Below average — CMS composite of the measures below.
The next survey window likely opens around February 2027
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 Milford Center during CMS and state inspections, most recent first.
The facility failed to offer a cognitively intact resident the opportunity to formulate an AD. The resident stated he did not have an AD and was not offered help with completing one, and the SW confirmed the assessment showed the right to formulate an AD was not offered.
A resident admitted with schizoaffective disorder and insomnia was receiving Seroquel and Trazodone, with a GDR initiated for Seroquel and a later increase in Trazodone. Staff interviews showed CNAs did not document sleep patterns, while nursing staff were expected to document sleep-related interventions and nighttime wakefulness. The NP confirmed the resident was stable on the medication combination, but the facility failed to monitor and document the effectiveness of sleep meds and failed to document the rationale for the Trazodone increase.
A resident’s MDS assessments did not accurately reflect his dental, hearing, and vision status. The resident stated he had no teeth and needed to see a dentist, and he was observed having difficulty hearing during interview. The MDS Coordinator confirmed the resident had been coded as having no hearing or vision issues, while PT and OT evaluations documented hearing loss.
A resident with insomnia had a care plan that included general sleep interventions, but it lacked measurable goals and person-centered interventions. An LPN stated that non-pharmacological interventions for insomnia should be documented in progress notes and the care plan, and the DON confirmed the plan was initiated but did not include person-centered interventions related to the resident’s sleep disturbance.
An LPN completed a resident’s admission assessment, Braden Scale assessment, and lift evaluation instead of an RN, even though Delaware scope of practice requires RN completion of admission assessments. An RN later confirmed that all admission assessments for new residents were expected to be completed by an RN.
Failure to Identify and Refer A Resident for Hearing and Vision Services: A resident with documented cataracts and left ear hearing impairment was repeatedly assessed in MDS records as having adequate hearing and vision with no aids or corrective lenses, despite observations that he frequently asked staff to repeat themselves, held his hand to his ear, and said his readers were not helping him see clearly. The resident stated he wanted hearing aids and glasses and would attend appointments if they could be obtained, but the facility did not identify, routinely assess, or refer him for the needed hearing and vision services.
Failure to follow a physician-ordered heel dressing change occurred for a resident with diabetes, acute kidney failure, and a pressure injury present on admission. The right heel treatment was entered as an ancillary order instead of on the TAR, leaving no place for nursing staff to document completion of the ordered foam dressing changes twice daily. During wound rounds, an LPN found the dressing dated several days earlier, and an RN confirmed the order entry error.
Failure to document a clinical rationale for not completing a GDR and to respond to an MRR recommendation within the expected timeframe. One resident with schizophrenia remained on Abilify without a documented rationale in the MD progress note for not attempting a GDR, and another resident’s Depakote dose reduction recommendation from pharmacy was not acted on until 41 days later. The DON confirmed MRR recommendations were expected to be addressed within 30 days.
A facility failed to assist two residents with obtaining routine dental services. One resident with broken teeth/cavities was observed missing multiple teeth, reported a tooth fell out while eating and that he sometimes had pain, and was not on the dental list when surveyed. Another cognitively intact resident with no teeth stated he needed to see the dentist and had requested dental services, but no dental referral was initiated and he was not listed for dental care.
A family member of a resident with multiple serious health conditions raised concerns about care and communication after the resident was sent to the ER. The facility documented the grievance and discussed it with clinical staff, but did not provide a written decision to the complainant, only leaving a voice message and escalating the issue to a reportable event.
A resident with CHF who required daily weights consistently refused to be weighed due to distrust in the Hoyer lift and wheelchair scales. Nursing staff documented the refusals and the resident's concerns, but the care plan was not updated to address these refusals or to provide alternative interventions.
A resident's medical record was found to be incomplete, with missing documentation of daily weights on multiple dates as required by the TAR. This deficiency was confirmed by the Clinical Lead and reviewed with facility leadership.
Surveyors observed mold on ceiling tiles in the dry food storage room and inside the tubing of the kitchen juice machine, indicating a failure to store and serve food and beverages in accordance with professional standards.
Multiple residents requiring respiratory support, including those using IVAPS, Bi-PAP, and continuous oxygen, were found with improperly managed respiratory equipment and supplies. Masks for non-invasive ventilators were left on bedside tables or nightstands without protective bags, oxygen concentrator filters were observed with thick gray dust despite orders for regular cleaning, and oxygen tubing lacked required labeling with date and staff initials. Staff interviews confirmed that these practices did not follow existing orders or expected procedures for respiratory equipment storage, cleaning, and labeling.
A resident admitted with pneumonia and respiratory failure had MD orders for continuous O2 at 6 L/min via nasal cannula and for use of an incentive spirometer as tolerated. The incentive spirometer was observed at the bedside, and the resident reported using it. Despite these active respiratory treatments, review of the clinical record showed no care plan addressing oxygen administration or incentive spirometer use, a fact confirmed by the facility’s quality manager during surveyor interviews.
A dependent resident with severe cognitive impairment, care planned as requiring assistance with all ADLs and maximal help for personal hygiene, was repeatedly observed over several days with long fingernails and dark debris under each nail on both hands. Staff interviews revealed that a CNA reported nail care was performed on bath days, while an LPN and the Quality Manager confirmed the presence of long nails with debris, demonstrating that necessary nail care was not provided for this resident.
A resident with severe cognitive impairment and dependence in all ADLs had an active order and care plan for a left palm guard to be applied daily after AM care to help maintain ROM and prevent contractures. Over multiple observations, the resident was repeatedly seen without the palm guard during times it should have been in place, and CNAs reported they had never applied or seen the device on the resident. The Quality Manager confirmed the resident did not have a palm guard, and the Rehab Director later acknowledged the order had been mistakenly discontinued, resulting in the resident not receiving the ordered ROM-related intervention.
A resident who was cognitively able to participate in care and initially required only supervision or minimal assistance for toileting was assessed as a candidate for prompted voiding, but no toileting plan or care plan update was developed. Over several months, CNA documentation showed increasing urinary incontinence, while MDS assessments documented a decline from cognitive intactness to moderate impairment and a change from occasional to frequent incontinence, with no toileting program in place. CNA records lacked individualized toileting approaches and combined bowel and bladder data, obscuring continence status. In interviews, the resident reported being continent and able to toilet independently, whereas a CNA and an LPN stated the resident needed assistance, was taken to the toilet every two hours, had increased incontinence episodes, and was not on a toileting program, demonstrating the facility’s failure to implement an individualized toileting program to maintain bladder continence.
A resident with documented intact oral status on a prior MDS later exhibited loosely fitting dentures, but had not been assisted in obtaining routine dental services. The guardian reported the resident had never seen a dentist, despite the facility having access to an on-site dentist and outside dental providers. Staff explained that residents are added to a list when they request dental care, yet the resident had not been scheduled or seen by a dentist, resulting in a failure to facilitate needed dental services.
A resident’s clinical record did not accurately reflect their presence in the facility and care received prior to transfer to the ER. On the day the resident was involved in an altercation with another resident and subsequently ordered by a physician to be sent to the ER, CNA documentation for the day shift recorded the resident as “not available” for all ADL tasks. In a later interview, a CNA confirmed the resident had been in the facility during that shift, and a regulatory compliance advisor confirmed the resident left for the ER later in the day and that documentation should have shown care provided before departure.
A resident with a history of elopement risk and a physician's order for a wander guard device was able to leave the facility unsupervised through an unsecured sliding door left unlocked by a contractor. The resident was missing for over an hour and was later found asleep on the grass after crossing a busy roadway, indicating a failure to provide adequate supervision and secure exits.
The facility failed to provide adequate hydration and monitoring for three residents, leading to severe health issues. One resident with acute kidney injury did not meet fluid intake goals, resulting in hospital admission for dehydration. Another resident with chronic conditions experienced a critical rise in sodium levels due to delayed IV hydration, leading to hospital transfer. A third resident suffered significant weight loss without proper weight monitoring.
A resident with dementia and a history of falls experienced multiple falls, including two with head trauma requiring hospital transfer, due to the facility's failure to conduct ongoing urinary continence assessments and implement individualized toileting interventions. Despite repeated incidents related to attempts to use the bathroom, the facility did not reassess or adjust the resident's care plan, and leadership confirmed that only admission assessments for voiding patterns were performed.
The facility failed to store, prepare, and serve food safely, risking foodborne illness. The Dietary Manager found insufficient sanitizer levels in buckets, mold-like stains on kitchen ceilings, a damaged freezer door causing ice build-up, and dust and a black substance on juice machine tubes. These issues were discussed with the NHA and DON.
The facility failed to ensure comprehensive care planning by not conducting regular care plan meetings and lacking input from all required interdisciplinary team members. Several residents' care plans were not updated to reflect current needs, such as refusal of care, and meetings often lacked participation from essential staff like physicians and CNAs. These deficiencies were confirmed through staff interviews.
The facility failed to assess and provide adequate care for residents with incontinence issues. Several residents, including those who were frequently incontinent of bowel and bladder, were not placed on toileting programs despite their needs. Staff interviews confirmed the lack of individualized care plans and assessments, leading to increased incontinence episodes. The facility did not analyze CNA data to create personalized care plans, resulting in inadequate continence management.
The facility did not conduct thorough investigations into allegations of abuse and neglect for four residents, as required. In each case, documentation of staff interviews was missing or incomplete, even when residents were dependent for ADLs or had specific care needs such as wound treatment. Facility leadership confirmed that direct care staff interviews were not obtained or included in the investigative process.
A resident with a history of dialysis refused treatment, and the facility failed to ensure the provider was consulted. Staff interviews indicated the expectation to notify the provider and family, but it was noted that the provider was already aware of the resident's refusal behavior. The issue was discussed with the NHA and DON.
A resident's grievances regarding inadequate care during specific shifts were not resolved by the facility. The grievances, documented by the social worker, lacked follow-up actions, and interviews with the NHA and DON confirmed the absence of resolution. The grievance process was halted when grievances were considered reportable, leaving the issues unaddressed.
A facility failed to report an allegation of neglect involving a resident in a timely manner. A CNA reported that an LPN was neglectful in responding to a resident's needs, but the incident report was submitted to the state agency eight days later, and the five-day follow-up report was delayed by fifteen days. The DON confirmed the late reporting during an interview.
The facility failed to complete PASARR referrals for two residents. One resident, admitted with bipolar disorder, later showed aggressive behaviors and new mood disorder diagnoses without a PASARR update. Another resident had multiple mood disorder diagnoses, but the facility did not update the PASARR to reflect these changes. The social worker confirmed the oversight, and a subsequent resubmission indicated a need for a PASARR Level II evaluation.
The facility failed to provide adequate assistance for activities of daily living (ADLs) to several residents, resulting in poor hygiene and unmet care needs. Observations revealed residents with unclean nails and soiled clothing, despite care plans indicating the need for assistance. Staff interviews confirmed confusion about responsibilities and a lack of documentation for care refusals.
The facility failed to provide necessary treatment for pressure ulcers for two residents. One resident's wound care was not completed due to being away or refusing treatment, with the dressing unchanged for eight days. Another resident was observed wearing incorrect boots, contrary to orders and recommendations. Staff interviews revealed a lack of understanding regarding proper equipment use, leading to inconsistent preventative measures.
A resident with multiple psychiatric and dementia-related diagnoses was prescribed Ativan for anxiety, but the facility failed to monitor for side effects of the psychotropic medication. This deficiency was confirmed by the Unit Manager and discussed with the Nursing Home Administrator during the exit conference.
A resident with a suspected urinary tract infection had lab results indicating a positive infection, but the facility failed to notify the provider promptly. The results were available over the weekend, but the on-duty nurse did not communicate them, resulting in a delay in treatment until the following Monday.
A facility failed to assist a resident in obtaining routine dental services. The resident, admitted in 2021, reported having several missing teeth and not being offered dental services. Staff confirmed that a dentist visits the facility and residents can see outside providers, but the resident was not on the list for dental services. The deficiency was reviewed with the NHA and DON.
The facility failed to maintain accurate clinical records for two residents, including an instance where an LPN signed off on wound care that was not performed and a CNA documented a resident as independent in ADLs despite requiring extensive assistance. Additionally, CNAs inconsistently documented toileting and elimination for another resident, with some staff unaware of the correct procedures and lacking formal training.
Failure to Offer Advance Directive Opportunity
Penalty
Summary
The facility failed to offer one cognitively intact resident, R7, the opportunity to formulate an advance directive. R7 was admitted on 2/3/26, and a BIM's assessment completed on 2/6/26 at 11:31 AM showed a score of 15, indicating the resident was cognitively intact. An admission Social Services Assessment completed on 2/6/26 at 11:34 AM documented that R7 did not have an advance directive in place and marked the opportunity to complete an advance directive as No. During an interview on 3/2/26, R7 stated that he did not have an advance directive and that the facility did not offer to assist with formulating one. On 3/3/26, the SW stated the expectation was to complete the assessment with the resident and, if they did not have an advance directive, to offer assistance in enacting one, and confirmed that based on R7's assessment the right to formulate an advance directive was not offered.
Unnecessary Psychotropic Medication Use and Inadequate Sleep Medication Monitoring
Penalty
Summary
The facility failed to ensure that one resident was free from unnecessary medications. The resident was admitted on 7/12/23 and had physician orders for Trazodone 50 mg at bedtime for insomnia beginning 10/8/24 and Seroquel 12.5 mg at bedtime for schizoaffective disorder beginning 1/10/25. On 11/13/25, a provider progress note documented initiation of a GDR of Seroquel, and later that day a physician order increased Trazodone to 50 mg one tablet at bedtime for insomnia. An IDT progress note the same evening stated the resident had no change in behaviors, no increase or change in medications in the last 30 days, and pharmacy recommended GDR when the resident was clinically stable; it also noted the resident was currently on Seroquel and Trazodone 50 mg. During interviews, a CNA stated staff are expected to monitor residents with insomnia and maintain safety while they are awake, but CNAs do not document sleep patterns, including times or frequency of awakenings. An LPN stated staff should monitor residents with insomnia and document non-pharmacological interventions in progress notes, including how often the resident is awake during the night and the duration of wakefulness. An NP stated staff should monitor and document sleep patterns and interventions for residents taking sleep medications and notify the provider if patterns change. The NP also confirmed the resident was on a GDR of Seroquel and stated that when one medication is decreased, another may be increased to offset the decrease, but was not sure why Trazodone was increased. The NP stated the resident was stable on the medication combination and did not have increased behaviors or concerns, and the facility failed to monitor and document effectiveness of medications used for sleep and failed to document the rationale for the increase of Trazodone.
MDS Assessment Did Not Accurately Reflect Resident’s Dental, Hearing, and Vision Status
Penalty
Summary
The facility failed to ensure that one resident’s Minimum Data Set (MDS) assessment accurately reflected the resident’s dental, vision, and hearing status. The resident’s admission clinical assessment included an oral/dental section, but the oral/dental examination was documented as not assessed/no information. The admission MDS later coded the resident as having adequate hearing and vision, a BIMS score of 15, and oral/dental status as none of the above. Subsequent quarterly MDS assessments also documented adequate hearing, no hearing aid, adequate vision, and no corrective lenses. During observation and interview, the resident stated that he had told staff he needed to go to the dentist and that he did not have any teeth. The resident was also observed frequently saying “huh,” holding his hand to his left ear when questions were asked, and needing questions repeated with the interviewer raising their voice to obtain responses. The MDS Coordinator confirmed the resident had been coded on the MDS as having no hearing or vision issues and reviewed PT and OT evaluations that documented hearing loss. The Physical Therapist stated the initial evaluation documented hearing loss in the left ear during the admission assessment.
Care Plan Lacked Measurable, Person-Centered Insomnia Interventions
Penalty
Summary
A comprehensive care plan was not developed for one resident with insomnia, and the existing plan did not include measurable goals and person-centered interventions. The resident was admitted to the facility on 7/12/23. On 4/10/25, the care plan documented sleep pattern disturbances with interventions to increase daytime activity, maintain the resident’s preferred bedtime, and provide an environment conducive to adequate sleep and the resident’s preferred sleep/wake schedule, with a goal that the resident would maintain a pattern of sleep sufficient to promote health and well-being throughout the review period. During an interview on 3/4/26, an LPN stated that nurses are expected to document non-pharmacological interventions used to assist residents with insomnia in progress notes and that those interventions should be documented in the care plan, and that care plans should have measurable goals and person-centered interventions. On 3/6/26, the DON confirmed that the care plan was initiated but lacked person-centered interventions related to the resident’s insomnia.
LPN Completed RN-Required Admission Assessments
Penalty
Summary
The facility failed to ensure services were provided in accordance with professional standards of quality by allowing a Licensed Practical Nurse to complete admission assessments that, under the Delaware Board of Nursing scope of practice, are required to be completed by a Registered Nurse. For one resident, the clinical admission assessment, Braden Scale assessment, and lift evaluation were completed by an LPN at the time of admission rather than by an RN. The record also showed that an RN later confirmed the expectation was for a Registered Nurse to complete all admission assessments for new residents, and the LPN who completed the assessments was identified as the staff member who performed them.
Failure to Identify and Refer Resident for Hearing and Vision Services
Penalty
Summary
The facility failed to ensure that R42 received proper treatment and assistive devices to maintain hearing and vision abilities. On admission, the clinical assessment documented that R42 was not using hearing aids, hearing and vision abilities were not assessed, and no corrective lenses were in use. Subsequent therapy evaluations documented that R42 had vision impairment, cataracts, and left ear hearing impairment, yet the admission MDS and later quarterly MDS assessments documented adequate hearing and vision, no hearing aids, and no corrective lenses. R42 later told Social Services that he wanted referrals for dental, hearing, and vision services, and the care plan documented acceptance of ancillary services with interventions related to discussing and educating about those services. However, interviews and observations showed R42 frequently asked staff to repeat themselves, held his hand to his left ear, stated that readers were not helping him see clearly, and said he would go to appointments if hearing aids and glasses could be obtained. Staff interviews confirmed that changes in hearing or vision should be reported and evaluated, and that the social worker would make outside appointments once the IDT determined services were needed. The facility failed to identify R42's vision and hearing deficits, routinely assess and evaluate them, and refer him for necessary services related to hearing and vision.
Failure to Follow Ordered Heel Dressing Changes
Penalty
Summary
Provide appropriate pressure ulcer care and prevent new ulcers from developing was not followed for one resident with a right heel blister. The resident was admitted with diagnoses including displaced fracture of the left femur, acute kidney failure, and diabetes, and an initial MDS documented the resident was cognitively intact with one unstageable pressure injury present on admission. A physician ordered skin prep to the right heel blister followed by a foam dressing twice daily, but the treatment was entered as an ancillary order and did not appear on the TAR, leaving no designated place for nursing staff to document completion. During wound rounds, the right heel foam dressing was observed dated 3/2/26, showing it had not been changed twice daily as ordered. An LPN confirmed the dressing date and changed it immediately, and an RN confirmed the order had been entered incorrectly as an ancillary order rather than on the TAR.
Failure to Document GDR Rationale and Timely Address MRR Recommendations
Penalty
Summary
The facility failed to ensure a clinical rationale was documented for not completing a gradual dose reduction (GDR) of an antipsychotic medication for one resident. R6 was admitted with schizophrenia and was receiving Abilify 15 mg daily. A Medication Regimen Review (MRR) on 1/2/26 recommended considering a trial dose reduction to 10 mg daily, and the provider documented that a GDR was not indicated because a dose reduction attempt would risk decompensation and referenced a physician progress note for rationale. However, the 2/9/26 physician progress note stated that a GDR of the resident’s antipsychotic medication was not recommended or ordered during the visit, but it did not include a clinical rationale explaining why the GDR was not attempted. During interview, the DON and Clinical Lead confirmed the progress note lacked the required rationale. The facility also failed to respond promptly to an MRR recommendation for another resident. R72 had orders for Depakote Sprinkles for agitation, and an MRR on 12/2/25 recommended provider evaluation and consideration of dose reduction for duloxetine, Depakote, and Seroquel. The provider documented that the resident was clinically stable and to attempt a GDR on Depakote, signed the form on 1/7/26, and changed the Depakote order to a lower dose on 1/2/26. The provider’s response and medication change occurred 36 days and 41 days, respectively, after the pharmacy recommendation was completed. The DON stated that MRR recommendations were expected to be addressed as soon as possible and within 30 days, and confirmed that R72’s medication was not reduced until 41 days after the recommendation.
Failure to Assist Residents With Dental Services
Penalty
Summary
The facility failed to assist two residents in obtaining routine dental services. One resident had an admission MDS documenting a BIMS score of 15 and oral/dental status coded for broken teeth or cavities. The resident was observed missing multiple teeth and stated that a tooth fell out while eating and that he sometimes had pain. He also reported telling an LPN when the tooth fell out, but the resident was not listed in the dental binder at the time of surveyor review, and the unit dental book did not show him until after surveyor inquiry. Another resident had an admission clinical assessment in which oral/dental status was documented as not assessed/no information, and the admission MDS documented a BIMS score of 15 with oral/dental status coded as none of the above. A social services note documented that the resident wished to be referred to dental, hearing, and vision services, but there was no evidence that a dental referral was initiated. The resident was observed missing both upper and lower teeth and stated that he had told staff he needed to go to the dentist and that he did not have any teeth. The resident was not listed for dental services, and the DON confirmed that the resident had not been referred for dental evaluation despite requesting dental services.
Failure to Provide Prompt Grievance Resolution and Written Decision
Penalty
Summary
The facility failed to ensure prompt resolution of a grievance and did not provide a written decision to the complainant, as required by its grievance policy. A family member of a resident who had multiple complex medical conditions, including congestive heart failure, diabetes, chronic kidney disease, and a recent amputation, raised concerns about the care provided after the resident was sent to the emergency room for a change in respiratory status and low blood sugar. The family member reported issues such as difficulty reaching staff for updates, concerns about staff communication during the resident's transfer to the ER, and dissatisfaction with the clinical response to the resident's acute episode. Although the grievance was documented and discussed in an impromptu meeting with facility leadership and clinical staff, the investigation was ultimately escalated to a reportable event. The facility's Grievance Officer attempted to contact the complainant by leaving a voice message but did not provide a written decision regarding the outcome of the grievance. The complainant confirmed in an interview that she had not received any follow-up or written response from the facility regarding her concerns.
Failure to Revise Care Plan for Resident Refusing Daily Weights
Penalty
Summary
A deficiency was identified when the facility failed to revise the person-centered care plan interventions for a resident with congestive heart failure (CHF) who consistently refused daily weight monitoring. The resident was admitted with CHF and had a physician's order to notify the provider if there was a significant weight gain. Despite the care plan noting the risk for decreased ability to perform activities of daily living and resistance to daily weights, documentation showed that daily weights were not obtained on multiple days, and the resident's refusals were repeatedly documented in the nurse's progress notes. The resident, who had intact cognition and required assistance with mobility, expressed distrust in the accuracy of the Hoyer lift and wheelchair scales, leading to ongoing refusals to be weighed. Nursing staff acknowledged the resident's concerns and refusals, but the care plan was not updated to address these specific issues or to implement alternative interventions. The facility did not ensure that the care plan reflected the resident's preferences and refusals regarding weight monitoring, nor did it address the resident's concerns about the weighing equipment.
Incomplete Documentation of Resident Daily Weights
Penalty
Summary
The facility failed to maintain a complete and accurate medical record for one of three sampled residents. Specifically, review of the resident's clinical record showed that daily weights were not documented on several dates in October and November 2025, as required by the Treatment Administration Record (TAR). This lack of documentation was confirmed during an interview with the Clinical Lead. The findings were subsequently reviewed with facility leadership during the exit conference. No additional information about the resident's medical history or condition at the time of the deficiency was provided in the report.
Mold Observed in Food Storage and Beverage Equipment
Penalty
Summary
The facility failed to ensure that food and beverages were stored, prepared, and served in a manner that prevents foodborne illness. During observation, numerous ceiling tiles in the dry food storage room were found to have various sizes of black and gray circular areas that appeared to be mold. Additionally, the clear plastic tubing connecting the kitchen juice machine to the beverage dispenser contained several areas of a blackish gray substance that also appeared to be mold. These findings were reviewed with the Nursing Home Administrator, Quality Manager, and Director of Nursing during the exit conference. No information was provided regarding specific residents affected, their medical history, or their condition at the time of the deficiency.
Failure to Properly Store, Clean, and Label Respiratory Equipment and Oxygen Supplies
Penalty
Summary
The deficiency involves the facility’s failure to provide safe and appropriate respiratory care by not properly storing and maintaining respiratory equipment and supplies for multiple residents. One resident with chronic respiratory failure and an order to use IVAPS nightly had the IVAPS mask left on the bedside table without a protective bag. Another resident with COPD and acute and chronic respiratory failure, ordered to use Bi-PAP at bedtime and as needed, had the Bi-PAP mask sitting on the bedside table without a protective bag, and the external filter on the oxygen concentrator was observed to be completely full of dark gray dust. A third resident admitted with obstructive sleep apnea and congestive heart failure had a Bi-PAP mask and tubing sitting on the nightstand without any protective bagging. Additional deficiencies were identified with oxygen concentrator maintenance and oxygen tubing labeling. One resident receiving continuous oxygen via nasal cannula had a physician’s order for weekly cleaning of the external filter on the oxygen concentrator, yet observations on consecutive days showed the filter covered with dusty, thick gray particles; the resident reported the nurse had cleaned the filter that morning and that this was not normally done, and an LPN confirmed the filter had been heavily soiled despite being signed off as cleaned previously. Another resident admitted with pneumonia and respiratory failure had a physician’s order to change oxygen tubing weekly and label each component with date and initials, but the oxygen tubing was observed without any label, which was confirmed by an RN. These observations and interviews demonstrate multiple failures to follow orders and facility practices for respiratory equipment storage, cleaning, and labeling.
Failure to Care Plan Oxygen Therapy and Incentive Spirometer Use
Penalty
Summary
Surveyors identified a deficiency in that the facility failed to develop a care plan addressing oxygen administration via nasal cannula and the use of an incentive spirometer for one resident. The resident was admitted on 8/29/25 with diagnoses including pneumonia and respiratory failure. On 9/2/25, a physician ordered continuous oxygen at 6 L/min via nasal cannula, and on 9/3/25, a physician ordered use of an incentive spirometer, encouraging the resident to use it as often as tolerated. On 9/15/25, an observation of the resident’s bedside table showed an incentive spirometer, and the resident stated he was using it. However, on 9/16/25, review of the resident’s care plan showed no evidence of a care plan addressing either the ordered oxygen therapy or the incentive spirometer use. During an interview, the quality manager confirmed that no care plan had been developed for these treatments, and these findings were later reviewed with facility leadership during the exit conference.
Failure to Provide Nail Care for Dependent Resident
Penalty
Summary
Surveyors identified a deficiency in the facility’s provision of activities of daily living (ADL) care when a dependent resident did not receive appropriate nail care. The resident was admitted on 6/30/21 and had a care plan dated 6/11/25 indicating dependence for all ADLs, with an annual MDS on 6/16/25 documenting severe cognitive impairment and a need for substantially maximal assistance with personal hygiene. On three separate observations on 9/15/25, 9/16/25, and 9/17/25, the resident’s fingernails on both hands were noted to be long and in need of trimming, with dark debris present under each fingernail. During an interview on 9/17/25, a CNA stated that she trims and cleans residents’ nails on the days they receive baths, and an LPN and the Quality Manager each confirmed that the resident’s fingernails on both hands were long with dark debris underneath. These findings showed that the facility failed to provide necessary nail care for this dependent resident.
Failure to Provide Ordered Palm Guard to Maintain Resident ROM
Penalty
Summary
A resident with severe cognitive impairment, dependent for all ADLs, was admitted with a physician’s order for a left palm guard to be applied in the morning with AM care and removed with PM care, with no stop date. The care plan also directed staff to apply a palm guard to the resident’s left hand at 10:00 AM for up to six hours daily as tolerated after morning care, as part of interventions to maintain skin integrity and prevent contractures. An annual MDS documented that the resident required substantially maximal assistance with all ADLs. On multiple observations over several days, the resident was repeatedly seen without the ordered left-hand palm guard during morning and afternoon timeframes when it should have been in place. Two CNAs interviewed stated they had never applied and had not seen the palm guard on the resident’s left hand. The Quality Manager confirmed that the resident did not have a left palm guard, and the Director of Rehab later confirmed that the left hand palm guard order, originally entered as a standard order with no stop date, had been stopped by mistake about one month after admission. The facility lacked evidence that the palm device was applied to the resident’s left palm as ordered and care planned.
Failure to Develop Individualized Toileting Program to Maintain Bladder Continence
Penalty
Summary
The deficiency involves the facility’s failure to provide services to maintain or restore bladder continence for one resident reviewed for bowel and bladder care. The resident was admitted on 3/21/21 and was initially care planned on 8/18/22 as incontinent of urine and unable to cognitively or physically participate in retraining, with interventions limited to assistance with perineal care, monitoring for infection, and providing privacy and comfort. On 1/10/25, a post-voiding diary follow-up assessment documented that the resident was assessed for urinary and fecal incontinence and determined to be a candidate for prompted voiding, but the assessment did not include a toileting plan or any update to the care plan. A quarterly MDS dated 5/15/25 showed the resident had a BIMS score of 15 (cognitively intact), required supervision or minimal assistance for toileting, was occasionally incontinent of urine, and was not on a toileting program. Subsequent CNA documentation from May through September 2025 showed increasing urinary incontinence episodes, with incontinence recorded 9 times out of 111 opportunities in May, 27/117 in June, 29/113 in July, 44/112 in August, and 20/59 in September. An MDS dated 8/14/25 documented a BIMS score of 12 (moderately impaired), supervision or minimal assistance for toileting, frequent urinary incontinence, and no toileting program in place. CNA documentation and task lists lacked evidence of toileting frequency or individualized approaches, and continence records combined urinary and bowel incontinence, making continence status unclear. During interviews, the resident stated she was able to toilet herself and was continent, while a CNA and an LPN reported the resident required assistance with toileting and hygiene, was not on a toileting program, was taken to the toilet every two hours, and had increased incontinence episodes. The facility failed to develop an individualized toileting program despite assessments indicating the resident was a candidate for prompted voiding and documentation of increasing incontinence.
Failure to Assist Resident in Obtaining Routine Dental Services
Penalty
Summary
The facility failed to assist one resident in obtaining routine dental services despite observable need and available on-site and community dental resources. The resident was admitted on 7/23/23, and an annual MDS dated 6/27/25 documented no issues with dentures, natural teeth, tooth fragments, abnormal mouth tissue, or obvious broken teeth. However, on 9/15/25 at 9:57 AM, an observation revealed that the resident had loosely fitting dentures. Later that morning, the resident’s guardian reported that the resident had not seen a dentist. On 9/17/25, the facility scheduler confirmed that a dentist comes to the facility and that residents can also go to outside dental providers, explaining that residents request to see the dentist and are then added to a list. On the same day, the Regulatory Compliance Advisor confirmed that the resident had not been seen by a dentist, and these findings were subsequently reviewed with facility leadership during the exit conference.
Inaccurate Clinical Documentation of Resident Presence and Care
Penalty
Summary
The deficiency involves the facility’s failure to ensure that a resident’s clinical record contained accurate documentation in accordance with accepted professional standards. The resident was admitted on 11/28/23 and was later involved in a resident-to-resident altercation on 9/10/25, after which a physician ordered the resident to be sent to the ER for treatment and evaluation at 11:06 AM. Certified nursing assistant (CNA) documentation for that same date and the 7:00 AM to 3:00 PM shift recorded the resident as “not available” for all ADL tasks. However, during an interview, the CNA confirmed that the resident was in the facility at approximately 12:15 PM on 9/10/25 and that the “not available” documentation was inaccurate. In a separate interview, the Regulatory Compliance Advisor confirmed that the resident was sent to the ER at 12:15 PM and that the documentation should have reflected that the resident received care prior to leaving the facility. These findings were reviewed with the Nursing Home Administrator, Quality Manager, and DON during the exit conference, confirming that the clinical record did not accurately document the resident’s presence and care provided before transfer to the ER on the date of the incident.
Failure to Prevent Elopement Due to Unsecured Exit
Penalty
Summary
A deficiency occurred when a resident with a history of paranoid schizophrenia, sick sinus syndrome, cardiac pacemaker, and anxiety, who was assessed as being at risk for elopement and had a physician's order for a wander guard device, was able to leave the facility unsupervised. The resident's care plan documented previous attempts to leave the building without an escort, and the elopement risk assessment indicated wandering behavior. Despite these documented risks and interventions, the resident was able to exit through an unsecured sliding door in the conference room, which had been left unlocked by a contractor. The resident was discovered missing after staff noticed the wheelchair in front of the open conference room door. A facility-wide search confirmed the resident was the only one missing, and the elopement protocol was initiated. The resident was later found asleep on the grass approximately 0.6 miles away, having crossed a busy roadway. The resident was missing for 1 hour and 23 minutes before being returned to the facility. The incident was determined to be immediate jeopardy due to the failure to provide adequate supervision and secure assistive devices to prevent elopement.
Failure to Ensure Adequate Hydration and Monitoring
Penalty
Summary
The facility failed to ensure adequate hydration for three residents, leading to significant health issues. One resident, admitted with acute kidney injury and other conditions, consistently failed to meet the fluid intake goal of 1700 ml per day for 24 consecutive days. Despite being at risk for dehydration due to nephrotoxic medications and a colostomy, the resident's fluid intake was not adequately monitored or encouraged, resulting in an emergency hospital admission for acute kidney failure and dehydration. Another resident, with a history of dementia, hypertension, chronic kidney disease, and diabetes, was not provided timely care for increasing sodium levels. Despite a documented fluid goal of 2100 ml per day, there was no evidence of increased fluid intake after a vomiting episode. The resident's sodium levels rose critically, and attempts to start IV hydration were unsuccessful, leading to a delay in treatment. The resident was eventually sent to the hospital with hypernatremia and facial droop, indicating a potential stroke. The third resident experienced significant weight loss, with a 12.6% reduction over six months. Despite a physician's order for weekly weight monitoring, the facility failed to record the resident's weight on the specified date. This oversight occurred despite the implementation of nutritional interventions, indicating a lack of proper evaluation and monitoring of the resident's condition.
Failure to Assess and Individualize Fall Prevention Interventions
Penalty
Summary
A deficiency was identified when the facility failed to assess and implement individualized interventions to reduce a resident's risk for falls. The resident, who was admitted with dementia and a history of falls, experienced twelve falls during their stay, including two incidents resulting in head trauma that required transfer to an acute care hospital. Despite repeated falls, documentation showed that the facility did not conduct urinary continence assessments that included voiding patterns, nor did they implement a resident-specific toileting program as part of the fall prevention plan. The facility's own Falls Management policy required assessment for fall risk upon admission and after falls, as well as the implementation and documentation of patient-centered interventions according to individual risk factors. However, the resident's care plans lacked evidence of an individualized toileting program, and interventions such as pelvic floor rehabilitation were not tailored to the resident's cognitive status. Incident reports repeatedly noted that the resident fell while attempting to use the bathroom, yet there was no evidence of reassessment or adjustment of interventions based on these events. Interviews with facility leadership confirmed that assessments for voiding patterns were only conducted on admission and not after repeated falls, even when falls were related to attempts to use the bathroom. The DON acknowledged that generic toileting plans were not effective in reducing fall risk without individualized assessment. The NHA also confirmed that the resident was not assessed for incontinence patterns and was not placed on an individualized toileting program, despite multiple falls related to toileting needs.
Food Storage and Sanitation Deficiencies
Penalty
Summary
The facility failed to ensure that food was stored, prepared, and served in a manner that prevents foodborne illness to the residents. During a kitchen tour, the surveyor observed the Dietary Manager testing the sanitizer level in two red sanitizing buckets, and the test strips indicated insufficient chemical concentration for proper sanitization. Additionally, the ceiling in the main kitchen and adjacent dry storage room had dark spotted staining, resembling mold or mildew, on several ceiling tiles. The walk-in freezer's door was damaged, resulting in a poorly functioning seal and significant ice build-up along the interior edge. Furthermore, a black substance and a significant amount of dust were observed on top of the tubes supplying the juice dispensing machine and the back of the machine. These findings were reviewed with the Nursing Home Administrator and the Director of Nursing during the exit conference.
Deficiencies in Comprehensive Care Planning
Penalty
Summary
The facility failed to ensure comprehensive care planning for several residents, as evidenced by the lack of input from all required interdisciplinary team (IDT) members during care plan meetings. For six residents, the facility did not conduct care plan meetings every three months as required, and for some, the meetings lacked input from essential team members such as physicians, dieticians, and certified nursing assistants (CNAs). Additionally, there was no evidence of family representatives attending meetings for residents with impaired cognition, which is crucial for ensuring that the care plans are comprehensive and individualized. Specific cases highlighted include a resident who was admitted with cognitive intactness but later showed disorganized thinking. Despite this change, the facility did not conduct a quarterly care plan meeting or include all necessary IDT members in subsequent meetings. Another resident's care plan was not updated to reflect the use of recommended adaptive equipment, and several residents' care plans did not address their refusal of care, such as nail and hair care or dialysis, which were ongoing issues. The facility's failure to revise care plans to reflect residents' current needs and behaviors, such as refusal of care, indicates a lack of comprehensive and individualized care planning. This deficiency was confirmed through interviews with staff members, who acknowledged the absence of regular care plan meetings and the lack of input from all required participants. The report underscores the facility's systemic issues in maintaining up-to-date and inclusive care plans for its residents.
Failure to Implement Toileting Programs for Incontinent Residents
Penalty
Summary
The facility failed to assess and provide adequate care and services to maintain or restore bowel and bladder continence for several residents. Resident R6 was frequently incontinent of bowel and bladder, yet was not placed on a toileting program despite being able to stand and pivot with assistance. The CNA task flow sheets documented numerous instances of incontinence, and interviews with staff confirmed the lack of a toileting program. Resident R12 was also frequently incontinent of bladder and always incontinent of bowel, with no toileting program in place. The CNA task flow sheets showed high frequencies of incontinence, and staff interviews confirmed the absence of a toileting program and the resident's dependency for toileting. Similarly, Resident R43, who was aware of her need to use the bathroom, reported being incontinent while waiting for staff assistance, and staff confirmed the lack of a toileting program. Resident R89 experienced a decline in continence, with the facility failing to conduct a comprehensive assessment or implement an individualized toileting program. The continence records showed inconsistencies in toileting assistance, and interviews with staff revealed a lack of analysis of CNA data to create a personalized care plan. Resident R91, who was admitted with an indwelling catheter, was frequently incontinent after its removal, and no urinary assessment or toileting program was initiated. Interviews with staff confirmed the absence of incontinence monitoring and a toileting program.
Failure to Conduct Thorough Investigations into Allegations of Abuse and Neglect
Penalty
Summary
The facility failed to provide evidence of thorough investigations into allegations of abuse and neglect for four residents. For one resident who was dependent for activities of daily living (ADLs), documentation was missing regarding care provided on a specific date, and the facility's investigative documents lacked interviews with direct care staff involved. Another resident, also dependent for all ADLs, had an allegation of neglect investigated without including staff interviews, with only grievance forms and incident reports present in the documentation. In both cases, the Nursing Home Administrator (NHA) and Director of Nursing (DON) confirmed the absence of staff interviews during the investigation. A third resident with a wound care order experienced a lapse in wound treatment, and the facility's investigation included statements from only some staff, with no statements from other relevant shifts to clarify the missed treatment. For a fourth resident with intact cognitive status and a diagnosis of major mood disorder and anxiety, an allegation of verbal abuse was reported, but the facility failed to obtain staff statements as part of the investigation. In all cases, interviews with direct care staff were either missing or incomplete, as confirmed by facility leadership.
Failure to Notify Provider of Dialysis Refusal
Penalty
Summary
The facility failed to ensure that the provider was consulted when a resident refused dialysis services. The resident, who was admitted to the facility on 8/23/22, had a history of receiving dialysis as a special treatment. On 7/8/24, the resident refused dialysis, and the Unit Manager was informed. Interviews with staff revealed that the expectation was to notify the provider and the family if a resident refused dialysis. However, it was noted that the provider was already aware of the resident's behavior of refusing dialysis. The deficiency was discussed with the Nursing Home Administrator and the Director of Nursing during the exit conference.
Failure to Resolve Resident Grievances
Penalty
Summary
The facility failed to ensure prompt resolution of grievances for a resident, identified as R50, who was admitted on 12/19/23. In May 2024, the grievance log recorded two entries for R50, both dated 5/17/24, concerning inadequate care during the 7:00 AM to 3:00 PM shift on 5/8/24 and immediate needs not being addressed on 5/17/24. These grievances were documented by E4, the social worker and grievance officer, but the follow-up sections were left blank. Interviews with E4, E1 (NHA), and E2 (DON) confirmed that the grievances were not resolved and lacked evidence of being addressed. The grievance process was halted when grievances were deemed reportable, and E4 was unaware of any resolutions.
Delayed Reporting of Neglect Allegation
Penalty
Summary
The facility failed to report an allegation of neglect involving a resident, identified as R261, within the required timeframe. The incident occurred when a CNA alleged that an LPN was neglectful by not responding to the needs of R261 in a timely manner. This allegation was reported to the Director of Nursing (DON) on June 9, 2024. However, the incident report was not submitted to the state agency until June 17, 2024, which was eight days after the initial allegation. Furthermore, the required five-day follow-up report was not submitted until July 2, 2024, fifteen days after the allegation. During an interview, the DON confirmed the late reporting of the neglect allegation. These findings were reviewed with the Nursing Home Administrator (NHA) and the DON during the exit conference.
Failure to Complete PASARR Referrals for Two Residents
Penalty
Summary
The facility failed to ensure that referrals for PASARR screening were completed for two residents, R38 and R66. R38 was admitted with a diagnosis of bipolar disorder and later had a discharge summary indicating dementia with behaviors. Despite aggressive behaviors noted at a dialysis center and a new diagnosis of unspecified mood disorder and adjustment disorder with depressed mood, there was no evidence that a referral was made to the State PASARR authority. This was confirmed during an interview with the social worker, E4, who acknowledged that an update had not been sent. Similarly, R66 was admitted with multiple diagnoses, including bipolar disorder and major depressive disorder. Although a PASARR I screening was initially submitted, a psychology progress note later revealed a new diagnosis of other persistent mood disorder. The facility lacked evidence of an updated PASARR reflecting these changes. During an interview, E4 confirmed that an update had not been sent, and a subsequent resubmission indicated that a PASARR Level II evaluation was necessary. These findings were reviewed with the Nursing Home Administrator and Director of Nursing during the exit conference.
Failure to Provide Adequate ADL Assistance
Penalty
Summary
The facility failed to provide adequate care and services for residents who were dependent on assistance for activities of daily living (ADLs). For one resident, who was admitted with dementia and required assistance for ADLs, observations revealed black debris under her nails on multiple occasions. Despite the care plan indicating the need for assistance, there was no documentation of refusal of nail care, and staff interviews confirmed the lack of nail care provided. Another resident, also admitted with dementia and dependent on care, was observed with long nails and greasy, disheveled hair. The care plan did not address refusal of nail care or hair washing, and there was no evidence in the progress notes of offers or refusals of such care. Staff interviews revealed confusion about responsibility for nail care, and it was confirmed that the resident's nails were not attended to until a family member intervened. A third resident, who required assistance for toileting and other ADLs, was found with soiled clothing and bed linens, indicating a lack of care. Documentation inaccurately stated the resident was independent, and staff interviews confirmed the resident did not receive necessary assistance. The facility lacked evidence of a root cause analysis or actions beyond terminating the responsible employee. Another resident was observed with long nails and debris despite receiving a shower, indicating a failure to meet grooming needs during care.
Failure in Pressure Ulcer Management and Prevention
Penalty
Summary
The facility failed to provide necessary treatment to promote healing of a current pressure ulcer for two residents. For one resident, a care plan was initiated due to skin breakdown and a documented pressure ulcer, with interventions including wound care orders. However, the treatment administration record showed that the resident's wound care was not completed on multiple occasions due to the resident being away from the facility or refusing treatment. The wound dressing was not changed for eight days, and the facility's process for ensuring treatment completion when a resident is unavailable or refuses treatment was not effectively followed. For another resident, the facility did not adhere to the prescribed use of adaptive equipment for pressure ulcer prevention. The resident was observed wearing the wrong type of boots while in bed and in a wheelchair, contrary to the physician's order and therapy recommendations. Interviews with staff revealed a lack of understanding regarding the correct use of the boots, leading to inconsistent application of preventative measures. These deficiencies highlight lapses in the facility's adherence to care plans and treatment protocols for pressure ulcer management.
Lack of Side Effect Monitoring for Psychotropic Medication
Penalty
Summary
The facility was found deficient in monitoring for side effects of psychotropic medications for a resident. The resident, identified as R89, was admitted with diagnoses including major depressive disorder, adjustment disorder with mixed anxiety and depressed moods, unspecified dementia with psychotic behaviors, and unspecified dementia with other behavioral disturbances. On October 31, 2024, a physician's order was written for Ativan 0.5 mg three times a day for anxiety. However, a review of the November Medication Administration Record (MAR) showed a lack of evidence for monitoring side effects related to the psychotropic medication. This was confirmed during an interview with the Unit Manager (E12), who acknowledged that there was no order to monitor for side effects. The findings were discussed with the Nursing Home Administrator (E1) and another staff member (E2) during the exit conference.
Failure to Notify Provider of Lab Results
Penalty
Summary
The facility failed to promptly notify the ordering medical practitioner of laboratory results for a resident, identified as R50, who was admitted on 12/29/23. On 10/31/24, a nurse practitioner noted that R50 had malodorous and cloudy urine and ordered a urine analysis and culture sensitivity. On 11/1/24, lab results indicated a positive urinary tract infection, with the culture still pending. By 11/3/24, the culture showed positive growth, but the results were not communicated to the provider. It wasn't until 11/4/24 that a physician's order for an antibiotic was written. Interviews with staff confirmed that the results were available on 11/3/24 but were not relayed to the provider as expected, leading to a delay in treatment.
Failure to Assist Resident in Obtaining Dental Services
Penalty
Summary
The facility failed to assist a resident, identified as R13, in obtaining routine dental services. R13 was admitted to the facility on August 19, 2021, and a significant change MDS assessment on April 21, 2024, documented that R13 had no natural teeth or tooth fragments, no abnormal mouth tissue, and no obvious broken teeth. However, during an interview on November 12, 2024, R13 revealed having several missing teeth and only approximately five teeth left, and stated that she had not seen a dentist or been offered dental services by the facility. Interviews with staff members E22, a CNA, and E23, a Unit Clerk, confirmed that a dentist visits the facility and residents can also see outside dental providers. E23 stated that residents request to see the dentist and are added to a list, but confirmed on November 18, 2024, that the dentist had no record of R13 being seen. These findings were reviewed with the Nursing Home Administrator (E1) and the Director of Nursing (E2) during the exit conference on November 25, 2024.
Inaccurate Clinical Documentation and Incomplete ADL and Elimination Records
Penalty
Summary
The facility failed to ensure accurate and complete clinical documentation for two residents. For one resident, the treatment administration record (TAR) was signed by an LPN as if wound care to the right heel had been completed, but the treatment was not actually performed. The wound dressing was found to be unchanged for eight days, and the LPN later confirmed that the TAR was signed off before the treatment was done and then forgotten. Additionally, a CNA documented that the same resident independently performed activities of daily living (ADLs) such as toileting, hygiene, dressing, and transfers, despite the care plan indicating the resident required extensive assistance for these tasks. Another CNA confirmed that the resident could not perform these tasks independently and would require staff assistance or documentation of refusal if care was declined. For a second resident, documentation practices for toileting and elimination were inconsistent with facility expectations. The resident was assessed as dependent for toileting and hygiene, but interviews with CNAs revealed that they were only documenting one void per shift rather than each occurrence, as required. Some CNAs were unaware of the correct documentation procedure, and one CNA demonstrated that she learned the process independently rather than through formal orientation. The unit manager also confirmed a lack of knowledge regarding the documentation process for CNAs.
What surveyors are citing around you — mapped
All 10 risk areas, ranked with evidence
Repeat citations, what's rising near you, and quality measures — ranked so department heads know exactly where to look first.
Illustrative
What surveyors actually found near you
We read the 148 citations issued within 25 miles in the last 12 months — including the 3 immediate-jeopardy cases — 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
A prioritized, do-first checklist
Every risk area becomes concrete audit steps drawn from real citations at facilities like yours — run them this week, before your window opens.
Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Milford
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Polaris Healthcare And Rehabilitation Center | 0.4 mi | ★★★★★ | 9 | 0 |
| Delaware Veterans Home | 2.1 mi | ★★★★★ | 7 | 0 |
| Delaware Bay Rehabilitation And Healthcare Center | 15 mi | ★★★★★ | 2 | 0 |
| Bay Terrace Rehabilitation And Health Center | 17.6 mi | ★★★★★ | 6 | 1 |
| Center At Eden Hill, Llc | 17.8 mi | ★★★★★ | 3 | 0 |
Every risk area ranked, a do-first checklist, and your local survey patterns
Built specifically for Milford Center.
100% money-back within 48 hours.
Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.