Average — CMS composite of the measures below.
The next survey window likely opens around November 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 Avante At Mt Dora, Inc during CMS and state inspections, most recent first.
Incomplete resident records were found for ADL care, wound care, and insulin administration. A resident who was dependent for toileting had multiple blank continence entries, several residents had missing or inconsistent wound treatment documentation despite active orders, and multiple insulin records showed blank, NA, or refusal entries without consistent provider notification. Staff and the DON acknowledged missing charting and inaccurate documentation.
A resident with a diagnosis of brief psychotic disorder and later psychiatric documentation of depression, anxiety, insomnia, bipolar disorder, psychosis, and alcohol abuse did not have an updated PASRR Level II review. The existing PASRR did not include the brief psychotic disorder diagnosis, and the DON stated the facility did not have an updated PASSAR for the resident.
A resident had repeated refusals of physician-ordered meds documented on the MAR over two consecutive months, but the care plan did not include a problem statement, goals, or individualized interventions for the ongoing refusals. During an interview, the DON confirmed the resident should have been care planned for medication refusal.
The facility failed to follow physician orders for insulin administration for two residents and failed to complete ordered wound care for two residents. MARs showed insulin doses were held or coded as out of parameters on multiple occasions, and the PA and physician stated they were not notified. Two residents with foot and heel wounds were observed with dressings dated several days earlier, including one soiled and loosened dressing, while staff gave inconsistent accounts and the DON stated treatments had been checked off before being completed.
Unsafe Use of Mechanical Lift: A CNA was observed using a Hoyer lift with only one staff member present while a resident with muscle weakness, impaired balance/coordination, and non-ambulatory status was hanging off the bed with the floor beneath the resident’s bottom and legs. The resident’s care plan required 2-person Hoyer transfers, and the CNA, DON, and Director of Therapy all stated that the lift should be used with two staff members at all times.
Failure to provide nutritional services for two residents with significant wt loss. One resident had a 13.23% wt decline and health shakes were not documented in the MAR or active orders despite an RD note referencing fortified foods and shakes. Another resident had a 10.34% wt loss with no dietary progress notes or recent nutritional assessment, and the RD and DON stated the resident was missed and should have been seen. The facility policy required nutritional assessments annually and with significant change in condition.
Respiratory care was not provided as ordered for two residents. One resident with CHF was observed receiving oxygen at 4 L/min by nasal cannula even though the order was for 3 L/min, and an LPN acknowledged the mismatch. Another resident with multiple respiratory and chronic conditions had a nebulizer supply bag with tubing and a face mask that remained dated and unchanged beyond the weekly expectation stated by the DON.
The facility failed to document a physician rationale when pharmacist recommendations were not followed for two residents. One resident had a recommendation to discontinue Midodrine due to lack of use, but the chart only noted to continue it. Another resident had recommendations to reduce Eliquis and to add 12-hour removal instructions for a lidocaine patch; the record lacked signed, dated documentation explaining the disagreement or why no change was made, and the progress notes did not address the pharmacy concerns.
Unnecessary medication regimens and order administration errors were identified for three residents. One resident with dementia, HF, HTN, AFib, and DM received antihypertensives despite hold parameters not being met; another resident with HF, CKD, hypotension, and HTN received lisinopril-HCTZ and midodrine outside ordered BP limits after a nurse misinterpreted the orders; and a third resident with Parkinson's disease and other chronic conditions continued methocarbamol BID even after a pharmacist recommended reducing it to daily with the goal of discontinuation, with no documentation explaining why the recommendation was not followed.
Infection control and PPE were not maintained during medication administration for three residents. An RN picked up a dropped tablet from the medication cart without gloves and gave it to one resident, opened a capsule without gloves for another resident, and administered meds via a resident’s G-tube without wearing a gown despite EBP requirements. The DON confirmed PPE, including gloves and gowns, was required for close contact and G-tube care, and the RN acknowledged the missed PPE use.
A resident with multiple complex conditions, including acute kidney failure and diabetes, had abnormal lab results that were not promptly reported to the physician as required by facility policy. Both the physician and DON confirmed that the results should have been communicated immediately, but documentation and interviews showed this did not occur.
A resident with respiratory failure and COPD was observed receiving oxygen at 2 L/min, contrary to the physician's order for 3 L/min. This discrepancy was confirmed by an LPN, and the DON stated that oxygen settings should be checked regularly. The facility's policy requires adherence to physician orders for respiratory care.
The facility did not post daily nursing staff information as required. On observation, the staffing data in the main lobby was outdated by several days. The DON stated that posting was the responsibility of the staffing coordinator on weekdays and supervisors on weekends. The facility's policy requires daily posting of staffing information in a clear and accessible format.
The facility failed to properly store, label, and date food and dishes in the kitchen's coolers and freezer. Observations revealed raw eggs stored above produce, unlabeled containers, and exposed food items. Dishes were stored on a shelf with spills and debris, contrary to food safety policies.
A facility failed to ensure proper PPE use and hand hygiene, leading to infection control deficiencies. A CNA did not wear a gown while caring for a resident on enhanced barrier precautions, and an LPN did not perform hand hygiene or clean shared equipment between residents. Both staff members acknowledged their lapses, which were contrary to the facility's infection control policies.
Incomplete Documentation for ADLs, Wound Care, and Insulin Administration
Penalty
Summary
The facility failed to maintain complete and accurate medical records for multiple residents across ADL documentation, wound care records, and medication administration records. For one resident who was dependent for toileting hygiene and always incontinent, the bladder and bowel continence documentation for November 2025 contained multiple blank entries across day, evening, and night shifts. The DON stated there was no other supporting documentation regarding the care provided and expected staff to accurately complete the task when care was provided. For residents with wounds, the records showed repeated inconsistencies between physician orders, treatment records, and staff statements. One resident had a right heel pressure injury with an order for daily wound care, yet the TAR showed wound care documented on only some days, and the wound care nurse stated she could not recall what happened on certain dates and had no notes for training days. Another resident had multiple wound orders for the right heel, right foot, toes, and other areas, with several blank entries on the TAR for ordered treatments. Staff stated they sometimes checked off wound care and were unsure whether it was supposed to be completed by the wound care nurse, and the DON stated wound care should be documented accurately. Medication records also contained missing or incomplete documentation and lacked provider notification when ordered treatments were not given or were refused. One resident’s insulin orders were documented as held for glucose out of parameters, while another resident’s MAR had blank entries for Lantus on several days and the DON stated the nurse should document refusal instead of leaving it blank. A resident with repeated insulin refusals had MAR entries showing drug refused for Lantus and multiple sliding-scale insulin doses, but the record contained no documentation of provider notification. Another resident’s insulin administration record showed code entries, NA entries, and missing dose documentation, with staff stating they sometimes forgot to chart details and did not always remember to document provider notification. The physician and APRN stated they expected notification when medications or treatments were refused.
Failure to Update PASRR for Resident With Psychotic Disorder
Penalty
Summary
The facility failed to ensure that a resident with newly evident or possible serious mental disorder was referred for PASRR Level II review. Resident #74 was admitted with a diagnosis that included brief psychotic disorder, but the resident’s Florida AHCA PASRR dated 7/20/2023 did not include that diagnosis. A psychiatric subsequent note dated 3/17/2025 documented chief complaints of depression, anxiety, insomnia, bipolar disorder, psychosis, and alcohol abuse, and described the history as suggesting psychotic symptoms that were not consistent and long lasting and not attributed to a substance or another medical condition. During interview, the DON stated the facility did not have an updated PASSAR for the resident and would have to update it. The facility policy stated that all residents admitted to the facility receive a PASRR in accordance with state and federal regulations.
Care Plan Did Not Address Repeated Medication Refusals
Penalty
Summary
Resident #27 had repeated refusals of physician-ordered medications documented on the MAR, with 28 refusals recorded in November 2025 and another 28 refusals recorded in December 2025. Despite this ongoing pattern across two consecutive months, the resident's care plan did not include a problem statement, goals, or individualized interventions addressing medication refusal. During an interview on 12/4/2025 at 9:50 AM, the DON stated that Resident #27 should have been care planned for refusal of medications, confirming that the care plan did not reflect this clinically relevant issue.
Failure to Follow Insulin and Wound Care Orders
Penalty
Summary
The facility failed to administer insulin as ordered for two residents. For one resident, physician orders changed from Lantus 10 units daily to 12 units daily for hyperglycemia, but the November 2025 MAR documented doses as code 13, indicating glucose out of parameters, on multiple dates. For another resident, an order for insulin lispro protamine and lispro 16 units twice daily was later changed to 16 units once daily, with a separate order to hold insulin if blood sugar was less than 90 every shift; the MAR documented insulin as code 13 on several occasions when blood sugars were 114, 112, and 138. In interviews, the PA and physician stated they did not recall being notified when insulin was held, and the DON stated nurses should use judgment but communicate with the provider and follow physician orders. The facility also failed to provide ordered wound care for two residents with pressure-related and other foot wounds. One resident was observed with the right lower foot wrapped in Kerlix gauze secured with tape dated several days earlier, while the physician order required daily wound care to the right heel using skin prep, ABD pad, Kerlix, and tape for an unstageable pressure injury. Another resident was observed with the right foot wrapped in gauze secured with tape dated several days earlier, and the dressing was loosened and soiled. That resident had multiple wound care orders, including cleansing with Dakin's solution, applying skin prep, calcium alginate, ABD pad, rolled gauze, and tape to the right heel, right 2nd toe, right lateral great toe, and right lateral heel, as well as offloading the right lateral foot. During interviews, an LPN stated she did not really recall the wound care and suggested it may have been checked off even if not completed, and another LPN stated she did not remember what happened. The DON stated nurses had checked off wound care and planned to do it later but forgot, and that treatments should be checked off only once completed. Facility policies stated physician orders are to be followed as prescribed and wound dressings are to be changed in accordance with regulations and guidelines.
Unsafe Use of Mechanical Lift
Penalty
Summary
The facility failed to safely use a mechanical lift for one resident who was reviewed for accidents. During an observation on 12/01/2025 at 9:40 AM, a CNA entered the resident’s room with a Hoyer lift while the resident was on the lift with only that staff member present. The resident was observed hanging in the Hoyer lift completely off the bed on the left side, parallel to the bed, with the floor beneath the resident’s bottom and legs while the CNA stood next to the resident making the bed. The resident’s care plan, initiated on 10/4/2021, identified chronic ADL self-care performance deficits related to muscle weakness, impaired balance/coordination, historical pain, and non-ambulatory status, with an intervention requiring staff assistance for transfers with 2 persons via Hoyer lift. During interview, the CNA stated she knew the Hoyer lift should be used with two people at all times and said she was trying to change the linen and was not going to transfer the resident. The DON and the Director of Therapy and Rehabilitation both stated that a Hoyer lift should be used with two staff members at all times, and the facility policy stated that two staff members must be used when transferring a resident with a mechanical lift.
Failure to Provide Nutritional Services for Residents With Significant Weight Loss
Penalty
Summary
The facility failed to provide nutritional services for two residents with documented weight loss and no timely dietary follow-up or active nutrition orders in place. One resident had a weight decline from 189 lbs to 164 lbs, a 13.23% loss, and a dietary progress note stated the resident had a fair appetite, was on a downward weight trend, and was receiving fortified foods and health shakes; however, the physician orders and MAR did not document an active order or administration for health shakes after 11/23/2025, and no health shakes were documented in December 2025. During interview, the RD stated the resident was receiving palliative care, weight loss was unavoidable, and she did not see health shakes in the record even though they should have been added. The DON stated the RD entered her own orders, and the physician stated he did not remember being notified of the weight loss. A second resident had weight loss from 174 lbs to 156 lbs, a 10.34% loss, with no dietary progress notes in the record and no evidence of a nutritional assessment after the last comprehensive review in August 2023. The RD stated the resident was not on her list, should have been seen in October and November 2025, and she was not sure how the resident was missed. The RD later stated the resident was trending down and had palliative care for cancer, COPD, and CKD, while the DON stated the resident fell through the cracks and should have been seen by the RD. The facility policy required a comprehensive nutritional assessment within 72 hours of admission, annually, and upon significant change in condition, with follow-up assessments as needed.
Respiratory care orders were not followed for oxygen flow and nebulizer supplies
Penalty
Summary
Safe and appropriate respiratory care was not provided when Resident #88, who had diagnoses including CHF, was observed receiving oxygen by nasal cannula at 4 liters per minute even though the physician order dated 6/28/2025 specified continuous oxygen at 3 liters per minute. The resident was observed on multiple occasions with oxygen running at 4 liters per minute, and during an interview an LPN stated the oxygen was running at 4 liters per minute and that the resident had orders for 3 liters per minute. The DON stated nursing staff should check the oxygen flow rate for accuracy every shift and noted that some residents adjust their own oxygen, but Resident #88 was not one of them. The facility also failed to change Resident #50's nebulizer treatment bag and supplies as expected. Resident #50 had diagnoses including Parkinson's disease, diabetes with neuropathy and hyperglycemia, interstitial pulmonary disease, asthma, paroxysmal atrial fibrillation, and hypertension. On observation, the nebulizer supply bag containing the tubing and face mask was dated 11/22/25 on two separate occasions, and the DON stated the expectation was that oxygen, nebulizer, and other respiratory equipment tubing and masks were to be changed every week and dated when changed. Resident #50 had an order for Ipratropium-Albuterol inhalation solution 3 ml every 6 hours as needed for wheezing/cough, and the MAR documented administration on 11/23/2025.
Failure to Document Rationale for Not Following Pharmacist Recommendations
Penalty
Summary
The facility failed to ensure that the physician documented a rationale when no action was taken after pharmacist recommendations for two residents. For one resident, pharmacy consultation reports noted that Midodrine had not been used within the previous 60 days and recommended considering discontinuation due to lack of use. The resident’s progress note later stated to continue Midodrine, but it did not include a documented rationale for not discontinuing the medication. The physician order remained active for Midodrine 5 mg every 8 hours as needed for systolic blood pressure less than 100. For another resident with diagnoses including Parkinson’s disease, type 2 diabetes mellitus with neuropathy and hyperglycemia, interstitial pulmonary disease, asthma, long-term anticoagulant use, paroxysmal atrial fibrillation, and essential hypertension, the pharmacist recommended decreasing Eliquis from 5 mg twice daily to 2.5 mg twice daily. A handwritten note stated “Disagree,” but it was not signed or dated. Review of the resident’s progress notes showed no mention of Eliquis or any declination of the pharmacy recommendation, and the MAR documented administration of apixaban 5 mg twice daily during July and August. The record also showed a later pharmacist recommendation regarding the resident’s lidocaine patch, stating the order should include instructions to remove it after 12 hours. The DON signed and dated the comment section, but the physician progress note only stated that medications were reviewed and did not mention the lidocaine patch or any change to the order. Interviews with the DON and PA confirmed there was no documented rationale in the record for not following the pharmacist recommendations, and facility policy required the attending physician to document the review of irregularities and the rationale when no change was made.
Unnecessary Medication Regimens and Order Administration Errors
Penalty
Summary
The facility failed to ensure that residents' medication regimens were free from unnecessary medications, including excessive doses or dosages, for 3 of 5 residents reviewed. The report identified that Resident #22, who had diagnoses including Alzheimer's disease with late onset, acute chronic combined systolic heart failure, dementia, hypertension, atrial fibrillation, type 2 diabetes, anemia, and anxiety disorder, had physician orders for DIL-XR 120 mg, 2 capsules daily for hypertension with a hold parameter for SBP below 160, and Metoprolol Succinate ER 25 mg, 3 tablets daily for hypertension with the same hold parameter. The MAR showed DIL-XR was administered on multiple occasions in November 2025 when blood pressures were below 160, including readings such as 131/74, 123/83, 129/80, 131/65, and 131/76, and Metoprolol ER was also administered when the blood pressure was 123/68. Resident #71 had diagnoses including heart failure, muscle weakness, malignant neoplasm of the cecum, hypotension, anemia, chronic kidney disease, anxiety disorder, major depressive disorder, and essential hypertension. The resident had an order for Lisinopril-hydrochlorothiazide 10-12.5 mg daily for hypertension with a hold if SBP was less than 110, and a separate order for Midodrine 5 mg daily for hypotension to be given if BP was below 100/60. The MAR showed Lisinopril-hydrochlorothiazide was administered when the blood pressure was 103/62, and Midodrine was administered when blood pressures were 105/58 and 109/59. During interview, Staff B stated she misinterpreted the order and did administer the medications on those dates. Resident #50 had diagnoses including Parkinson's disease, diabetic neuropathy, hyperglycemia, interstitial pulmonary disease, asthma, long-term anticoagulant use, paroxysmal atrial fibrillation, and hypertension. A pharmacist recommendation dated 1/21/2025 stated Methocarbamol should be reduced to 750 mg daily with the end goal of discontinuation, and the recommendation was accepted and signed by the primary care physician. However, physician orders continued to show Methocarbamol 750 mg twice daily for muscle spasms, and the MAR documented administration twice daily throughout January and February 2025 and for 55 of 60 scheduled doses in November 2025. The DON stated the facility had problems getting pharmacist-recommended changes entered and carried out, and the record review found no progress notes or other documentation addressing why the recommendations had not been followed.
Infection Control Lapses During Medication Administration
Penalty
Summary
The facility failed to maintain infection control and prevention measures during medication administration for three residents. During an observation on 12/03/2025 at 8:19 AM, Staff A, RN expelled amlodipine 5 mg oral tablet from its package, dropped it onto the medication cart, picked it up without gloves, placed it in a medication cup with other medications, and administered it to Resident #101. During an observation at 8:34 AM, Staff A, RN opened a Lactobacillus acidophilus 10 mg oral capsule without wearing gloves and added the contents to a medication cup before adding pudding for Resident #120. During an observation at 8:59 AM, Staff A, RN donned gloves and administered six medications via Resident #121’s G-tube, but did not don a gown before providing the medication administration through the tube. Resident #121 was on EBP for a G-tube, and the DON stated that PPE, including gloves and gowns, was to be worn when providing care in close contact or administering medications through a PEG or G-tube. During interview, Staff A, RN stated she had overlooked wearing a gown while administering medications via Resident #121’s G-tube. She also stated she should not have picked up Resident #101’s tablet from the top of the medication cart, especially without wearing gloves, and then administered it to the resident. Regarding Resident #120’s capsule, Staff A, RN was not sure if she should have opened it without gloves, but said she would wear gloves in the future. Review of the facility’s policies showed that the infection prevention and control program required PPE training, that EBP applied to residents with indwelling medical devices such as feeding tubes, and that high-contact care activities included device care or use. The medication administration policy also stated that staff should comply with infection control policy before preparing or administering medications.
Failure to Timely Report Abnormal Lab Results to Physician
Penalty
Summary
The facility failed to report abnormal laboratory results to the physician in a timely manner for one resident who was recently admitted with multiple complex diagnoses, including acute kidney failure, type 2 diabetes mellitus, and right-sided hemiplegia. Laboratory results obtained on the day of admission showed significantly elevated BUN and creatinine levels, both outside the normal reference ranges. Despite these abnormal findings, there was no documentation in the resident's daily progress notes over the following two days indicating that the results were communicated to the physician. The physician confirmed during an interview that they did not receive a call regarding the resident's lab results and stated that such results should have been reported the same day. The DON also acknowledged that the facility's policy requires immediate notification of abnormal lab results to the physician. Review of the facility's policy confirmed the expectation for prompt reporting of out-of-range laboratory results to the ordering provider.
Failure to Adhere to Oxygen Therapy Orders
Penalty
Summary
The facility failed to provide respiratory care services consistent with professional standards of practice for a resident requiring oxygen administration. Observations on multiple occasions revealed that the resident was receiving oxygen at 2 liters per minute, despite a physician's order for continuous oxygen at 3 liters per minute via nasal cannula. This discrepancy was confirmed by a Licensed Practical Nurse (LPN) Unit Coordinator, who acknowledged that the oxygen concentrator was not set to the prescribed 3 liters per minute. The resident in question was admitted with diagnoses including acute and chronic respiratory failure with hypoxia, Chronic Obstructive Pulmonary Disease (COPD), pleural effusion, kidney failure, and chronic kidney disease Stage 3B. The Director of Nursing (DON) stated that nurses should check the oxygen settings at the beginning of their shift and every couple of hours thereafter. The facility's policy on respiratory care mandates that oxygen therapy be provided as ordered by the physician, yet this was not adhered to in the case of the resident, leading to the identified deficiency.
Failure to Post Daily Nursing Staff Information
Penalty
Summary
The facility failed to ensure that nursing staff information was posted daily at the beginning of each shift, as required by their policy. During an observation on July 8, 2024, at 9:00 AM, it was noted that the Nursing Staffing data displayed in the main lobby was dated July 4, 2024, indicating that the information had not been updated for several days. This was confirmed by photographic evidence. In an interview conducted on July 9, 2024, at 1:06 PM, the Director of Nursing stated that it was the staffing coordinator's responsibility to post the federal staffing schedule between 6:00 AM and 7:00 AM from Monday through Friday, while on weekends, the responsibility fell to the supervisors. The facility's policy, last reviewed on March 2, 2019, mandates that staffing information be made readily available in a readable format to residents and visitors at any given time, and that it should be posted daily at the beginning of each shift in a clear and readable format in a prominent place.
Improper Food and Dish Storage in Kitchen
Penalty
Summary
The facility failed to ensure proper storage, labeling, and dating of food and dishes in the kitchen's reach-in and walk-in coolers, and walk-in freezer. During an initial walk-through, numerous boxes of food were observed on the floor in the walk-in freezer. In the walk-in cooler, two cases of raw shell eggs were stored on the top shelf above produce and opened chocolate chips, contrary to food safety policies. Additionally, large containers of liquid and a bowl of diced white product were found without labels or dates. An opened package of butter or margarine was also found exposed in a reach-in cooler. Further observations revealed numerous dishes, including plates, ramekins, and bowls, stored on a shelf with visible spills and debris, without being covered or inverted. Interviews with the Dietary Manager and Regional Culinary Director confirmed these findings and acknowledged that the storage practices did not meet the facility's food safety policy, which requires proper labeling, dating, and storage of food items and dishes to prevent contamination.
Infection Control Deficiencies in PPE Use and Hand Hygiene
Penalty
Summary
The facility failed to ensure proper use of personal protective equipment (PPE) for a resident on enhanced barrier precautions. During observations, a Certified Nursing Assistant (CNA) was seen entering the room of a resident with multiple chronic wounds and failing to wear a gown while performing incontinence care, despite a clear sign indicating the requirement for both gown and gloves. The CNA admitted to not receiving adequate training on PPE requirements for enhanced barrier precautions, and the Director of Nursing confirmed that staff should wear gowns and gloves for such care. Additionally, the facility did not adhere to proper hand hygiene protocols. A CNA was observed handling soiled linen and moving between residents without performing hand hygiene. Similarly, a Licensed Practical Nurse (LPN) failed to wash hands before and after administering medications and using shared equipment, such as a blood pressure cuff, between residents. Both staff members acknowledged their lapses in hand hygiene, which were contrary to the facility's infection control policies. The facility's policies on infection control, including hand hygiene and cleaning of shared equipment, were not followed. The Director of Nursing stated that staff should perform hand hygiene before and after resident care and clean shared equipment between uses. The facility's policies align with state and federal regulations and national guidelines, but the observed practices did not meet these standards, leading to potential risks of infection spread.
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What surveyors actually found near you
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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.
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Nursing homes near Mount Dora
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Ruleme Center | 1.4 mi | ★★★★★ | 9 | 0 |
| Edgewater At Waterman Village | 2 mi | ★★★★★ | 9 | 0 |
| Solaris Healthcare Waterman | 2.3 mi | ★★★★★ | 1 | 0 |
| Lake Eustis Healthcare And Rehabilitation Center | 2.7 mi | ★★★★★ | 10 | 2 |
| Bayview Center | 2.8 mi | ★★★★★ | 7 | 0 |
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