Park Meadows Healthcare & Rehabilitation Center

Location & what’s nearby

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Nearest of each type, straight-line distance. Hospitals come from the CMS Hospital General Information registry; everything else from Overture Maps (public data). Hospital and park hours are typical — call ahead to confirm.

Quality measures — how residents actually fare

Quality-measure stars summarize outcomes CMS tracks from the assessments each home submits — avoidable hospitalizations and ER visits, falls with injury, pressure ulcers, unplanned weight loss, and long-term antipsychotic use. Because the underlying data is self-reported, weigh a high score against the independent inspection record. Long-stay = permanent residents; short-stay = rehab and post-hospital stays.

Short-stay rehab — if you are coming here from a hospital

Arriving from a hospital right now? Read the discharge guide → — your appeal rights, how to slow a rushed discharge, and what to ask about the numbers below.

42.6% of the Medicare patients who left this home got back to the community and stayed there for at least 31 days — which CMS reads as no different from the national rate. This is CMS’s risk-adjusted rate over 63 Medicare stays in Oct 2022–Sep 2024, and CMS’s own comparison — not ours.

Met the expected recovery: 72.1% of this home’s Medicare short-stay residents left it at or above the ability to care for themselves and move around that CMS predicted for them, across 111 stays in Oct 2024–Sep 2025. The median of the 11,061 homes CMS publishes this for is 56.6%. Read it beside the getting-home figure, not instead of it: unlike the two measures above, CMS makes no better-or-worse call on this one and publishes no confidence interval for it, so this is a comparison and not a verdict — but it is the short-stay measure that separates homes most, and the one to ask about.

Therapy staffing: this home’s payroll records show 0.35 therapist hours per resident per day in 2026Q1 — more than 60% of the 13,892 homes that report any therapy hours at all.

Weekend therapy: weekend therapy hours are 6% of this home’s weekday level — it runs some therapy at the weekend, at a lower level than on weekdays. The median home that reports therapy runs 13% — weekday-focused therapy is the industry norm, not a shortfall. But recovery does not pause on a Saturday: ask what the weekend actually looks like here.

This section is about rehab stays, not living here. Most of this page — the stars, the quality measures, the inspection record — describes the home the way a permanent resident experiences it. These figures describe the short Medicare stay after a hospital discharge: a hip, a stroke, a bad infection, six weeks and home. They are different residents, different staff, often a different wing. Therapy hours are per resident in the building, not per rehab patient — the count includes every long-stay resident, and they mostly get no therapy at all. So a home with a small rehab wing inside a large nursing population reads low here even if its rehab patients get plenty of therapy, and a mostly-rehab home reads high. Use it to compare homes doing similar work, ask what a rehab resident actually gets in a day, and remember that CMS does not publish therapy minutes per patient — nobody does.

Staffing

How full it usually is: this home is certified for 148 beds and averages 143.1 residents a day — about 97% occupied, or roughly 5 beds typically open. It runs essentially full — expect a waiting list. This is a CMS average, not live availability — no public source publishes real-time vacancies, and a home can be full the day you call. Confirm with the home, and if you need a Medicaid bed specifically, ask about that separately: a home with open beds may still not have an open Medicaid bed.

Against a benchmark — not a legal minimum. In May 2024 CMS finalized the first federal staffing floor for nursing homes: 3.48 total nurse hours per resident per day, including 0.55 RN hours and 2.45 nurse-aide hours. Its hour requirements never took effect and are no longer on the books. Homes had until 2026 (2027 if rural) to comply, and that deadline never arrived: a federal court vacated the hour requirements in April 2025 (CMS has appealed), Congress then barred enforcement until 2034, and CMS formally repealed them by rule effective February 2026. This home is not required to meet these numbers, and is not violating anything by missing them. We still show the comparison because the figures are CMS’s own published estimate of adequate staffing, which makes them a useful yardstick — but they are our benchmark, not federal law: this home’s total nurse staffing of 3.53 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 0.57 is at or above the 0.55-hour RN benchmark and nurse-aide staffing of 2.18 is below the 2.45-hour aide benchmark. What federal law does require today is unchanged: “sufficient” nursing staff for residents’ needs and an RN on duty at least 8 consecutive hours a day, 7 days a week (42 CFR 483.35). Those are judged by inspectors on site, not by these averages, so read this comparison alongside the inspection record rather than as a pass/fail.

Weekend coverage: total nurse staffing is 3.27 hrs/resident/day on weekends vs 3.63 on weekdays — 10% thinner on weekends. RN hours go from 0.61 to 0.46 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)

This home’s total nursing-staff turnover of 41% is about the same as the national median of 45%.

Payroll-based (PBJ) staffing hours, as reported for Jan–Mar 2026 (CMS PBJ CY2026Q1) — the most recent quarter CMS has published, so they can lag a change of operator or staffing agency. Higher is generally better. Registered-nurse coverage and weekend staffing are the numbers families most often overlook — an RN on site matters most when something goes wrong, and coverage usually thins on weekends. High turnover means residents rarely see the same caregiver twice. One caveat: these are hours as reported, not adjusted for how sick or heavy-care this home’s residents are. CMS separately publishes a case-mix-adjusted view; we show the reported hours. A home caring for higher-acuity residents needs more hours to deliver the same care, so compare these figures against homes doing similar work, and read them next to the inspection record rather than alone.

Inspection trend

Deficiencies are more than at the previous inspection — worsening. Fewer citations over time suggests a home is fixing problems; a rising count is a warning sign — though two surveys are a short record, and survey teams differ. These counts are from the standard annual health survey only; the full citation list below may also include findings from complaint investigations, so the two won’t always add up.

Inspection deficiencies

State health-inspection citations, most serious first. Each carries an F-code (the federal rule it cites, e.g. F-684 = quality of care) and a letter A–L marking how serious and how widespread the problem was — we translate that grid into the plain tiers shown here. Wording is the official federal description.

Each letter is a CMS scope-severity level; highlighted ones are where this home has citations. A–C = no harm found; D–F = potential for harm; G–I = actual harm; J–L = immediate jeopardy. Within each band the later letter is the more widespread finding (an isolated G is one resident; a widespread I is a pattern), so rightward and downward is worse.

39 citations, most serious first. The 18 most serious are shown; the remaining 21 are one tap away and print in full.

• Immediate jeopardy · Jcited before2024-11-15 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolated
  Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review, the facility failed to ensure residents were free from accidents and hazards when residents were served an inappropriate therapeutic diet for 1 (Resident #45) of 10 residents reviewed for nutrition. Resident #45 had a physician's order for a mechanical soft diet. On 10/15/2024 at 12:20 PM, Resident #45 was sitting in the dining room. Resident #45 requested an alternative food item from Staff J, Licensed Practical Nurse. Staff J went to the kitchen and returned with a hot dog in a hot dog bun on a plate. Resident #45's diet was not verified in the kitchen. Staff I, Registered Nurse, stated to Staff J Resident #45 was not supposed to have a hot dog. Neither Staff I nor Staff J removed the food item after identifying the error. Staff I again instructed Staff J Resident #45 was not supposed to have a hot dog. Staff I and Staff J did not remove the food item. Staff K, Certified Nursing Assistant cut the hot dog in half for Resident #45 to consume. Resident #45…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Quality of Life and Care Deficiencies · Deficient, Provider has plan of correction
• Immediate jeopardy · J2024-11-15 · tag F0805 — failed to prepare food in a form residents can eat — isolated
  Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review, the facility failed to serve food designed to meet individual needs for 1 (Resident #45) of 10 residents sampled who required mechanically altered diets. Resident #45 had a physician's order for a mechanical soft diet. On 10/15/2024 at 12:20 PM, Resident #45 was sitting in the dining room. Resident #45 requested an alternative food item from Staff J, Licensed Practical Nurse. Staff J went to the kitchen and returned with a hot dog in a hot dog bun on a plate. Resident #45's diet was not verified in the kitchen. Staff I, Registered Nurse, stated to Staff J Resident #45 was not supposed to have a hot dog. Neither Staff I nor Staff J removed the food item after identifying the error. Staff I again instructed Staff J Resident #45 was not supposed to have a hot dog. Staff I and Staff J did not remove the food item. Staff K, Certified Nursing Assistant, cut the hot dog in half for Resident #45 to consume. Resident #45 consumed the hot dog. The facility's failure to…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
• Immediate jeopardy · Jcited before2024-11-15 · tag F0835 — failed to run the facility competently — isolated
  Administer the facility in a manner that enables it to use its resources effectively and efficiently.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review, the facility administration failed to administer the facility in a manner that enables it to use its resources effectively and efficiently to attain and maintain the highest practicable physical well-being of each resident by failing to implement policies and procedures related to therapeutic diets. Resident #45 had a physician's order for a mechanical soft diet. On 10/15/2024 at 12:20 PM, Resident #45 was sitting in the dining room. Resident #45 requested an alternative food item from Staff J, Licensed Practical Nurse. Staff J went to the kitchen and returned with a hot dog in a hot dog bun on a plate. Resident #45's diet was not verified in the kitchen. Staff I, Registered Nurse, stated to Staff J, Resident #45 was not supposed to have a hot dog. Neither Staff I nor Staff J removed the food item after identifying the error. Staff I again instructed Staff J Resident #45 was not supposed to have a hot dog. Staff I and Staff J did not remove the food item. Staff…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Administration Deficiencies · Deficient, Provider has date of correction
• Immediate jeopardy · Jcited before2024-11-15 · tag F0867 — failed to act on quality-improvement findings — isolated
  Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview, record review, and observation, the facility failed to utilize the Quality Assessment and Performance Improvement (QAPI) process to investigate, develop and implement an effective performance improvement plan (PIP) when the facility identified policies and procedures were not implemented for modified consistency diets. On 10/15/2024 at 12:20 PM, Resident #45 was sitting in the dining room. Resident #45 requested an alternative food item from Staff J, Licensed Practical Nurse. Staff J went to the kitchen and returned with a hot dog in a hot dog bun on a plate. Resident #45's diet was not verified in the kitchen. Staff I, Registered Nurse, stated to Staff J Resident #45 was not supposed to have a hot dog. Neither Staff I nor Staff J removed the food item after identifying the error. Staff I again instructed Staff J Resident #45 was not supposed to have a hot dog. Staff I and Staff J did not remove the food item. Staff K, Certified Nursing Assistant cut the hot dog in half for Resident #45 to…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Administration Deficiencies · Deficient, Provider has date of correction
• Immediate jeopardy · K2023-09-01 · tag F0600 — failed to protect residents from abuse and neglect — pattern
  Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on interviews and record reviews, the facility failed to protect the residents' right to be free from medical neglect when the staff failed to notify the physician of elevated blood sugars for 1 of 5 residents, Resident #13, and failed to follow physicians' orders for the administration of long-acting insulin for 3 of 5 residents, Residents #100, #4, and #5, reviewed for long-acting insulin administration. The body must have insulin working 24 hours a day. If there is no glargine [Lantus/Detemir] and you have not given rapid acting insulin within the past 3-4 hours, it is likely that your body will make ketones and is at risk of developing life-threatening diabetic ketoacidosis (DKA) or Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHS) which as similar symptoms, causes, and treatments of DKA. DKA is caused by an overload of ketones present in your blood. When your cells don't get the glucose they need for energy, your body begins to burn fat for energy, which produces ketones. Ketones are chemicals that the body creates when it breaks down fat to use for energy. Diabetic…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Freedom from Abuse, Neglect, and Exploitation Deficiencies · Deficient, Provider has date of correction
• Immediate jeopardy · Kcited before2023-09-01 · tag F0684 — failed to provide proper treatment and quality of care — pattern
  Provide appropriate treatment and care according to orders, resident’s preferences and goals.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on interviews and record reviews, the facility failed to ensure residents received treatment and care in accordance with professional standards of practice by failing to notify the physician of changes in condition for 1 of 5 residents, Resident #13, and failed to follow physicians' orders for the administration of long-acting insulins for 3 of 5 residents, Residents #100, #4, and #5. The body must have insulin working 24 hours a day. If there is no glargine [Lantus/Detemir] and you have not given rapid acting insulin within the past 3-4 hours, it is likely that your body will make ketones and is at risk of developing life-threatening diabetic ketoacidosis (DKA) or Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHS) which as similar symptoms, causes, and treatments of DKA. DKA is caused by an overload of ketones present in your blood. When your cells don't get the glucose they need for energy, your body begins to burn fat for energy, which produces ketones. Ketones are chemicals that the body creates when it breaks down fat to use for energy. Diabetic ketoacidosis (DKA) is a…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Immediate jeopardy · Kcited before2023-09-01 · tag F0835 — failed to run the facility competently — pattern
  Administer the facility in a manner that enables it to use its resources effectively and efficiently.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on interviews and record reviews, the facility administration failed to use its resources effectively and efficiently to attain or maintain the highest practicable physical wellbeing of each resident when not assuming full responsibility for the day-to-day operations of the facility and failing to effectively implement a QAPI/QAA plan. The administration failed to identify medication errors for residents who were not administered long-acting insulin as ordered by the physician and failed to ensure physician notification when medication orders were not followed and residents had change of condition for 4 of 7 residents, Resident #13, #100, #4, and #5. The body must have insulin working 24 hours a day. If there is no glargine [Lantus/Detemir] and you have not given rapid acting insulin within the past 3-4 hours, it is likely that your body will make ketones and is at risk of developing life-threatening diabetic ketoacidosis (DKA) or Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHS) which as similar symptoms, causes, and treatments of DKA. DKA is caused by an overload of…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Administration Deficiencies · Deficient, Provider has date of correction
• Immediate jeopardy · Kcited before2023-06-29 · tag F0867 — failed to act on quality-improvement findings — pattern
  Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on interviews and record reviews, the Quality Assurance and Performance Improvement (QAPI) committee failed to take actions to fully implement a developed plan of correction and Performance Improvement Plan (PIP), which resulted in the facility's failure to identify licensed staff was not following physicians' orders for notification of elevated blood sugars for 1 of 5 residents, Resident #13, and failure to identify medication errors for 3 of 5 residents, Residents #100, #4 and #5, who were not administered physician ordered long-acting insulin. The body must have insulin working 24 hours a day. If there is no glargine [Lantus/Detemir] and you have not given rapid acting insulin within the past 3-4 hours, it is likely that your body will make ketones and is at risk of developing life-threatening diabetic ketoacidosis (DKA) or Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHS) which as similar symptoms, causes, and treatments of DKA. DKA is caused by an overload of ketones present in your blood. When your cells don't get the glucose they need for energy, your body begins to…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Administration Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Ecited before2026-04-24 · tag F0641 — pattern
  Ensure each resident receives an accurate assessment.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review and interview, the facility failed to ensure Minimum Data Set (MDS) assessments were accurate for 1 of 5 residents reviewed for unnecessary medications (Resident #67), 1 of 2 residents reviewed for communication (Resident #112), 1 of 3 residents reviewed for respiratory services (Resident #12), and 1 of 4 residents reviewed for infections (Resident #10).Findings include: 1) Review of Resident #67's Quarterly MDS assessment dated [DATE] showed the resident is taking diuretics under Section N- Medications. Review of Resident #67's physician orders showed no order for diuretics. Review of Resident #67's Medication Administration Record (MAR) for February 2026 showed no diuretics were administered. During an interview on 4/23/2026 at 10:21 AM, Staff D, MDS Licensed Practical Nurse (LPN), stated, [Resident #67's name] is currently taking Hydralazine. Review of Resident #67's physician order dated 5/29/2024 read, Hydralazine HCl [hydrochloride] Tablet 50 MG [milligram], Give 50 mg by mouth three…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Dcited before2026-04-24 · tag F0584 — failed to keep a safe, clean, comfortable home — isolated
  Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review, the facility failed to ensure a safe and clean homelike environment for 2 of 5 residents reviewed, Residents #87 and #66. Findings include: 1) During an observation on 4/20/2026 at 1:45 PM, Resident #87 had his right arm in a splint and was using his left arm and hand to move items in the room. The pull string to turn on the light over the resident's bed was not within reach of the resident. The pull string does not reach the bed (Photographic evidence obtained). During an interview on 4/20/2026 at 1:45 PM, Resident #87 voiced concerns about not being able to reach the pull string to turn on the light that was over his bed. He commented he had spoken to maintenance and administration. Review of Resident #87's admission record showed the resident was admitted on [DATE] with diagnoses to include hemiplegia and hemiparesis following cerebral infarction (stroke) affecting right dominant side. During an observation on 4/21/2026 at approximately 1:00 PM, the pull…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Resident Rights Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2026-04-24 · tag F0644 — isolated
  Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review and interview, the facility failed to coordinate Preadmission Screening and Resident Review (PASRR) for the residents with newly evident or possible serious mental disorder for 2 of 4 residents reviewed for behavioral health (Residents #13 and #117).Findings include:1) Review of Resident #117's admission record showed the resident was admitted on [DATE] and readmitted on [DATE] with diagnoses to include brief psychotic disorder (onset date of 2/26/2026), other recurrent depressive disorders (onset date of 2/26/2026), and post-traumatic stress disorder (onset date of 2/25/2026).Review of Resident #117's PASRR dated 1/27/2026 showed anxiety disorder and depressive disorder documented under mental illness or suspected mental illness in Section I. PASRR Screen Decision-Making. No brief psychotic disorder and post-traumatic stress disorder was documented.Review of Resident #117's psychiatry subsequent note dated 3/23/2026 read, Chief Complaint: Brief psychosis and depression.Review of Resident…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Dcited before2026-04-24 · tag F0656 — failed to write and follow a full care plan — isolated
  Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review, the facility failed to ensure resident-centered care plans were developed and implemented for 4 of 33 residents reviewed (Residents #11, #58, #39, and #112).Findings include: 1) Review of Resident #11's admission record showed the resident was admitted on [DATE] and readmitted on [DATE] with medical diagnoses to include hemiplegia and hemiparesis following cerebral infarction affecting right dominant side, overactive bladder, and other artificial openings of urinary tract status, and acute candidiasis of vulva and vagina. Review of Resident #11's care plan read, Focus: The resident has an artificial opening for bowel elimination (ostomy). Date initiated: 11/27/2025. Revision on: 03/05/2026. Interventions: Report any changes in bowel output to nurse such as swollen abdomen, resident complaining of pain, any change in color or consistency of the output. During an interview on 4/23/2026 at approximately 11:45 AM, Staff C, Minimum Data Set (MDS) Licensed Practical…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Dcited before2026-04-24 · tag F0684 — failed to provide proper treatment and quality of care — isolated
  Provide appropriate treatment and care according to orders, resident’s preferences and goals.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observation, record review, and interview, the facility failed to ensure residents received their medications as prescribed by their physician for 2 of 10 residents reviewed for medication management (Residents #90, and #93) and failed to ensure the wound dressings were changed for 2 of 4 reviewed for skin conditions (Residents #112 and #119).Findings include: 1) Review of Resident #93's physician order dated 2/28/2026 read, Insulin Glargine Solution 100 units per milliliter (units/mL), inject 10 units subcutaneously once daily for diabetes; notify physician for blood sugar less than 70 milligrams per deciliter (mg/dL). Review of Resident #93's Medication Administration Record (MAR) for administration of Insulin Glargine for March 2026 showed the medication was held by Staff CC, Registered Nurse (RN), on the following dates: 3/2/2026 for blood sugar of 82 mg/dL; 3/3/2026 for blood sugar of 105 mg/dL; 3/6/2026 for blood sugar of 96 mg/dL; 3/9/2026 for blood sugar of 103 mg/dL; 3/10/2026 for blood sugar of 117 mg/dL; 3/11/2026 with no documented blood sugar; 3/13/2026 with no…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2026-04-24 · tag F0688 — failed to keep residents mobile / prevent decline — isolated
  Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
  What the surveyor found here — an excerpt from the official record, may be distressing

  NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, interview, and record review, the facility failed to ensure residents with limited mobility received appropriate services to maintain or improve mobility for 1 of 4 residents reviewed for therapy services (Resident #16).Findings include:During an observation on 4/20/2026 at 10:33 AM, Resident #16 was sitting in a wheelchair next to his bed. The resident was not wearing a splint, or an AFO (Ankle Foot Orthoses).During an observation on 4/21/2026 at 11:05 AM, Resident #16 was sitting in a wheelchair at the nurses' station. The resident was not wearing an AFO.During an interview on 4/22/2026 at 2:52 AM, Staff A, Licensed Practical Nurse (LPN), stated, [Resident #16's name] is often up in his wheelchair when I come in at 7:00 AM and is not always wearing his AFO. Staff A was not able to provide any specific dates.During an observation on 4/22/2026 at 3:00 PM, Resident #16 was lying in bed. The resident was not wearing an AFO. There was an AFO stored on a shelf in the closet.Review of Resident…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · Dcited before2026-04-24 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolated
  Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observation, record review, and interview, the facility failed to ensure a safe and hazard-free environment for 1 of 4 residents reviewed (Resident #39).Findings include: During an observation on 4/20/2026 at 10:15 AM, there was a disposable razor on the back of Resident #39's bathroom sink (Photographic evidence obtained). During an observation on 4/21/2026 at 1:25 PM, there was a black disposable razor on the sink in Resident #39's bathroom. During an interview on 4/21/2026 at 1:27 PM, Staff F, Certified Nursing Assistant (CNA), stated that Resident #39 was using the razor earlier that day, and Resident #39 was somewhat independent. During an interview on 4/21/2026 at 3:00 PM, Staff G, Licensed Practical Nurse (LPN), stated that Resident #39 was mostly independent, he was steady, he moved on his own, and he shaved himself. During an interview on 4/21/2026 at 3:13 PM, Staff H, LPN Unit Manager, stated that Resident #39 was mostly independent. Residents should be observed while shaving and the razor should be disposed of after the resident shaved. During an interview on…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2026-04-24 · tag F0693 — failed to provide proper feeding-tube care — isolated
  Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on observation, record review, and interview, the facility failed to ensure residents received appropriate enteral feeding for 1 of 7 residents reviewed for nutrition and dining services (Resident #58).Findings include:During an observation on 4/20/2026 at 10:05 AM, Resident #58 was lying in bed. The resident's tube feeding pump was alarming. The bottle of enteral feeding was dated 4/18/2026, and the bag of water attached was dated 4/15/2026 (Photographic evidence obtained).During an interview on 4/22/2026 at 10:20 AM, Staff A, Licensed Practical Nurse (LPN), stated that more than likely when the bottle of enteral feeding was low, they would change the set-up. Changing [of the bottle and tubing] was based on what was left in the bottle. She thought the set-up was good for 24 hours. She would look at what time it was actually hung.During an observation on 4/22/2026 at 2:40 PM, Staff A, LPN, attached the tubing for the enteral feeding, set the feeding pump according to the order and started the pump. Staff A did not check for residual prior to the initiation of the enteral…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2026-04-24 · tag F0756 — failed to review each resident's drug regimen — isolated
  Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on record review and interview, the facility failed to ensure the providers acted upon the pharmacist recommendations for 2 of 5 residents reviewed (Residents #66 and #67).Findings include: 1) Review of Resident #66's Consultant Pharmacist Recommendation to Physician dated 9/17/2025 read, This resident is receiving the antipsychotic agent Quetiapine 100 mg po [orally] QHS [every night at bedtime] (9/11/25) but lacks an allowable diagnosis to support its use. Please adjust the diagnosis code as clinically indicated. There was no response or signature from the provider. Review of Resident #66's Pharmacist Recommendations (DON/Medical Director Copy)for recommendations created between 10/1/2025 and 10/28/2025 read, This resident is using the following duplicate antidepressant therapy. Paroxetine HCl Tablet 10 MG, Give 2 tablet by mouth one time a day related to major depressant disorder. Active 09/18/2025. Trazodone HCl oral tablet 100 MG (Trazodone HCl), Give 1 tablet by mouth three times a day for depression. Active 09/18/2025. There was no response or signature from the…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Pharmacy Service Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2026-04-24 · tag F0757 — failed to avoid unnecessary drugs — isolated
  Ensure each resident’s drug regimen must be free from unnecessary drugs.
  What the surveyor found here — an excerpt from the official record, may be distressing

  Based on record review and interview, the facility failed to ensure residents were free from unnecessary medications for 2 of 8 residents reviewed (Residents #50 and #55).Findings include:1) Review of Resident #55's physician order dated 3/29/2026 read, Metoprolol Succinate ER [Extended Release] Oral Tablet Extended Release 24 Hour 50 MG [milligram] (Metoprolol Succinate), Give 1 tablet by mouth two times a day for HTN [hypertension], hold for SBP [Systolic Blood Pressure] less than 110 or DBP [Diastolic Blood Pressure] less than 60.Review of Resident #55's Medication Administration Record (MAR) for April 2026 for administration of Metoprolol Succinate showed the medication was administered on 4/7/2026 at 9:00 AM for blood pressure (BP) of 111/58 (SBP/DBP), 4/14/2026 at 9:00 PM for BP of 110/54, 4/15/2026 at 9:00 PM for BP of 93/51, 4/17/2026 at 9:00 PM for BP of 108/90, and 4/19/2026 at 9:00 PM for BP of 108/65.During an interview on 4/22/2026 at 1:28 PM, Staff J, Licensed Practical Nurse (LPN), stated, I administered the medication in error.2) Review of Resident #50's physician…

  This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

  Pharmacy Service Deficiencies · Deficient, Provider has date of correction

“Cited before” means this same F-tag appears on at least one other survey date in the record we hold — counting complaint investigations as well as standard surveys, with no time limit. It is our own read of the data, not CMS’s: CMS uses repeat deficiency as a formal term tied to consecutive standard surveys, and that is a narrower test than this one. A tag marked here may or may not meet it.

Fines & penalties

$16,801 in federal fines across 2 penalties.

• $8,400 — penalty dated 2024-11-15
• $8,401 — penalty dated 2024-11-15

Dates are the dates CMS records the penalty, not the date of the conduct behind it. CMS publishes penalties on a rolling window, so this is what is currently on the public file — not the home’s lifetime history, and an older fine may attach to a problem that has since been corrected. The amounts are as imposed: the CMS file does not record whether a penalty was appealed, reduced, or paid, so we don’t say. Ask the home what each one was for and what changed since.

Part of a chain

This home belongs to GOLD FL TRUST II — 36 facilities. Here is how its ratings compare with the chain’s average across all its homes: See the whole chain — ratings, flags, fines and finances →

A home rated well below its chain’s average can signal local problems; a chain with a low average across the board is a bigger pattern worth researching. CMS chain data under-reports private-equity and REIT ownership, so treat this as a floor, not the full picture.

Who owns this facility

2 organizational owners listed — a facility can be part of a larger chain. CMS ownership data is known to under-report private-equity and REIT ties; treat as a starting point.

Follow the money — this home’s finances

Where a nursing home’s revenue comes from and where it goes — including money paid to companies under the same ownership. Most consumer sites never show this; we reproduce it straight from the Medicare cost report.

About 81% of this home’s resident-days are paid by Medicaid, which reimburses well below the cost of care in most states. Heavily Medicaid-dependent homes run on thinner budgets — a context worth holding next to the staffing and inspection record, not a fault in itself.

Source: CMS Healthcare Provider Cost Reporting Information System (HCRIS), Medicare cost report Form CMS-2540 · fiscal year 2023. Facilities self-file these reports; figures are unaudited and a year or two behind. A home with no Medicare cost report on file shows no figures here.

Cost & finances

Straight from this home’s Medicare cost report (CMS, FY2023). These are its operating economics — what it costs to run per resident-day and what it collects on average across Medicare, Medicaid, and private pay — not a private-pay quote. Your out-of-pocket cost depends on payer and room type, so ask the facility directly; a higher operating cost can reflect richer staffing or a sicker population. The cost-of-care planner shows regional benchmarks by care type.

What families pay in FL