Pr SNF Operations LLC
5111 Palmer Ranch Parkway, Sarasota, FL 34238 · For profit - Limited Liability company · 60 certified beds · (941) 926-7733 Medicare & Medicaid certified
This home has serious findings on its record. Read them closely before you consider it.
- a strong health-inspection score (4/5) — the hardest rating to game (though it’s ranked within its own state, not nationally)
- fewer deficiencies at its most recent standard inspection than at the one before — a sign of improvement
- it has an abuse, neglect, or exploitation citation (F0600), cited Jul 2025
- it has 2 actual-harm citations
- a high number of inspection citations overall (19) — worth reading through, though larger and more-often-surveyed homes tend to accrue more lower-severity tags
- the CMS record shows $59,696 in federal fines (most recent 2025-03-19)
- nursing-staff turnover (67%) runs well above the national median (45%)
- its last standard health inspection was over 2 years ago — the star rating may not reflect current conditions
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 | 4 of 5 |
| StaffingFrom payroll records (PBJ) | 3 of 5 |
| Quality measuresSelf-reported by the facility | 3 of 5 |
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 | 3 of 5 |
| Long-stay residentspeople who live here | 3 of 5 |
| Short-stay residentsrehab / post-hospital | 3 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 improved from 1 to 2 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 | 17.6% | 8.7% | 15.4% | worse |
| Long-stay residents who lose too much weight | 8.5% | 5.5% | 5.4% | worse |
| Long-stay residents with a catheter left in their bladder | 0.7% | 0.3% | 0.9% | worse than state‡ — see note marked double-dagger below the table |
| Long-stay residents with a urinary tract infection | 5.6% | 0.7% | 2.0% | worse than state‡ — see note marked double-dagger below the table |
| Long-stay residents with depressive symptoms | 0.0% | 4.6% | 6.5% | check this* — see note marked star below the table |
| 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 | 1.7% | 2.5% | 3.3% | better |
| Long-stay residents whose ability to walk worsened | 21.2% | 9.5% | 16.1% | worse |
| Long-stay residents on antianxiety or hypnotic medication | 9.4% | 14.4% | 18.9% | better |
| Long-stay residents given the seasonal flu vaccine | 100.0% | 99.2% | 95.3% | typical |
| Long-stay residents with pressure ulcers | 4.3% | 4.5% | 4.7% | typical |
| Long-stay residents with worsening bladder/bowel control | 16.5% | 10.5% | 21.2% | worse than state‡ — see note marked double-dagger below the table |
| Long-stay residents who got an antipsychotic medication§ — see the note below the table | 2.9% | 8.6% | 17.1% | better |
| Short-stay residents who newly got an antipsychotic medication | 1.0% | 1.5% | 1.4% | better |
| Short-stay residents given the seasonal flu vaccine | 96.6% | 94.7% | 79.4% | better |
| Short-stay residents rehospitalized after admission | 25.9% | 26.1% | 22.6% | worse |
| Short-stay residents with an outpatient ER visit | 14.2% | 9.1% | 12.0% | worse |
| Long-stay hospitalizations per 1,000 resident days | 3.26 | 2.13 | 1.67 | worse |
| Long-stay outpatient ER visits per 1,000 resident days | 1.50 | 1.15 | 1.80 | better |
* This home reported 0% on a measure where lower is better. That can mean genuinely excellent care — but because the number is self-reported, a zero can also mean the problem was not recorded. Weigh it against the inspection record above.
‡ 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.
63.8% 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 216 Medicare stays in Oct 2022–Sep 2024, and CMS’s own comparison — not ours.
Met the expected recovery: 56.9% 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 58 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 0.48 therapist hours per resident per day in 2026Q1 — more than 79% of the 13,892 homes that report any therapy hours at all.
Weekend therapy: weekend therapy hours are 17% 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 | 63.8%CMS range 57.6–70.3 | 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 | 11.7%CMS range 8.7–16.9 | 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 | 56.9% | 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 | 36.2% | 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 | 46.5% | 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 | 100.0% | 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 | 100.0% | 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 | 0.8% | 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 | 3.0% | 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 | 7.5%CMS range 4.4–11.3 | 7.1% | Oct 2023–Sep 2024 | no different from U.S. |
| Medicare spending per stayMedicare Spending Per Beneficiary (MSPB) for residents in SNFs | 0.94 | 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 60 beds and averages 47.0 residents a day — about 78% occupied, or roughly 13 beds typically open. It usually has some room. 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 3.95 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 1.13 is at or above the 0.55-hour RN benchmark and nurse-aide staffing of 2.33 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 3.52 hrs/resident/day on weekends vs 4.13 on weekdays — 15% thinner on weekends. RN hours go from 1.25 to 0.84 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)
This home’s total nursing-staff turnover of 67% is well above the national median of 45%. 1 administrator has left in the past year.
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 fewer than at the previous inspection — improving. 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.
This trend is not current. The most recent of these two inspections was over 2 years ago; the arrow describes what inspectors found then, not what the home is like now.
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.
19 citations, most serious first. The 12 most serious are shown; the remaining 7 are one tap away and print in full.
- Actual harm · Gcited before2025-03-19 · tag F0600 — failed to protect residents from abuse and neglect — isolatedProtect 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
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, staff interview and record review, the facility failed to prevent neglect through lack of adequate assessments and supervision for a confused resident to prevent elopement from the facility for 2 (Resident #5 and #6) of 3 residents reviewed. The lack of supervision contributed to the elopement of Resident #5 and the incorrect assessment of Resident #6 who was confused and mobile via wheelchair. The findings included: Facility policy provided by the DON (Director of Nursing) for Elopement Risk with effective date of 03/2008 and last revision date of 10/2022 was defined as a situation in which a resident leaves the premises or a safe area without the community's knowledge and supervision which may represent a risk to the resident's health and safety. Evaluating for elopement risk prior to admission. admission associate should identify potential risk for elopement and notify the Director of Clinical Services/designee of the following: The resident has a pertinent diagnosis of dementia,…
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.
- Actual harm · Gcited before2025-03-19 · tag F0755 — failed to provide safe pharmacy services — isolatedProvide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
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 ensure to obtain physician ordered medications in a timely manner for newly admitted residents for 2 (#1 and #2) of 3 residents reviewed. The findings included: Review of the policy titled admission Data Collection and Orders last revised on 10/24 stated that the Nursing department is responsible for recording specific clinical data in the medical record upon a resident's admission to the community . The charge nurse who admits the resident is responsible for completing the Nursing admission Data Collection, verifying orders are present for admission, additional corresponding data collection, and reviewing the information sent by the discharging community, hospital and/or attending physician . The charge nurse should contact the attending physician after the resident has been admitted to the community and resident data is collected including orders should be reviewed with the physician and verified. The designated pharmacy should be notified of the new…
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 · Ecited before2025-07-21 · tag F0600 — failed to protect residents from abuse and neglect — patternProtect 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 record review, review of facility's policies and procedures, staff and residents interviews, the facility failed to protect residents' right to be free from abuse by willfully administering unauthorized over the counter medications with known effect of drowsiness during the night shift to 2 (Residents #800, and #825) of 5 residents reviewed.The findings included:Review of the facility's policy and procedure titled, Abuse, Neglect and Exploitation with an effective date of 7/20/2016 and last revised date of 10/22 revealed the facility, is committed to maintaining a safe environment for residents . Residents have the right to be free from abuse . and any physical or chemical restraint imposed for the purposes of discipline or convenience and not required to treat the resident's medical symptoms .Review of the facility provided incidents investigations revealed on 7/10/25 the facility initiated an abuse investigation related to an allegation that a Licensed Nurse was administering everyone medications to make them sleep.The investigation noted:On 7/8/25 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.
- Potential for harm · D2025-03-19 · tag F0697 — failed to manage pain — isolatedProvide safe, appropriate pain management for a resident who requires such services.
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 interviews, the facility failed to ensure that the resident receives pain management services based on the resident's goals and preferences for 1 resident (#1). The findings include: Review of the policy titled admission Data Collection and Orders last revised on 10/24 stated that the Nursing department is responsible for recording specific clinical data in the medical record upon a resident's admission to the community. The charge nurse should contact the attending physician after the resident has been admitted to the community and resident data is collected including orders should be reviewed with the physician and verified. The designated pharmacy should be notified of the new admission and order confirmation of pharmacy supplied items. Resident #1 was admitted to the facility on [DATE] at 6:30 p.m. from an acute care hospital following joint replacement surgery. Resident #1 had right knee replacement surgery and admission diagnosis of Heart Failure, Cardiomyopathy and Type 2…
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 · D2025-03-19 · 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 record review and interviews, the facility failed to maintain complete and accurate medical records for 2 of 3 (#1 and #2) residents reviewed. The findings included: The facility policy admission Data Collection and Orders dated 12/08 last revised 10/24 stated that the nursing department is responsible for recording specific clinical data in the medical record upon the residents admission to the community. The charge nurse who admits the resident is responsible for completing the nursing admission data collection, verifying orders are present for admission, additional data collection and reviewing information sent by the discharging community, hospital or attending physician. Resident #1 was admitted to the facility on [DATE] at 6:30 p.m. for aftercare following joint replacement surgery. The hospital discharge records include physician orders for pain medication, insulin, aftercare of incision instructions, proper positioning while in bed, weight baring status, activity orders, and equipment. Record…
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 · F2023-05-11 · tag F0812 — failed to store, cook, and serve food safely — widespreadProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
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 store and serve food in accordance with professional standards for food service and safety and ensure food was handled in a sanitary manner that prevented cross contamination. The findings included: Cross-contamination means the transfer of harmful substances or disease-causing microorganisms to food by hands, food contact surfaces, sponges, cloth towels, or utensils which are not cleaned after touching raw food, and then touch ready-to-eat foods. Cross-contamination can also occur when raw food touches or drips onto cooked or ready-to-eat foods. This had the potential to affect all 55 residents who reside in the facility and receive food from the kitchen. Facility policy titled, Storage of Perishable Food-DS-04.014; effective 2005 stated: Perishable food must be refrigerated in a manner that optimizes food safety, nutrient retentions, and aesthetic quality. Perishable foods include fruits, vegetables, meats, daily etc. All pre-dished items must be covered, labeled, and dated to prevent off-flavors, drying,…
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 · D2023-05-11 · 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
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review the facility failed to develop a comprehensive care plan for a newly inserted pacemaker for 1 (Resident #204) of 3 residents reviewed for pacemakers. The findings included: Review of Resident #204's clinical record revealed an admission date of 4/26/23. Diagnoses included cardiac dysrhythmia (abnormal heart activity). Review of the hospital documentation revealed on 4/6/23 Resident #204 underwent a surgical insertion of a cardiac pacemaker (Device to help control the heartbeat). On 5/10/23 at 3:45 p.m., Resident #204 said he recently had a pacemaker implanted in his chest. The resident said no one told him about any special precautions for the pacemaker. The admission Minimum Data Set (MDS) assessment dated [DATE] listed the code for the presence of a Pacemaker in the diagnoses. The physician's orders as of 5/10/23 did not include instructions on care of the cardiac pacemaker. The care plans initiated on 4/26/23 did not address the recently inserted pacemaker with appropriate…
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 · D2023-05-11 · 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 observation, record review, review of facility's policies and procedures, staff and resident interviews the facility failed to provide care and services in accordance with professional standards of practice for 2 (Resident #37, and #38) of 26 sampled residents. The findings included: Facility policy PL.6-011, revised 12/2020, titled following physician orders stated, a physician order is required for, changes in plan of care, treatment changes and discontinuation of treatments. Facility Policy titled Referrals, Social Services, Revised December 2008 stated Social services personnel shall coordinate most resident referrals with outside agencies. Social Services will collaborate with the nursing staff or other pertinent disciplines to arrange for services that have been ordered by the physician. 1. Resident #38 was admitted on [DATE], with the diagnoses of Acute Disseminated Demyelination, Drug Induced Dyskinesia, (Tardive Dyskinesia), Dysphagia, Muscle Weakness, Peripheral Vascular Disease, Chronic…
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 · D2023-05-11 · tag F0688 — failed to keep residents mobile / prevent decline — isolatedProvide 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
Based on observation, record review, and staff interview, the facility failed to provide appropriate services to maintain highest level of range of motion for 1 (Resident #37) of 3 residents reviewed for limited range of motion and activities of daily living. The findings included: A review of the Clinical Services Policy, Support Activities of Daily living (ADL), effective 4/2022 stated residents should be provided with care, treatment, and services such that their activities of daily living do not diminish unless the circumstances of their clinical condition(s) demonstrate that diminishing ADLS are unavoidable. A review of the clinical record for Resident #37 revealed a Quarterly Minimum Data Set (MDS) assessment completed on 2/15/23 noted Resident #37 had functional limitation in Range of Motion (ROM) on one side of the upper extremities. The resident's cognition was severely impaired. The resident was rarely or never understood. Resident #37's diagnoses included Dementia, Contracture (deformity, rigidity of joint) of the right hand. The physician's orders dated 11/18/22 included…
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 · D2023-05-11 · tag F0690 — failed to manage incontinence, catheters, and urinary infections — isolatedProvide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
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, staff interviews and record review the facility failed to ensure 1 (Resident #1) of 5 residents reviewed with an indwelling foley catheter had a valid medical justification for continued use of an indwelling foley catheter (catheter placed in the bladder to drain urine). The facility failed to provide appropriate care and services to 2 (Resident #13 and #203) of 5 sampled residents with a urinary catheter to prevent urinary tract infections. The findings included: 1. On 5/8/23 at 10:18 a.m. Resident #1 was observed connected to an indwelling foley catheter. A review of Resident #1's medical record revealed Resident #1's initial admission was 5/3/22 with a readmission date of 4/27/23. Initial admission diagnoses were acute cystitis with hematuria, atherosclerotic heart disease, hyperlipidemia, anxiety disorder, syncope, and nonrheumatic aortic stenosis. The comprehensive nursing progress note dated 2/7/23 noted Resident #1 as continent of bowel and bladder. A hospital transfer form dated…
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 · D2023-05-11 · 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 record review, observation and staff interview the facility failed to ensure all drugs and biologicals were labeled or stored in a locked compartment for 2 (Residents #32 and #39) of 2 residents reviewed for medication storage. The findings included: Facility Policy and Procedure for Resident Self-Administration of Medications-MED-4, revised on 3/19 states It is the policy of Brookdale that those residents who desire to self-administer medications may do so if the review determines the resident is capable: 1) If the resident desires to self-administer medications, the charge nurse will review the resident's mental and physical abilities in conjunction with a Self-Administration of Medication Data Collection; 2) This skills review is conducted as part of the care plan process including (but not limited to) the resident's: ability to read and understand medication labels, comprehension of the purpose and proper dosage and administration times of the medications, ability to remove medications from the package and, in case of nonsolid dosage forms such as an inhaler, 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.
- Potential for harm · D2023-05-11 · tag F0791 — failed to provide routine dental services — isolatedProvide or obtain dental services for each resident.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observation, interview, record review, staff and resident interview the facility failed to provide timely dental care services to meet the needs of 1 (Resident #38) of 1 resident reviewed for dental services. The findings included: The facility policy titled Oral Health Care and Dental Services-CS-110-2, revised 11/2017, stated Oral health care and dental services will be provided to each resident. The nursing associates will conduct oral health evaluations on admission and at least quarterly (through the MDS) process. The charge nurse or designee will request a consultation if needed. Social Services or designee will be responsible for making necessary dental appointments. Review of the clinical record for Resident #38 revealed an admission date of 7/21/22. The Quarterly Minimum Data Set with an ARD of 2/26/23 indicated the resident's cognition was intact. No oral concern were noted. Clinical record review noted resident #38 had an order for a dental consult for dentures related to eating/diet on 1/6/2023. On 5/8/23 at 3:27 p.m., Resident #38 was observed in his room. He…
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 7 citations
- Potential for harm · D2023-05-11 · tag F0801 — isolatedEmploy sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on record review, and staff interviews the facility failed to ensure the Dietary Manager was qualified per the regulation. The failure could potentially lead to therapeutic menus not being followed, portion sizes not being followed, and clinical indicators of nutritional deficits not being addressed in a timely manner. The findings included: The facility job description, POL 147; revised 9/12/2018 stated the primary responsibility was to organize and coordinate the Food and Nutrition Services Department's clinical program. The facility job description stated the Registered Diet Technician has completed a 2 year degree program and passed the exam. A minimum of 1 year of dietary management experience, preferably in a health care setting, is required. The Dietary Manager orientation guide dated 10/28/22 revealed section G was not completed. Section G included a review of local/state/federal regulations and the food code. On 5/9/23 at 3:01 p.m., the Registered Dietician (RD) stated she was contracted to work 18 hours per week. The RD was required to complete quarterly notes,…
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 · D2021-09-10 · tag F0686 — failed to prevent and treat pressure sores (bedsores) — isolatedProvide appropriate pressure ulcer care and prevent new ulcers from developing.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observation, record review, review of facility policies, and staff and family interviews, the facility failed to implement ordered preventive measures and monitoring to prevent the development of pressure ulcers for 1 (Resident #32) of 3 sampled residents at risk for developing pressure ulcers. The findings included: The facility policy CS-100-1 (revised 11/19) Skin Observation and Wound Prevention documented, Charge nurses will observe the condition of the resident's skin on admission and on a routine basis. This system also provides a communication process for the nursing assistant to report residents with skin changes to the Charge Nurse . Upon admission the Charge Nurse should complete physical observation, documenting findings within the admission Data Collection form. If a wound is present on admission the Charge Nurse will initiate and describe the wound on the Weekly Wound Data Collection Sheet .Weekly: The Charge Nurse should complete the Skin Integrity Review Form for all residents.Initiate treatment interventions per healthcare provider order for new or newly…
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 · D2021-09-10 · tag F0700 — isolatedTry different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observation, staff interviews, and facility policy review the facility failed to review the risks and benefits of bed rails with the resident or resident representative and obtain informed consent prior to installation of bed rails for 2 (Resident #32 and #34) of 3 residents observed with bed rails. The findings included: The facility policy GEN-6, Bedside Mobility Aid (revised 3/2020) specified, Residents utilizing bedside mobility aids should have a Negotiated Risk Agreement (NRA) or other state required form completed, making sure risks are fully disclosed. A healthcare provider order for the use of bedside mobility aid should be obtained prior to its use. The health care provided must indicate that the bedside mobility aid is to be used for bed mobility and positioning. Specific instructions related to beside mobility aids and their use should be documented on the resident's care plan, reviewed by associates and updated regularly per existing standards of upon a residents change in condition .The use of bedside mobility aids should be reviewed at the time of 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 before2021-09-10 · tag F0755 — failed to provide safe pharmacy services — isolatedProvide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observation, staff interviews, and review of facility policy and procedures, the facility failed to implement a system to account for periodic reconciliation and disposition of all controlled substances. The facility also failed to identify and dispose of expired medications to prevent use. The findings included: The facility policy MED-9 (revised 9/2017) Controlled Substances Policy, documented, Controlled drugs will be properly stored and accounted for as outlined by State and Federal regulations. All discontinued drugs need to be logged and stored in a designated area until drugs can be properly disposed of. The facility policy Storage and Expiration of medications, Biologicals, Syringes and Needles 5.3(revised 1/1/13) documented, .Facility should ensure that medications and biologicals have an expiration date on the label; have not been retained longer than recommended by the manufacturer or supplier guidelines . Once any medication or biological package is opened, facility should follow manufacturer/supplier guidelines with respect to expiration dates for opened…
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 · D2021-09-10 · tag F0759 — failed to keep medication error rate low — isolatedEnsure medication error rates are not 5 percent or greater.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observation, clinical record review, and staff interviews, the facility failed to administer medication according to physician's orders and manufacturer's specification for 2 (Residents #190 and #191) of 9 residents observed for medication administration. Three licensed nurses on two different shifts with 26 opportunities were observed. Two medication errors were observed resulting in a 7.69% error rate. The findings included: On 9/9/21 at 8:25 a.m., Licensed Practical Nurse (LPN) Staff B was observed administering 7 different medications to Resident #190. Upon reconciliation with the physician's orders, it was revealed an order for Voltaren Gel 1% to be applied topically to the right hip two times a day for pain. LPN Staff B was not observed applying the Voltaren Gel to the resident's right hip but documented on the medication administration record the Voltaren Gel was administered at 9:00 a.m. On 9/9/21 2:44 p.m., in an interview, Resident #190 said the nurse did not apply the Voltaren gel to her hip. On 9/10/21 at 2:00 p.m., in an interview LPN Staff B confirmed she 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 · D2021-09-10 · tag F0880 — failed to prevent and control infections — isolatedProvide and implement an infection prevention and control program.
What the surveyor found here — the official record, unedited, may be distressing
Based on observation and interview, the facility failed to administer medications in a sanitary manner for 2 (Resident #190 and #191) of 9 residents observed for medication administration. The findings included: On 9/9/21 at 8:25 a.m., LPN Staff B was observed preparing to administer six oral medications to Resident #190. She punched one of the pills from a blister card into her ungloved hand, placed it in a medication cup and administered all medications to the resident. On 9/9/21 at 8:36 a.m., LPN Staff B was observed preparing to administer 5 oral medications to Resident #191. She punched out each pill from the blister cards into her ungloved hands and transferred them into a medication cup. She administered all the medications to the resident. On 9/9/21 at approximately 8:45 a.m., LPN Staff B verified she touched Resident #190 and #191's medications with ungloved hands and verified the breach of infection control.
- Potential for harm · D2021-09-10 · tag F0909 — failed to maintain a comfortable temperature — isolatedRegularly inspect all bed frames, mattresses, and bed rails (if any) for safety; and all bed rails and mattresses must attach safely to the bed frame.
What the surveyor found here — the official record, unedited, may be distressing
Based on record review, and staff interview, the facility failed to conduct regular inspection of all bed frames, mattresses, and side bed rails, as part of a regular maintenance program to identify areas of possible entrapment. The findings included: The facility Bed Entrapment Guide documented, the threat of bed entrapment within bed rails, bed frames, or mattresses is serious and can result in debilitating chest, head, or neck injuries, sometimes even death. That is why it is important to take every step to reduce the risk of entrapment. On 9/10/21 at 10:24 a.m., in an interview the Maintenance Director said he was new in the position at the facility and was at the facility for two days. The Maintenance Director said he spoke with the Administrator and there was no record of maintenance completed for the assist bars used in the facility. He confirmed the facility had no documentation of assessment of a regular maintenance program that included the inspection of all bed frames, mattresses, and bed rails.
“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
$59,696 in federal fines across 1 penalty.
- $59,696 — penalty dated 2025-03-19
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.
Who owns this facility
| Owner / manager | Type | Role | Since |
|---|---|---|---|
| Ownership Data Not Available |
The source lists no ownership percentage for any party here — 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 $176K paid to related parties (affiliated landlords or management companies) in its most recent cost report. A reported operating loss is common in this industry and is not by itself a sign of trouble — but paired with large related-party payments it can mean profit is being taken elsewhere in the ownership structure.
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 106022. CMS refreshes its data monthly, and the star rating rests on the last standard inspection — dated 2024-08-29, 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.