents.
F676 Help Residents Keep Daily Living Abilities: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F658 Care That Meets Professional Standards: risk of harm, no one found hurt, one or a few residents.
F657 Updating the Care Plan on Time: risk of harm, no one found hurt, widespread, found on a complaint visit.
F656 A Complete Care Plan: risk of harm, no one found hurt, a pattern, several residents, found on a complaint visit.
F655 Baseline Care Plan at Admission: risk of harm, no one found hurt, one or a few residents.
F645 Screening for Mental Illness or Intellectual Disability: risk of harm, no one found hurt, one or a few residents.
F641 Accurate Resident Assessments: risk of harm, no one found hurt, one or a few residents.
F625 Written Notice of Bed Hold Policy: risk of harm, no one found hurt, one or a few residents.
F623 Notice Before Transfer or Discharge: risk of harm, no one found hurt, one or a few residents.
F622 Valid Reasons and Paperwork for Transfer or Discharge: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F610 Investigating Abuse Allegations: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F605 Avoid Unnecessary Sedating or Psychiatric Drugs: risk of harm, no one found hurt, one or a few residents.
F584 A Safe, Clean, Homelike Room: risk of harm, no one found hurt, a pattern, several residents.
F580 Telling the Family About a Change: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F578 The Right to Refuse Treatment: risk of harm, no one found hurt, one or a few residents.
F561 Respect Resident Choices and Self Determination: risk of harm, no one found hurt, a pattern, several residents.
F557 Respect, Dignity, and Personal Belongings: risk of harm, no one found hurt, one or a few residents.
F552 Keep Residents Informed About Health and Care: risk of harm, no one found hurt, one or a few residents.

24 citations dated June 18, 2024

F865 Written Quality Improvement Plan: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F842 Medical Records and Privacy: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F790 Routine and Emergency Dental Care: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F760 Significant Medication Errors: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F740 Behavioral Health Care and Services: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F726 Nurses and Aides Have Needed Skills: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F711 Doctor Reviews Care and Writes Notes Each Visit: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F692 Enough Food and Fluids: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F689 Accident Hazards and Supervision: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F686 Pressure Ulcer (Bedsore) Care: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F684 Quality of Care: risk of harm, no one found hurt, a pattern, several residents, found on a complaint visit.
F661 Share Information at Planned Discharge: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F656 A Complete Care Plan: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F641 Accurate Resident Assessments: risk of harm, no one found hurt, a pattern, several residents, found on a complaint visit.
F622 Valid Reasons and Paperwork for Transfer or Discharge: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F610 Investigating Abuse Allegations: risk of harm, no one found hurt, a pattern, several residents, found on a complaint visit.
F609 Reporting Suspected Abuse: risk of harm, no one found hurt, a pattern, several residents, found on a complaint visit.
F600 Freedom From Abuse and Neglect: residents were harmed, one or a few residents, found on a complaint visit.
F583 Keep Resident Records Private: residents were harmed, one or a few residents, found on a complaint visit.
F580 Telling the Family About a Change: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F578 The Right to Refuse Treatment: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F558 Meeting Residents' Needs and Preferences: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F554 Let Residents Take Own Medicines When Appropriate: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.
F550 Dignity and Resident Rights: risk of harm, no one found hurt, one or a few residents, found on a complaint visit.

Seven citations dated Sept. 27, 2019

F880 Infection Prevention and Control: risk of harm, no one found hurt, widespread.
F689 Accident Hazards and Supervision: risk of harm, no one found hurt, a pattern, several residents.
F658 Care That Meets Professional Standards: risk of harm, no one found hurt, one or a few residents.
F656 A Complete Care Plan: risk of harm, no one found hurt, a pattern, several residents.
F609 Reporting Suspected Abuse: risk of harm, no one found hurt, one or a few residents.
F603 Freedom From Being Isolated or Confined: risk of harm, no one found hurt, one or a few residents.
F550 Dignity and Resident Rights: risk of harm, no one found hurt, one or a few residents.

Payment Denials and Fines

Date	Penalty	Amount
Sept. 23, 2024	Fine	$100,523
Sept. 23, 2024	Payment denial for new admissions	20 days
June 18, 2024	Fine	$53,073

Ownership and Management of the Home

The direct 100% owner is Thunder Health Holdco LLC.
Owns 10% through another company: Rma Equity LLC.

Two people with an ownership stake are also listed by CMS.

The CMS Care Compare files, updated every month, provide provider information, health deficiencies, penalties, and ownership. The CMS certification number is 215168. Other homes in Maryland.