Above average — CMS composite of the measures below.
Past the typical resurvey interval — a standard survey could occur at any time
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 Aviata At Lake Mary during CMS and state inspections, most recent first.
The facility failed to complete MDS Comprehensive Assessments within the required time frame for five residents. Delays ranged from two to twelve days, with one assessment remaining incomplete. The MDS Coordinator and Regional Director acknowledged the delays, citing challenges in completing specialized sections on time.
The facility failed to complete MDS Quarterly Assessments within the required time frame for two residents, with one assessment being 23 days late and another 7 days late. The MDS Coordinator acknowledged ongoing issues with timely completion, and the DON noted the absence of a Social Worker as a contributing factor. The facility's guidelines required assessments every three months, but these were not adhered to.
A facility failed to maintain adequate communication with a dialysis center and ensure post-dialysis assessments for a resident with ESRD. Despite receiving dialysis thrice weekly, multiple Dialysis Communication Records from January to June 2024 were incomplete or missing documentation from both the dialysis center and facility nurses. Interviews revealed that despite attempts to address the issue, communication forms continued to be returned incomplete, indicating a lapse in protocol adherence.
A resident with hypotension was improperly administered Midodrine 110 times over four months, despite orders to hold the medication if SBP was less than 110 mmHg. Nursing staff misunderstood the parameters, and the consultant pharmacist failed to identify the errors during monthly reviews.
The facility failed to prevent bacterial growth by improperly handling dishes. Observations revealed wet nesting of plastic pellet bases and improper air drying of cups and bowls. A Dietary Aide noted that bases were stacked wet, and the Dietary Manager recognized the need for better storage methods to ensure proper airflow and drying.
The facility failed to administer oxygen therapy as per physician orders for two residents. One resident received oxygen at a higher rate than prescribed, while another did not receive oxygen despite a continuous order. Staff acknowledged the discrepancies, and the facility's policy required regular review and documentation of oxygen therapy.
Facility Fails to Complete MDS Assessments Timely
Penalty
Summary
The facility failed to complete Minimum Data Set (MDS) Comprehensive Assessments within the regulatory time frame for five residents. Resident #82's Annual MDS assessment was completed four days late, while Resident #88's Significant Change MDS assessment was two days late. Resident #227's Admission MDS assessment was nine days late, and Resident #228's Admission MDS assessment was twelve days late. Resident #233's Admission MDS assessment was incomplete and seven days late at the time of review. The MDS Coordinator acknowledged the delays and explained that the facility's process involved daily reviews of the MDS in progress list with the Interdisciplinary Team (IDT) to remind them of due dates and incomplete sections. The Regional Director of Clinical Reimbursement noted that the facility was behind and faced challenges in completing specialized sections on time. The facility's standards and guidelines require comprehensive assessments at least every three months, following the CMS Resident Assessment Instrument (RAI) guidelines.
Failure to Complete MDS Assessments Timely
Penalty
Summary
The facility failed to ensure that Minimum Data Set (MDS) Quarterly Assessments were completed within the regulatory time frame for two residents. Resident #63's Quarterly MDS assessment was completed 23 days late, and Resident #111's assessment was completed 7 days late. The MDS Coordinator acknowledged the late completion of these assessments and noted that there had been ongoing issues with timely completion since she started working at the facility. The facility's process involved reviewing the list of due assessments each morning with the Interdisciplinary Team (IDT), but this process did not prevent the delays. The Director of Nursing (DON) confirmed awareness of the ongoing issue with late MDS assessments and mentioned the absence of a Social Worker as a contributing factor. The Regional Director of Clinical Reimbursement also identified multiple additional incomplete and late assessments. The facility's job description for the MDS Nurse-LPN emphasized the importance of completing required documentation accurately and timely, and the facility's standards required assessments to be conducted no less than every three months. Despite these guidelines, the facility did not adhere to the required timelines for MDS assessments.
Inadequate Communication and Documentation for Dialysis Care
Penalty
Summary
The facility failed to maintain adequate communication with the dialysis center and ensure post-dialysis assessments were completed for a resident with end-stage renal disease (ESRD) who required dialysis. The resident, who had intact cognition and no behavioral symptoms, received dialysis treatments three times a week. However, a review of the Dialysis Communication Records from January to June 2024 revealed multiple instances of missing or incomplete documentation from both the dialysis center and the facility's nurses. Out of 29 forms reviewed over five months, only 8 forms had all sections completed, indicating a significant lapse in communication and documentation. Interviews with facility staff, including a Licensed Practical Nurse (LPN) and the 100 hall Unit Manager (UM), revealed that the facility's protocol involved sending a communication form with the resident to the dialysis center, which was to be completed by both the facility and the dialysis center. Despite attempts by the UM to address the issue through emails and phone calls to the dialysis center, the communication forms continued to be returned incomplete. The UM acknowledged the incomplete records and stated that the expectation was for nurses to complete the documentation upon the resident's return and to inform the dialysis center when records were not completed. The facility's policy required the nursing staff to review and complete the communication forms and coordinate with the resident's physician and other departments as needed, which was not consistently followed in this case.
Failure to Adhere to Medication Administration Parameters
Penalty
Summary
The facility failed to properly administer Midodrine, a medication used to treat low blood pressure, to a resident over a four-month period. The resident, who had multiple diagnoses including hypotension, was prescribed Midodrine with specific parameters to hold the medication if the systolic blood pressure (SBP) was less than 110 mmHg. However, the medication was administered 110 times when it should have been held, as the nurses did not adhere to the physician's parameter orders. This oversight was not identified by the nursing staff or the consultant pharmacist during their monthly reviews. Interviews with the nursing staff revealed a lack of awareness and understanding of the medication's purpose and the specific parameters for its administration. Several nurses, including RNs and LPNs, admitted to administering Midodrine without holding it as ordered, due to misunderstandings about the correct SBP threshold. The consultant pharmacist also failed to identify these errors during her reviews and did not report any discrepancies. The Director of Nursing confirmed the oversight and acknowledged that the pharmacist should have detected the errors during the monthly drug regimen reviews.
Improper Dish Drying Practices
Penalty
Summary
The facility failed to ensure that dishes were handled in a manner to prevent bacterial growth. During a kitchen tour, it was observed that plastic pellet bases were wet nesting, and cups and bowls were inverted on trays in a way that did not allow them to completely air dry. A Dietary Aide mentioned that the bases were kept stacked on top of each other next to the tray line for service, and when one base was removed, it was noted to be wet. The Dietary Manager acknowledged the need for liners between dishes and trays and a different storage method to prevent wet-nesting, emphasizing the importance of airflow to prevent bacterial growth.
Failure to Administer Oxygen Therapy as Ordered
Penalty
Summary
The facility failed to administer oxygen therapy according to physician orders for two residents. Resident #327, who was admitted with diagnoses including heart failure and shortness of breath, had a physician order for continuous oxygen at 2 liters per minute. However, observations revealed the oxygen concentrator was set at 4.5 liters per minute. The LPN acknowledged the discrepancy but could not explain who set the oxygen at the incorrect rate. The Unit Manager and Director of Nursing confirmed the expectation that nurses should verify and ensure the correct oxygen flow rate as per physician orders. Resident #90 had an order for continuous oxygen at 2-4 liters per minute, but observations showed the oxygen was not being administered, and the nasal cannula was not connected. The LPN stated the resident's oxygen saturation was 94, and the resident was known to pull out the nasal cannula. Despite this, the oxygen was not administered, and the order was later changed to as-needed oxygen. The RN acknowledged the resident did not receive oxygen as ordered, and the electronic MAR indicated oxygen was signed off as provided, despite it not being administered.
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Illustrative
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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Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Lake Mary
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Island Lake Center | 4.3 mi | ★★★★★ | 11 | 0 |
| Longwood Health And Rehabilitation Center | 4.9 mi | ★★★★★ | 10 | 0 |
| Village On The Green | 5.6 mi | ★★★★★ | 0 | 0 |
| Healthcare And Rehab Of Sanford | 6.5 mi | ★★★★★ | 5 | 0 |
| Life Care Center Of Altamonte Springs | 6.7 mi | ★★★★★ | 4 | 0 |
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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.