Above average — CMS composite of the measures below.
A standard survey is most likely before around September 2026
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Silver Oaks Health And Rehabilitation during CMS and state inspections, most recent first.
Surveyors identified inaccurate MDS assessments for three residents, including incorrect coding of mental health status, feeding tube presence, and discharge destination. Facility leadership confirmed the errors, which were inconsistent with residents' diagnoses, care plans, and actual discharge outcomes.
Staff failed to perform proper hand hygiene during medication administration, incontinence care, and meal assistance. A CNA assisted multiple residents with dining after touching various surfaces and personal items without sanitizing hands. An LPN administered oral medication to a resident after handling multiple items without hand hygiene. During incontinence care, a CNA left the bedside to retrieve supplies without removing gloves or sanitizing hands, leading to cross contamination.
A resident with memory impairment and a need for enteral feeding received incontinence care that did not follow infection prevention protocols, as a CNA wiped from back to front. During the same care episode, the head of the bed was lowered to flat while enteral nutrition was infusing, without pausing the feeding pump, contrary to facility policy and standard practice. Staff interviews confirmed these actions did not meet required standards.
The facility failed to provide timely incontinence care for three residents, resulting in them being left in urine-saturated conditions. One resident with moderate cognitive impairment was found with a saturated brief and wet bed linens. Another resident, also moderately impaired, had wet linens and expressed that staff did not respond promptly to call lights. A third resident with memory issues was found with wet clothing and furniture, despite facility records indicating regular incontinence checks. Video footage confirmed that rounds were not performed as documented.
A facility failed to clarify and administer the correct flush amounts for a resident with a PEG tube, leading to severe dehydration and hospitalization. The resident's care plan and physician's orders were inconsistent, and staff did not properly administer the prescribed flushes, resulting in the resident being found in a lethargic state with elevated respirations and clammy skin.
The facility failed to ensure proper food storage and sanitation practices, affecting 89 residents. Observations revealed unlabeled food items, rust stains, peeling paint, and damaged door frames in the kitchen. Dietary staff did not follow handwashing protocols, increasing the risk of foodborne illness.
A resident with adjustment disorder and morbid obesity was observed lying in a compromising position visible from the hallway, and later found incontinent of stool. Staff failed to intervene promptly, and during incontinence care, the resident's buttocks were exposed without the privacy curtain being pulled, compromising the resident's dignity in front of a roommate.
The facility failed to provide a safe, clean, and comfortable environment for two residents. One resident with Alzheimer's and bladder dysfunction was found in a room with a strong urine odor and flies, while another resident with morbid obesity and incontinence was in a room with a strong urine smell and a wet floor.
The facility failed to ensure that a narcotic box in the medication storage room was permanently affixed and did not remove expired medications from the medication room and medication cart. An LPN confirmed the presence of narcotics in an unsecured box and was unaware of who checks for expired medications.
The facility failed to ensure that pureed food items were blended to a smooth, lump-free consistency for residents on pureed diets. During a breakfast observation, pureed sausage was lumpy, pureed biscuit was thick, and pureed eggs were separated. Staff confirmed the inconsistencies, affecting 10 residents.
The facility failed to store clean linens away from dirty items, and staff did not follow proper hand hygiene and wound care procedures. Clean linens were placed on the floor before being used, and a nurse used contaminated supplies during wound care for a resident with multiple pressure ulcers.
The facility failed to evaluate and determine if two residents were able to self-administer medication. One resident with Rheumatoid Arthritis and Systemic Lupus was found with antifungal powder and cream at her bedside, and another resident with Gastro-esophageal reflux disease and mild cognitive impairment was found with a chewable antacid tablet. Both residents' care plans lacked documentation for self-administration, and the facility's policy on medication storage was not followed.
A resident with Alzheimer's, major depressive disorder, and anxiety disorder was found without privacy curtains in their semi-private room for several days. Staff were unaware of the removal or duration of the absence, and the Director of Nursing confirmed the importance of privacy curtains for dignity and privacy. The curtains were not replaced until the issue was highlighted.
Inaccurate MDS Assessments for Multiple Residents
Penalty
Summary
The facility failed to ensure the accuracy of Minimum Data Set (MDS) assessments for three residents, as identified through observations, interviews, record reviews, and policy review. For one resident with diagnoses including schizophrenia, anxiety, and depression, the annual MDS was incorrectly coded to indicate the absence of a serious mental illness, despite documentation and confirmation from the Administrator and DON that the resident was a PASARR level II and had a mental health diagnosis. Another resident, who required tube feedings due to swallowing difficulties, was inaccurately coded on the quarterly MDS as not having a feeding tube, even though the care plan and staff interviews confirmed the presence of a feeding tube. A third resident, admitted with multiple fractures, was discharged home with medications and home health services, but the discharge MDS inaccurately indicated a transfer to a short-term acute hospital. Multiple sources, including care plans, discharge summaries, and progress notes, confirmed the resident was discharged home. The Administrator acknowledged discrepancies in the MDS coding for all three cases and confirmed that the assessments did not accurately reflect the residents' conditions or discharge status, as required by facility policy.
Failure to Perform Proper Hand Hygiene During Resident Care
Penalty
Summary
Surveyors identified multiple instances where staff failed to perform proper hand hygiene during resident care activities. During meal service, a CNA assisted residents with dining after touching residents, tables, a wheelchair, his own hair, and picking a spoon up off the floor, all without washing or sanitizing his hands. The CNA confirmed in an interview that he did not perform hand hygiene after these actions. The Director of Nursing and Administrator both stated that staff are expected to wash or sanitize hands after such contacts. In another instance, an LPN administered oral medication to a resident with limited physical mobility after handling various items such as the medication cart, computer mouse, and keys, without sanitizing or washing his hands before placing medication in the resident's mouth. The LPN acknowledged his hands were not clean at the time. Additionally, during incontinence care for a resident who was totally dependent on staff, a CNA left the bedside to retrieve a clean brief without removing gloves or performing hand hygiene, which she later recognized as cross contamination. Facility policy requires hand hygiene before and after resident contact, after touching the resident's environment, and after contact with contaminated surfaces.
Improper Incontinence and Enteral Feeding Care Practices
Penalty
Summary
Certified Nursing Assistants (CNAs) were observed providing incontinence care to a resident with both short-term and long-term memory problems, as well as actual or potential skin integrity impairment due to incontinence and immobility. During care, a CNA was seen wiping from back to front, toward the resident's genitalia, contrary to facility policy and best practice, which require wiping from front to back to prevent infection. Interviews with the CNA, the Director of Nursing (DON), and the Administrator confirmed that the correct procedure was not followed, and that staff are expected to wipe away from the genitalia to reduce infection risk. Additionally, while the same resident was receiving enteral nutrition via a feeding pump, a CNA was observed lowering the head of the bed to a flat position to provide care, without pausing the feeding pump. This action was inconsistent with facility policy and standard practice, which require the feeding pump to be paused and the head of the bed to remain elevated to prevent aspiration. Interviews with staff, including the DON and an LPN, confirmed that the feeding pump should have been paused and the bed should not have been laid flat during enteral feeding. The resident's care plan indicated a need for tube feedings due to swallowing difficulties.
Failure to Provide Timely Incontinence Care
Penalty
Summary
The facility failed to provide timely incontinence care for three residents, leading to them being left in urine-saturated conditions. Resident #7, with moderate cognitive impairment, was found with a saturated brief, draw sheet, and fitted sheet, indicating a lack of timely care. Certified Nursing Assistants (CNAs) confirmed the resident's condition, and the facility's policy on perineal care was not adhered to, as the resident's bed was wet, suggesting incontinence care was not performed promptly. Resident #8, also moderately cognitively impaired, was observed with wet linens and gown due to incontinence. CNAs reported that they were unaware of the resident's condition until they turned the resident, and the resident expressed that not all staff responded to call lights promptly. This indicates a failure in the facility's protocol to check and provide care for incontinent residents regularly, as outlined in their care plan. Resident #9, with memory problems and a risk of skin integrity issues, was found with wet clothing and furniture. The facility's records indicated that incontinence checks were supposed to occur every two hours, but video footage revealed that rounds were not performed as documented. The Administrator acknowledged that wet linens could indicate untimely care, which could lead to skin breakdown, further highlighting the deficiency in adhering to the facility's care policies.
Failure to Clarify and Administer Correct PEG Tube Flush Amounts
Penalty
Summary
The facility failed to clarify orders for the correct flush amount to be administered before and after medications through a PEG tube for Resident #52, who had diagnoses including dysphagia, cerebral infarction, and required a feeding tube for nutrition. The physician's orders were inconsistent and did not specify how the flush should be provided, leading to confusion among the staff. The resident's care plan indicated the need for tube feeding and water flushes as per physician's orders, but the electronic Medication Administration Record (eMAR) showed discrepancies in the administration of the flushes, with varying amounts being given at different times and not aligning with the orders. On multiple occasions, observations revealed that the feeding pump was set incorrectly, and the flush amounts were not being administered as required. For instance, on 04/15/2024, the pump showed zero flushes had been administered despite being set to 175 ml every 0 hours. The resident was found in a lethargic state with elevated respirations and clammy skin, prompting the surveyor to alert the Assistant Director of Nursing (ADON) and the Director of Nursing (DON). The resident was later assessed by a practitioner and sent to the emergency room for observation due to severe dehydration, as indicated by elevated sodium and chloride levels in the hospital records. Interviews with the staff confirmed that the flush orders were not properly clarified, and the resident did not receive the prescribed flush amounts. The Licensed Practical Nurse (LPN) admitted that the flushes were not administered correctly, and the DON confirmed that any concerns with a physician's order should be clarified by the nurse taking care of the patient. The facility's Enteral Nutrition policy required complete orders, including instructions for flushing, which were not followed in this case, leading to the resident's dehydration and subsequent hospitalization.
Food Storage and Sanitation Deficiencies
Penalty
Summary
The facility failed to ensure proper food storage and sanitation practices in the kitchen, which had the potential to affect 89 residents. Observations revealed that food items in the freezer and spices in the cabinet were not labeled with open dates. Additionally, a box of spaghetti with meat sauce in the freezer lacked identification and a received date. The storage room and kitchen had multiple issues, including rust stains, peeling paint, cracks, and discoloration on vents, ceiling tiles, and door frames. The floor leading to the walk-in refrigerator and the door frame itself were stained and damaged, exposing wood. The ceiling tile above the food preparation counter had black stains, and vents in various locations had rust, lint, and black dust accumulation. Dietary staff failed to follow proper handwashing protocols, increasing the risk of foodborne illness. One dietary employee handled clean plates and portioned desserts without washing her hands after returning from the dining room. Another employee used pan liners and handled cake slices without washing her hands. A third employee handled utensils and napkins without washing her hands after touching dirty objects. These actions were in direct violation of the facility's policy on employee cleanliness and handwashing techniques, which requires handwashing before beginning a shift and any other time deemed necessary.
Failure to Maintain Resident Dignity and Privacy
Penalty
Summary
The facility failed to treat Resident #5 with respect and dignity, as observed by the surveyor. Resident #5, who has diagnoses of adjustment disorder with depressed mood and morbid obesity, was found lying sideways on the bed with feet on the floor and legs open toward the door, exposing an incontinence brief. This situation was visible from the hallway, and three staff members passed by without intervening. Later, the surveyor observed Resident #5 incontinent of stool, which had spilled onto the fitted sheet. The surveyor reported this to an LPN, who then called CNAs to perform incontinence care. During the transfer of Resident #5 from the bed to a shower chair, the resident's buttocks were exposed, and the privacy curtain was not pulled, compromising the resident's dignity in front of a roommate who was present in the room. The surveyor questioned the LPN and CNAs involved, who acknowledged that the resident's privacy and dignity were compromised. The Director of Nursing (DON) also confirmed that such actions could invade the resident's privacy and dignity. The facility's policy on dignity, which emphasizes promoting and protecting resident privacy and bodily privacy during personal care and treatment procedures, was not adhered to in this instance.
Failure to Maintain Clean and Comfortable Environment
Penalty
Summary
The facility failed to ensure a safe, clean, and comfortable environment for two residents. Resident #15, who has Alzheimer's disease and neuromuscular dysfunction of the bladder, was observed multiple times over two days in a room with a strong odor of urine and several flies crawling on and around them. Dirty clothes were also noted on the floor. Both the LPN and the DON confirmed the presence of multiple flies and the strong odor of urine in the resident's room. The DON also mentioned that Resident #15 frequently urinated on the floor, contributing to the unsanitary conditions. Resident #5, who has an adjustment disorder with depressed mood and morbid obesity, was also found in an unsanitary environment. The resident, who is always incontinent of bowel and bladder and requires extensive assistance with bed mobility, was observed in a room with a strong smell of urine and a wet floor where a fall mat had been. CNA #7 confirmed that the wet substance on the floor smelled like urine. The DON acknowledged that such conditions do not meet the facility's cleanliness standards as outlined in their policy for maintaining a homelike environment.
Failure to Secure Narcotics and Remove Expired Medications
Penalty
Summary
The facility failed to ensure that a narcotic box located in the refrigerator in the medication storage room was permanently affixed. During an interview, an LPN confirmed the presence of narcotics inside the refrigerator and demonstrated that the metal lock box containing the narcotics was not permanently affixed. Additionally, the LPN had to retrieve keys from another nurse to unlock the narcotic box, which contained various medications including Lorazepam. This indicates a lapse in the secure storage of controlled substances as required by regulations. The facility also failed to ensure that expired medications were removed from the medication room and medication cart. During an inspection, expired medications were found in the 100 Hall Medication Cart and the medication storage room. The LPN was unaware of who was responsible for checking the medication room for expired medications. The facility's Medication Labeling and Storage policy requires that expired or discontinued medications be returned or destroyed, and controlled substances be stored in permanently affixed compartments, which was not adhered to in this instance.
Failure to Provide Properly Pureed Food
Penalty
Summary
The facility failed to ensure that pureed food items were blended to a smooth, lump-free consistency for residents who required pureed diets. During a breakfast observation, pureed sausage was found to be lumpy with visible pieces, pureed biscuit was thick, and pureed eggs were separated. Certified Nursing Assistants and the Dietary Supervisor confirmed that the pureed sausage was gritty and the pureed bread was either thick or sticky. This deficiency had the potential to affect 10 residents who were on pureed diets.
Infection Control Deficiencies in Linen Storage and Wound Care
Penalty
Summary
The facility failed to ensure clean linens were stored away from dirty items to prevent the spread of infection. During an observation of the dirty side of the laundry area, clean shoes and privacy curtains were found stored on a white wire shelf above laundry chemicals and an eye wash station. Additionally, a storage closet propped open with a blue barrel contained clean pillows and linens, with green curtains hanging from a shelf. On the clean side of the laundry, cardboard boxes and laundry baskets containing resident items were stored directly on the floor, posing a risk of contamination if the area were to flood or become dirty. The Treatment Nurse did not follow facility guidelines when performing wound care for a resident with multiple pressure ulcers. The nurse handled gloves and wound care supplies without proper hand hygiene, placing gloves on a laptop keyboard and using bare hands to gather supplies. During the wound treatment, the nurse dropped a packet of Collagen Dressing on the floor, picked it up, and used it on the resident's wound, despite knowing it should not have been used after falling on the floor. The resident was moderately cognitively impaired and had several pressure ulcers, including stage II, III, IV, and unstageable ulcers. Certified Nursing Assistant (CNA) #6 placed clear bags of clean linens on the floor before placing them on bedside tables and resident beds without cleaning the surfaces afterward. During incontinence care for a resident, CNA #6 did not sanitize hands between glove changes and used peri-care wipes instead of proper sanitizing wipes to clean the bedside table. The Director of Nursing confirmed that these actions could lead to cross-contamination and infection control issues, and that proper hand hygiene and sanitizing procedures were not followed as per facility policy.
Failure to Evaluate Residents' Ability to Self-Administer Medications
Penalty
Summary
The facility failed to evaluate and determine if two residents were mentally and physically able to self-administer medication. Resident #33, who had diagnoses of Rheumatoid Arthritis and Systemic Lupus, was found with antifungal powder and Nystatin-Triamcinolone cream at her bedside, which she admitted to applying herself. There was no documentation in her care plan indicating that she was permitted to self-administer medication, and the Director of Nursing (DON) confirmed that residents are not allowed to self-administer medications. Additionally, the facility's policy on self-administration of medications was not followed, as medications were not stored in a safe and secure place. Resident #44, who had diagnoses of Gastro-esophageal reflux disease and mild cognitive impairment, was found with a pill cup containing a chewable antacid tablet on the bedside table. There was no physician's order allowing the resident to self-administer medications, and the resident's care plan did not document the ability to self-administer. The resident was not in the room when the medication was found, and upon return, confirmed the presence of the antacid tablet. The facility failed to assess and document the resident's ability to self-administer medications, leading to the deficiency.
Failure to Provide Privacy Curtains for Resident
Penalty
Summary
The facility failed to ensure privacy curtains were provided for a resident residing in a semi-private room. The resident, who had diagnoses of Alzheimer's disease, major depressive disorder, and anxiety disorder, was observed without privacy curtains in their room on multiple occasions over several days. Certified Nursing Assistants (CNAs) and Maintenance staff were unaware of why the curtains were removed or how long they had been down. The Director of Nursing (DON) confirmed that the purpose of privacy curtains is to protect the resident's dignity and privacy and acknowledged that the curtains should not have been down for three months. The resident's care plan did not indicate that a privacy curtain was inappropriate for use. Despite the facility's policy on dignity, which emphasizes the importance of respecting private space and property, the privacy curtains were not replaced until the issue was brought to the attention of the staff. The DON admitted that staff could not provide privacy for the resident without the curtains, and there was no known reason for the absence of the curtains in the resident's room.
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Illustrative
What surveyors actually found near you
We read the 4 citations issued within 25 miles in the last 12 months — and tell you exactly what happened, in plain English, matched to your record.
Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
Illustrative
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Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Camden
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Ouachita Nursing And Rehabilitation Center | 1.7 mi | ★★★★★ | 3 | 0 |
| The Springs Of Camden | 1.8 mi | ★★★★★ | 0 | 0 |
| The Springs Magnolia | 24 mi | ★★★★★ | 1 | 0 |
| Hudson Memorial Nursing Home | 25.4 mi | ★★★★★ | 1 | 0 |
| Courtyard Rehabilitation And Health Center, Llc | 25.6 mi | ★★★★★ | 4 | 0 |
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