Edgewater At Waterman Village
300 Brookfield Ave, Mount Dora, FL 32757 · Non profit - Corporation · 120 certified beds · (352) 383-0051 Medicare & Medicaid certified
This home’s record is mixed — some reassuring signs, some worth asking about.
- a middle-of-the-pack inspection score (3/5)
- no federal fines or payment denials on record
- a high payroll-based staffing rating (4/5)
- a high number of inspection citations overall (18) — worth reading through, though larger and more-often-surveyed homes tend to accrue more lower-severity tags
- its facility-reported quality-measure score sits well above its independent inspection score
One thing this read cannot see: what residents and families actually experience day to day. Public data misses the feel of a place — visit unannounced, ideally at a mealtime or on a weekend, talk to staff and families, and ask your tour questions.
A plain-English summary of the public record below — not a rating, ranking, or recommendation. We take no money from any facility.
| Health inspectionSurveyor-assigned, ranked within your stateInspector-verified | 3 of 5 |
| StaffingFrom payroll records (PBJ) | 4 of 5 |
| Quality measuresSelf-reported by the facility | 5 of 5 |
Worth a closer look. This home's quality-measure rating runs 2 stars above its independent health-inspection score. The inspection is done by state surveyors; the quality-measure score leans on data the facility reports about itself — so a gap this large is worth reading the inspection record for.
Location & what’s nearby
Open in Google Maps ↗ · Directions ↗ · Larger map ↗
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
| Overall quality measures | 5 of 5 |
| Long-stay residentspeople who live here | 5 of 5 |
| Short-stay residentsrehab / post-hospital | 5 of 5 |
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.
Trend — is this home getting better or worse?
Over 2025-02 to 2026-06, this home’s CMS overall rating held steady at 4 stars. From monthly CMS archive snapshots.
Horizontal axis runs 2025-02 to 2026-06. That is where CMS’s monthly archive ends, so the right-hand edge of each line is that month — not today.
See all quality measures vs. state & national benchmarks
| Measure | This home | State avg | Typical state | vs typical state |
|---|---|---|---|---|
| Long-stay residents whose need for help with daily activities increased | 9.6% | 8.7% | 15.4% | better |
| Long-stay residents who lose too much weight | 2.0% | 5.5% | 5.4% | better |
| Long-stay residents with a catheter left in their bladder | 0.9% | 0.3% | 0.9% | typical |
| Long-stay residents with a urinary tract infection | 2.6% | 0.7% | 2.0% | worse than state‡ — see note marked double-dagger below the table |
| Long-stay residents with depressive symptoms | 1.5% | 4.6% | 6.5% | better |
| Long-stay residents who were physically restrained | 0.0% | 0.0% | 0.1% | better than state‡ — see note marked double-dagger below the table |
| Long-stay residents with falls causing major injury | 1.8% | 2.5% | 3.3% | better |
| Long-stay residents whose ability to walk worsened | 8.9% | 9.5% | 16.1% | better |
| Long-stay residents on antianxiety or hypnotic medication | 18.1% | 14.4% | 18.9% | typical |
| Long-stay residents given the seasonal flu vaccine | 100.0% | 99.2% | 95.3% | typical |
| Long-stay residents with pressure ulcers | 3.1% | 4.5% | 4.7% | better |
| Long-stay residents with worsening bladder/bowel control | 22.6% | 10.5% | 21.2% | typical |
| Long-stay residents who got an antipsychotic medication§ — see the note below the table | 10.5% | 8.6% | 17.1% | better |
| Short-stay residents who newly got an antipsychotic medication | 2.1% | 1.5% | 1.4% | worse |
| Short-stay residents given the seasonal flu vaccine | 100.0% | 94.7% | 79.4% | better |
| Short-stay residents rehospitalized after admission | 19.0% | 26.1% | 22.6% | better |
| Short-stay residents with an outpatient ER visit | 7.1% | 9.1% | 12.0% | better |
| Long-stay hospitalizations per 1,000 resident days | 2.00 | 2.13 | 1.67 | worse |
| Long-stay outpatient ER visits per 1,000 resident days | 0.75 | 1.15 | 1.80 | better |
‡ On this measure the state average is at least twice (or half) the typical state — a gap that size is usually how the state codes and reports the measure, not how its homes actually perform. Against a benchmark this state does not sit on, a “vs typical state” verdict would mostly be measuring the state, so we compare this home with its own state instead and show both averages.
§ Antipsychotics carry an FDA boxed warning — they raise the risk of death in older people with dementia-related psychosis, and are not approved for that use. So this measure is partly a read on whether a home sedates residents instead of staffing for them. But read a low rate carefully in both directions: CMS excludes residents coded with schizophrenia (and Tourette's or Huntington's) from this measure, and federal auditors have found implausible increases in schizophrenia coding since the measure was published — so a very low rate can reflect recoding rather than less prescribing. Ask the home what share of its residents carry a schizophrenia diagnosis, and how it handles behavioral symptoms without medication.
CMS quality measures, as Care Compare shows them. For most rows lower is better (fewer falls, ulcers, hospitalizations); vaccination rates are the exception. Not every row is risk-adjusted. CMS adjusts some measures for resident mix, but falls with major injury, antipsychotic use, physical restraints and the vaccination rates are unadjusted rates — so a home caring for heavier or more behaviorally complex residents can look worse on them without providing worse care. The “typical state” column is the median of the 50 state averages — not a national average of all homes. We use it because a plain average across homes is pulled badly off course by a few states’ reporting habits (long-stay depressive symptoms is the clearest case: Illinois codes it several times higher than most states, which alone lifted the all-homes figure to about twice what a typical state records). The median of state averages resists that — but it does weigh every state equally, so a large state counts no more than a small one, and it is a benchmark of our construction rather than a CMS-published figure. better/worse means the home differs from that benchmark by more than 10% of it; closer than that reads typical. CMS does not publish how many residents each measure covers, and the counts are often small — a single resident can move a rate by several points — so treat small gaps as noise. These come from data the facility reports, so weigh them against the independent inspection record above.
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.
62.8% of the Medicare patients who left this home got back to the community and stayed there for at least 31 days — CMS rates that better than the national rate. This is CMS’s risk-adjusted rate over 406 Medicare stays in Oct 2022–Sep 2024, and CMS’s own comparison — not ours.
Met the expected recovery: 47.6% 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 170 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 0.78 therapist hours per resident per day in 2026Q1 — more than 94% of the 13,892 homes that report any therapy hours at all.
Weekend therapy: weekend therapy hours are 16% 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.
See every short-stay measure CMS publishes for this home
| Measure | This home | U.S. median | Period covered | CMS’s call |
|---|---|---|---|---|
| Got home and stayed homeRate of successful return to home or community from a SNF | 62.8%CMS range 58.2–66.7 | 51.5% | Oct 2022–Sep 2024 | better than U.S. |
| Went back to hospitalRate of potentially preventable hospital readmissions 30 days after discharge from a SNF | 8.9%CMS range 6.8–11.1 | 10.7% | Oct 2022–Sep 2024 | no different from U.S. |
| Met the expected recoveryPercentage of residents who are at or above an expected ability to care for themselves and move around at discharge | 47.6% | 56.6% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Self-care at dischargePercentage of residents who are at or above an expected ability to care for themselves at discharge | 30.0% | 52.8% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Moving around at dischargePercentage of residents who are at or above an expected ability to move around at discharge | 45.3% | 50.0% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Medication problems followed upPercentage of residents whose medications were reviewed and who received follow-up care when medication issues were identified | 98.4% | 98.7% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Medication list to the next providerPercentage of residents where the SNF provided a current medication list to the next health care setting | 96.4% | 100.0% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Medication list to the familyPercentage of residents where the SNF provided a current medication list to the resident, family, and/or caregiver at final discharge | 100.0% | 98.7% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Falls with major injuryPercentage of SNF residents who experience one or more falls with major injury during their SNF stay | 0.0% | 0.0% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| New or worsened pressure ulcersPercentage of residents with pressure ulcers/pressure injuries that are new or worsened | 0.0% | 1.9% | Oct 2024–Sep 2025 | CMS makes no comparison for this measure |
| Infections that led to hospitalPercentage of infections residents got during their SNF stay that resulted in hospitalization | 6.9%CMS range 4.0–9.9 | 7.1% | Oct 2023–Sep 2024 | no different from U.S. |
| Medicare spending per stayMedicare Spending Per Beneficiary (MSPB) for residents in SNFs | 1.04 | 1.02 | Oct 2022–Sep 2024 | CMS makes no comparison for this measure |
From the CMS Skilled Nursing Facility Quality Reporting Program — Medicare short-stay outcomes, which is a different dataset from the long-stay quality measures above and describes a different set of residents. Where CMS risk-adjusts a measure we show its adjusted rate, and the CMS range beside it is the confidence interval CMS publishes: a home whose range is wide is a home with few stays, where one patient moves the number several points. Read the period column. These measures do not share a window — the claims-based ones (getting home, readmission, spending) lag by a year or more, because a stay has to finish and its claims settle before it can be counted. CMS’s call is CMS’s, not ours: it is the only place anyone tests whether this home differs from the national rate at all, and most homes on most measures do not. Two caveats on it. CMS tests only three of these measures — getting home, readmission, and infections that led to hospital; on the other nine it publishes a rate and no comparison, and rather than compute a verdict CMS declined to make, we say so in the column. And on readmission almost every home in the country lands on “no different”, so that row separates homes far less than getting-home does — which is why met the expected recovery, a measure CMS does not test but which spreads across the whole range, is called out above the table rather than left in this list. The U.S. median column is our own, taken across every home CMS publishes that measure for in this same file; it is not a CMS-published benchmark. Homes CMS gives no rate for are left out of it rather than counted as zero. Medicare spending per stay is a ratio, not a percentage — 1.00 means this home’s Medicare spending for a stay matched the national figure CMS compares it against, and it measures cost to Medicare, not quality of care.
Staffing
How full it usually is: this home is certified for 120 beds and averages 104.0 residents a day — about 87% occupied, or roughly 16 beds typically open. It runs fairly full. 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 4.11 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 0.51 is below the 0.55-hour RN benchmark and nurse-aide staffing of 2.28 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 3.63 hrs/resident/day on weekends vs 4.31 on weekdays — 16% thinner on weekends. RN hours go from 0.59 to 0.30 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)
This home’s total nursing-staff turnover of 40% is about the same as the national median of 45%. 2 administrators have left in the past year — frequent leadership churn is a warning sign families often miss.
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.
18 citations, most serious first. The 10 most serious are shown; the remaining 8 are one tap away and print in full.
- Potential for harm · Dcited before2026-03-12 · tag F0641 — isolatedEnsure 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 observation, interview, and record review, the facility failed to ensure Minimum Data Set (MDS) assessments were accurate for 1 of 2 residents reviewed for positioning and mobility (Resident #19), 1 of 9 residents reviewed for medication management (Resident #3), and 1 of 6 residents reviewed for behavior/mood (Resident #1). Findings include: 1) During an observation on 3/10/2026 at 10:23 AM, there was a mechanical lift pad underneath Resident #19, who was sitting in her wheelchair. During an interview on 3/10/2026 at 10:23 AM, Resident #19 stated that she needed two-person assist for transfer from mechanical lift to wheelchair, but she could self-propel wheelchair when needed. During an interview on 3/12/2026 at 9:32 AM, Resident #19 stated, I haven't been able to walk since my stroke, and I am weak on my left side. I can eat independently, but I must use wheelchair for mobility. Review of Resident #19's MDS assessment dated [DATE] showed Section GG0115- Functional Limitation in Range of Motion was…
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.
- Potential for harm · Dcited before2026-03-12 · tag F0656 — failed to write and follow a full care plan — isolatedDevelop 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
Based on record review and interview, the facility failed to develop and implement a comprehensive care plan for 1 of 9 residents reviewed for medication management (Resident #3).Findings include:Review of Resident #3's progress note dated 2/2/2026 read, Insulin Glargine Solostar Subcutaneous Solution Pen injector 100 unit/ml [milliliter], Inject 15 unit subcutaneously at bedtime for DM [Diabetes Mellitus]. bg [blood glucose] 160 pt [patient] refused med stated if bg below she is not taking it.Review of Resident #3's Medication Administration Record (MAR) for February 2026 for administration of Insulin Glargine showed code 2 (Drug Refused) was documented on 2/3/2026, 2/6/2026, 2/8/2026, 2/12/2026, 2/13/2026, 2/16/2026, 2/20/2026, 2/22/2026, 2/25/2026, 2/26/2026, and 2/27/2026 at 9:00 PM. Further review of the MAR showed the blood sugar value of 120 and staff initials for administration of the medication on 2/18/2026 at 9:00 PM.Review of Resident #3's MAR for January 2026 for administration of Insulin Glargine showed code 9 was documented on 3/3/2026, and code 2 was documented 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.
- Potential for harm · D2026-03-12 · tag F0756 — failed to review each resident's drug regimen — isolatedEnsure 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 physician/prescriber documented the rationale for declining the pharmacist's recommendation and failed to ensure physician's order was implemented upon pharmacist's recommendations for 2 of 9 residents reviewed for medication management (Residents #3 and #6).Findings include: 1) Review of Resident #6's consultation report with the recommendation date of 10/14/2025 read, Comment: [Resident #6's name] has a PRN [as needed] order for an anxiolytic, without a stop date: Lorazepam. Recommendation: Please discontinue PRN Lorazepam, tapering as necessary (e.g. decreasing the dose by no more than 25%, or 10-12% in high-risk residents, every 2 weeks). If the medication cannot be discontinued at this time, please document the indication for use, the intended duration of therapy, and the rationale for the extended time period. Physician's Response: [checked box] I decline the recommendation(s) above and do not wish to implement any changes due to the reasons below: PRN only. The form was signed by Physician #1 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.
- Potential for harm · D2026-03-12 · tag F0757 — failed to avoid unnecessary drugs — isolatedEnsure 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' drug regimens were free from unnecessary medications for 2 of 9 residents reviewed for medication management (Residents #3 and #77).Findings include: 1) Review of Resident #77's physician order dated 2/25/2026 read, Midodrine HCl [Hydrochloride] Oral Tablet 10 mg [milligram] (Midodrine HCl), Give one tablet by mouth every 8 hours for Hypotension, Hold for SBP [Systolic Blood Pressure] of > [higher than] 100. Review of Resident #77's Medication Administration Record (MAR) for March 2026 for administration of Midodrine HCl showed the medication was administered on 3/1/2026 at 2:00 PM for BP (Blood Pressure) of 105/63, 3/4/2026 at 10:00 PM for BP of 127/78, 3/5/2026 at 6:00 AM for BP of 116/72, 3/6/2026 at 6:00 AM for BP of 123/64, 3/7/2026 at 6:00 AM for BP of 108/63, 3/8/2026 at 6:00 AM for BP of 109/68, and 3/10/2026 at 6:00 AM for BP of 110/62. During an interview on 3/11/2026 at 10:29 AM, Staff A, Registered Nurse (RN), stated that she administered Midodrine and was not aware of the parameters…
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.
- Potential for harm · D2026-03-12 · tag F0760 — failed to prevent significant medication errors — isolatedEnsure that residents are free from significant medication errors.
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 of significant medication errors for 1 of 9 residents reviewed for medication management (Resident #123).Findings include:Review of Resident #123's physician order dated 3/7/2026 read, NovoLog FlexPen Subcutaneous Solution Pen-injector 100 unit/ml [milliliter] (Insulin Asparat), Inject as per sliding scale if 1-150= 2 units; 200-249= 4 units; 250-299= 6 units; 300-349= 8 units; 350-400= 10 units, subcutaneously three times a day for DM II [type II diabetes mellitus].Review of Resident #123's Medication Administration Record (MAR) for March 2026 for administration of Insulin Asparat showed 2 units of insulin were administered on 3/9/2026 at 9:00 AM for a blood glucose reading of 62 and 1:00 PM for a blood glucose reading of 122.During an interview on 3/9/2026 at 1:30 PM, the Director of Nursing reviewed the sliding scale insulin order for Resident #123 and stated that the sliding scale was not the typical sliding scale utilized at the facility and that she would contact the physician to verify 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.
- Potential for harm · Dcited before2026-03-12 · tag F0761 — failed to label and store drugs safely — isolatedEnsure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observation, interview, and record review, the facility failed to ensure drugs and biologicals used in the facility were stored in accordance with accepted professional principles in 1 of 2 halls.Findings include: 1) During an observation on 3/9/2026 at 10:19 AM, there was one box of Alka Seltzer on top of Resident #64's bedside table. Resident #64 was not in her room (Photographic evidence obtained).During an interview on 3/9/2026 at 11:35 AM, when asked if Resident #64 was able to self-administer medications, Staff F, Licensed Practical Nurse (LPN), stated, Not to my knowledge.During an observation on 3/9/2026 at 11:35 AM, Staff F, LPN, entered Resident #64's room and removed the box of Alka Seltzer.2) During an observation on 3/9/2026 at 10:48 AM, Resident #62 was sitting in her room. There was one bottle of nasal decongestant Oxymetazoline HCl [hydrochloride] on top of her bedside table (Photographic evidence obtained).During an interview on 3/9/2026 at 10:48 AM, Resident #62 stated, I will administer the nasal mist myself. The doctor said I can have it.During an…
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.
- Potential for harm · Dcited before2026-03-12 · tag F0842 — failed to keep accurate, complete medical records — isolatedSafeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
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 medical records were complete and accurate for 1 of 9 residents reviewed for medication management (Resident #95).Findings include:Review of Resident #95's physician order dated 11/29/2025 read, Midodrine HCl [Hydrochloride] Oral Tablet 5 MG [milligram] (Midodrine HCl), Give 5 mg by mouth three times a day for hypotension hold if systolic BP [Blood Pressure] above 130.Review of Resident #95's Medication Administration Record (MAR) for administration of Midodrine HCl for December 2025 showed the medication was administered with no blood pressure documented from 12/1/2025 through 12/8/2025, and from 12/10/52025 through 12/31/2025 at 9:00 AM; from 12/1/2025 through 12/8/2025, from 12/10/2025 through 12/11/2025, and from 12/12/2025 through 12/31/2025 at 1:00 PM; and from 12/1/2025 through 12/6/2025, from 12/8/2025 through 12/11/2025, and from 12/13/2025 through 12/31/2025 at 5:00 PM.Review of Resident #95's MAR for administration of Midodrine HCl for January 2026 showed the medication was administered with no blood…
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.
- Potential for harm · D2026-03-12 · tag F0880 — failed to prevent and control infections — isolatedProvide and implement an infection prevention and control program.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observation, interview, and record review, the facility failed to ensure staff used appropriate Personal Protective Equipment (PPE) while providing high-contact care for 1 of 3 residents reviewed for enhanced barrier precautions (Resident #111) and failed to ensure staff followed infection control procedures during medication administration for 1 of 5 residents observed (Resident #79) and during handling laundry in the laundry unit to prevent the possible spread of infection and communicable diseases.Findings include: 1) During an observation on 3/10/2026 at 2:00 PM, Staff H, Registered Nurse (RN) Unit Manager, entered Resident #111's room, performed hand hygiene, and donned gloves. Staff H did not wear a gown. Staff J, Occupational Therapy Assistant, was in the room assisting resident reposition in the bed. Staff J was wearing gloves and no gown. Staff J called for assistance to position the resident in bed. Staff I, Certified Nursing Assistant (CNS), entered Resident #111's room and donned gloves and no gown. Staff J and Staff I pulled Resident #111 up in the bed. Staff I…
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.
- Potential for harm · Dcited before2024-11-06 · tag F0684 — failed to provide proper treatment and quality of care — isolatedProvide 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
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on record review, and interview, the facility failed to ensure the residents received medication as ordered in accordance with professional standards of practice for 1 (Resident #1) of 3 residents reviewed. Findings include: Review of Resident #1's clinical record showed the resident was admitted on [DATE] with diagnoses that included Stage 3 chronic kidney disease, and malignant neoplasm of prostate. Review of Resident #1's physician order dated 9/19/2024 read, Bisacodyl Rectal Suppository 10 MG [milligrams] (Bisacodyl), Insert 1 suppository rectally at bedtime for constipation. Review of Resident #1's Medication Administration Record (MAR) for October 2024 revealed no documentation on 10/2/2024 and 10/7/2024 for administration of Bisacodyl rectal suppository. During a telephonic interview on 11/6/2024 at 2:03 PM, Staff B, Licensed Practical Nurse (LPN), stated, I did not give the suppository because he had a bowel movement. I should have given the suppository routinely like the orders are written. I did…
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.
- Potential for harm · D2024-11-06 · tag F0770 — failed to provide lab services — isolatedProvide timely, quality laboratory services/tests to meet the needs of residents.
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 provide laboratory services to meet the needs for 1 (Resident #1) of 3 residents reviewed. Findings include: Review of Resident #1's clinical record showed the resident was admitted on [DATE] with diagnoses that included Stage 3 chronic kidney disease, and malignant neoplasm of prostate. Review of Resident #1's physician order dated 10/4/2024 read, CBC [Complete Blood Count]; CMP [Complete Metabolic Panel]; UA C&S [Urinalysis Culture and Sensitivity]. Review of Resident #1's UA C&S results read, Collection Date: 10/05/2024 00:00 [12:00 AM], Received date: 10/05/2024 10:05 [10:05 AM], Reported Date: 10/07/2024 13:15 [1:15 PM] . Source: Urine. Organism 1 > [more than] 100,000 CFU/ML [Colony Forming Units per Milliliter] Enterococcus faecalis. Sensitivity MIC ORG [microorganism] #5. Ampicillin <= [less than equals to] 2 S [Susceptible], Ciprofloxacin <=1 S, Nitrofurantoin <=32 S, Penicillin 2 S, Tetracycline >8 R [Resistant], Vancomycin 2 S. Review 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.
Show the remaining 8 citations
- Potential for harm · Dcited before2024-11-06 · tag F0842 — failed to keep accurate, complete medical records — isolatedSafeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
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 and record review, the facility failed to ensure resident records were complete and accurate for 1 (Resident #1) of 3 residents reviewed. Findings include: Review of Resident #1's clinical record showed the resident was admitted on [DATE] with diagnoses that included Stage 3 chronic kidney disease, and malignant neoplasm of prostate. Review of Resident #1's physician order dated 9/23/2024 read, Prostat AWC every shift for wounds. Review of Resident #1's physician orders dated 9/19/2024 read Senna S Oral tablet 8.6- 60 MG [milligrams], Give 1 tablet by mouth every 12 hours for constipation. Review of Resident #1's physician order dated 9/19/2024 read, Carbidopa-Levodopa Oral Tablet 10-100 MG, Give 2 tablet by mouth four times a day for Parkinson's. Review of Resident #1's Medication Administration Record (MAR) for October 2024 revealed no documentation on 10/7/2024 at night shift for administration of Prostat AWC, no documentation on 10/7/2024 at 9:00 PM for administration of Senna S and…
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.
- Potential for harm · Dcited before2024-09-25 · tag F0656 — failed to write and follow a full care plan — isolatedDevelop 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
Based on observation, interview, and record review, the facility failed to ensure the comprehensive care plans were implemented for 2 of 4 residents reviewed for positioning, Residents #73 and #74. Findings include: 1) During an observation on 9/23/2024 at 9:59 AM, Resident #74 was resting with her eyes closed. The resident's feet were not offloaded while in bed. There was a yellow pillow with white cover on top of the wheelchair. During an observation on 9/23/2024 at 12:14 PM, Resident #74 was lying in bed with her eyes closed. The resident's feet were not offloaded while in bed. During an observation on 9/23/2024 at 12:53 PM, Resident #74 was lying in bed with her eyes closed. The resident's feet were not offloaded while in bed. During an observation on 9/24/2024 at 7:45 AM, Resident #74 was lying in bed with her eyes closed. The resident's feet were not offloaded while in bed. There was a yellow pillow with white cover on top of the wheelchair. During an observation on 9/24/2024 at 8:40 AM, Resident #74 was sitting up in bed with breakfast tray in front of her. The resident's…
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.
- Potential for harm · Dcited before2024-09-25 · tag F0761 — failed to label and store drugs safely — isolatedEnsure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observation, interview, and record review, the facility failed to ensure the drugs and biologicals used in the facility were stored in accordance with currently accepted professional principles. Findings include: 1) During an observation on 9/23/2024 at 9:44 AM, Resident #46 was sitting in her wheelchair in her room. There was a bottle of Biofreeze fast-acting menthol pain relief gel roll-on on top of the nightstand (Photographic evidence obtained). During an interview on 9/23/2024 at 9:44 AM, Resident #46 stated, I have arthritis and have the girls put it on at night for me. 2) During an observation on 9/23/2204 at 10:08 AM, Resident #2 was sitting up in her bed. On top of the resident's bedside table, there were one bottle of Biofreeze fast-acting menthol pain relief gel roll-on, one Voltaren cream, and one Lotrimin Clotrimazole cream. During an interview on 9/23/2024 at 10:08 AM, Resident #2 stated, I use the Biofreeze for my neck and the cream is a muscle relaxer that I use. During an observation on 9/24/2024 at 11:15 AM with Staff A, Licensed Practical Nurse (LPN),…
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.
- Potential for harm · Dcited before2023-06-02 · tag F0641 — isolatedEnsure each resident receives an accurate assessment.
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 an accurate assessment reflective of a resident's status at the time of the assessment for 1 (Resident #84) of 3 residents reviewed for discharge. Findings include: Review of Resident #84's admission record documented, Date of Discharge 03/26/2023. Review of Resident #84's physician's order dated 3/25/23 read May DC [discharge] home when arrangements made. Review of Resident #84's Minimum Data Set (MDS), Resident Assessment and Care Screening titled Discharge Return not anticipated dated 3/26/2023 read, Summary Section A - Identification Information Target, the discharge date [Section A2000} read 3/26/2023 and the discharge status [Section A2100] read Acute hospital. During an interview on 5/31/23 at 1:35 PM Staff D, Case Manager stated, This resident [Resident #84] went home with home health care. He went home with his daughter. The MDS is incorrect. He did not go to the hospital. He went home. During an interview on 6/1/23 at 1:30 PM the Administrator stated, We do not have a policy and procedure for MDS…
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.
- Potential for harm · Dcited before2023-06-02 · tag F0684 — failed to provide proper treatment and quality of care — isolatedProvide 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, interview, and record review the facility failed to ensure care and services for central venous access devices in accordance with professional standards of practice for 2 (Resident #237 and #238) of 2 residents reviewed with a central venous access devices. Findings include: 1). During an observation on 5/30/2023 at 11:45 AM Resident #237 was lying in bed with a single lumen midline with gauze under the transparent dressing. The dressing was dated 5/28/2023. During an observation on 5/31/2023 at 1:00 PM, Resident #237 was lying in bed with a single lumen midline with gauze under the transparent dressing. The dressing was dated 5/28/2023. During an observation on 6/01/2023 at 8:20 AM Resident #237 was lying in bed with single lumen midline with gauze under the transparent dressing. The dressing was dated 5/28/2023. During an interview on 6/1/2023 at 8:20 AM Staff C, License Practical Nurse (LPN), stated, [Resident #237's name] has a midline dressing dated 5/28/2023 with gauze under the transparent dressing. Normally IV [intravenous] dressings are changed weekly.…
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.
- Potential for harm · D2023-06-02 · tag F0695 — failed to provide proper breathing / tracheostomy care — isolatedProvide safe and appropriate respiratory care for a resident when 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 observation, interview, and record review, the facility failed to ensure residents received respiratory care services consistent with professional standards of practice for 3 of 6 residents (#71, #238, and #239) reviewed. Photographic Evidence Obtained Findings include: 1). During an observation on 5/30/2023 at 9:39 AM, Resident #71 was observed lying in bed and not wearing her nasal cannula which was observed to be wrapped around the right handrail of the bed. The nasal cannula was not bagged. During an observation on 6/1/2023 at 7:52 AM, Resident #71's nasal cannula was wrapped around the right handrail of the bed. The nasal cannula was not bagged. During an interview with Staff A, Licensed Practical Nurse (LPN) on 6/1/2023 at 8:11 AM, Her tubing was not bagged. During an interview with the Director of Nursing on 6/1/2023 at 9:23 AM, Ultimately, staff are expected to bag and date all oxygen tubing. 2). During an observation on 05/30/23 at 11:20 AM Resident #238 was lying in bed, nasal cannula wrapping…
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.
- Potential for harm · Dcited before2023-06-02 · tag F0761 — failed to label and store drugs safely — isolatedEnsure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observation, interview, and record review the facility failed to ensure the medication storage rooms were free from expired medications for two of two medication storage rooms. Findings include: During an observation on 5/31/23 at 10:12 AM of medication storage room one, there was one bottle of normal saline with an expiration of 12/4/21, four bottles of normal saline with an expiration date of 10/29/22, one bottle of normal saline with an expiration date of 1/17/23, two bottles of normal saline with an expiration date of 3/31/23, three bottles of normal saline with an expiration date of 3/25/22, and two bottles of unopened Sterile Water with expiration date of 3/15/23. During an observation on 5/31/23 at 10:30 AM of medication storage room two, there was two Irrigation Tray Piston Syringe containers with an expiration date of 5/22/22 and one Irrigation Tray Piston Syringe container with an expiration date of 1/11/22. During an interview on 5/31/23 at 11:00 AM the Director of Nursing stated, those items (one bottle of normal saline with an expiration of 12/4/21, four…
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.
- Potential for harm · D2023-06-02 · tag F0847 — isolatedInform resident or representatives choice to enter into binding arbitration agreement and right to refuse.
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 arbitration agreements presented to 3 (Resident #66, Resident #237 and Resident #240) of 3 residents reviewed were given 30 days to rescind the arbitration agreement. Findings include: Review of the facility Arbitration Agreements presented to Resident #66 on 10/17/2021, presented to Resident #237 on 5/7/2023 and presented to Resident #240 on 5/21/2023, read, This agreement shall remain in full force and effect not withstanding the termination, cancellation or natural expiration of the Resident admission Agreement. If this Arbitration Agreement is not rescinded within three (3) business days of signing as provided for in the final paragraphs of this Agreement, this Agreement shall remain in effect for and shall be binding on the Facility and Resident for this and all of the Resident's other admission or re-admission to the Facility (if any) without any need for further renewal. During an interview on 6/1/2023 at 1:05 PM the Administrator stated, I spoke to the risk manager and we did have three days written in…
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.
“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.
- Long-Term Care Ombudsman — a free, confidential advocate for the resident. They act only with the resident’s consent and work to resolve the problem. Find yours at theconsumervoice.org/get_help.
- Adult Protective Services — the state agency that investigates suspected abuse, neglect, or exploitation of a vulnerable adult. Not sure of your state’s APS number? The federal Eldercare Locator will route you: 1-800-677-1116 or eldercare.acl.gov.
- State survey agency — the regulator that licenses and inspects the home. Every state has an official nursing-home complaint line and most take complaints online; the Ombudsman or Eldercare Locator can connect you.
Fines & penalties
No federal fines in the current CMS record.
Who owns this facility
| Owner / manager | Type | Role | Since |
|---|---|---|---|
| DUJON, ANDREW | Individual | CORPORATE OFFICER; OPERATIONAL/MANAGERIAL CONTROL | since 12/08/2008 |
| LARSON, DAVID | Individual | CORPORATE OFFICER | since 09/18/2023 |
| BUCHANAN, YVONNE | Individual | OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNF | since 03/19/2025 |
CMS files one row per role, so the 5 rows in the source record cover these 3 parties — each is shown once here with every role it holds. Nothing is omitted. The source lists no ownership percentage for any of them — PECOS records a share only for equity interests, not for board or management roles.
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.
This home reported $2.1M paid to related parties (affiliated landlords or management companies) in its most recent cost report.
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
This is a Medicare- and Medicaid-certified nursing home, so it can accept Medicaid for long-term care — like nearly all U.S. nursing homes. The private-pay figures below are what families without Medicaid pay; once a resident qualifies for Medicaid, out-of-pocket cost for covered nursing-home care is typically close to $0 (almost all of their income goes to the home as their share of the cost; they keep a small personal needs allowance — for clothing, haircuts, a phone — and Medicaid pays the rest). The amount of that allowance is set by each state. Confirm Medicaid-bed availability with the home, and see the Florida Medicaid page.
Median private-pay cost, CareScout (Genworth) 2025 Cost of Care Survey — a regional midpoint, not any single community’s rate. Private rooms and higher care levels cost more; ask for a current quote. Project your own in the cost-of-care planner.
Every figure above is reproduced from the CMS Provider Data Catalog (a public record), from the CMS extract processed 2026-08-01 — CMS provider number 105796. CMS refreshes its data monthly, and the star rating rests on the last standard inspection — dated 2026-03-12, which can lag current conditions. Staffing hours are CMS PBJ CY2026Q1 (Jan–Mar 2026). Check this record against the government’s own page for it: this home on Medicare Care Compare ↗ — the authoritative source, and the place to confirm anything here before you act on it. How we present it →
Not a government site. Eldercare Lens is not affiliated with, endorsed by, or authorized by the Centers for Medicare & Medicaid Services (CMS), Medicare, or any government agency. The star ratings, citations, and inspection wording on this page are reproduced from the public CMS record; the plain-English summaries, tiers, and comparisons around them are ours. We do not speak for CMS, and CMS has not reviewed this page. For the official record, go to Medicare Care Compare. How we’re funded →
Are you this operator? If the record here is out of date, or misses what you have since fixed, tell us and we will look: hello@eldercarelens.com. We reproduce the public CMS record and cannot change what it says — corrections to the underlying data go through CMS and your state survey agency — but we will correct anything we have got wrong about it, and we will say so on the page.