Above average — CMS composite of the measures below.
A standard survey is most likely before around August 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 Covenant Village Care Center during CMS and state inspections, most recent first.
The facility did not develop care plans for monitoring behaviors and side effects in two residents on psychotropic medications, and failed to initiate a care plan for pain monitoring in a resident on narcotic medication. Although monitoring was documented in the MAR and some care plan elements addressed related risks, comprehensive care plans for these specific issues were missing.
Surveyors identified that discontinued narcotic medications for two residents remained in locked medication carts well past the facility's required disposal timeframe. The medications, including Alprazolam and Hydrocodone-acetaminophen, were found during cart reviews with RNs, despite orders having been discontinued and no recent administration.
A resident with dementia and depression was prescribed Fluoxetine, but the facility failed to document monitoring for side effects or behavioral changes as required by the care plan. A nurse confirmed the absence of behavioral monitoring orders and noted that the resident often refused medication, with no recent administration or monitoring documented.
A medication error rate of 7.14% was found when a nurse prepared an incorrect dose of Amoxicillin and failed to hold Carvedilol for a resident whose blood pressure and heart rate were below the prescribed parameters. The errors were identified during observation before the medications were administered.
A RN was observed leaving the medication cart unlocked and unattended during medication administration to several residents, with the cart accessible to others in the hallway. Additionally, a spilled dose of Glipizide ER was improperly disposed of in a trash receptacle instead of the designated pill buster, contrary to facility policy.
Failure to Initiate Care Plans for Psychotropic and Narcotic Medication Monitoring
Penalty
Summary
The facility failed to develop and implement comprehensive care plans addressing the monitoring of behaviors and side effects for two residents receiving psychotropic medications, and failed to initiate a care plan for pain monitoring for one resident on narcotic medication. For one resident with diagnoses including hemiplegia, hemiparesis, and epilepsy, orders were in place for psychotropic and narcotic medications, and monitoring was documented in the medication administration record. However, the comprehensive care plan did not include interventions for monitoring behaviors or side effects related to psychotropic use, nor for pain assessment related to narcotic use. Another resident with urinary tract infection and parkinsonism was also prescribed psychotropic medication, with orders for behavior and side effect monitoring, and documentation of these assessments in the medication administration record. While the care plan addressed monitoring for side effects and mood related to antidepressant use, it did not include a care plan for monitoring behaviors or side effects specifically related to psychotropic medications. The MDS coordinator stated that monitoring was not deemed necessary for psychotropics prescribed for non-psychiatric reasons and acknowledged the missing care plan for narcotic use.
Failure to Timely Remove Discontinued Narcotics from Medication Carts
Penalty
Summary
Surveyors found that the facility failed to promptly remove discontinued narcotic medications from two of three medication carts, as required by facility policy. During a review of the east medication cart with a registered nurse, a medication card for Alprazolam 0.25 mg prescribed to a resident was discovered in the narcotic locked box, despite the order having been discontinued several months prior and the last dose administered over two months ago. Similarly, on the middle medication cart, a medication card for Hydrocodone 5 mg-acetaminophen 325 mg for another resident was found in the narcotic locked box, with the order discontinued and the last dose given nearly a month earlier. The facility's policy mandates that controlled substances be disposed of immediately, and no later than three days after discontinuation, but these medications remained on the carts well beyond that timeframe.
Failure to Monitor Antidepressant Side Effects and Behaviors
Penalty
Summary
A resident with diagnoses of dementia and major depressive disorder was admitted to the facility and prescribed Fluoxetine 10 mg daily for depression. The resident was moderately cognitively impaired, requiring supervision and assistance with activities of daily living. The care plan included goals to observe for changes in mood and behavior and to record these on a behavior tracking form. However, review of the treatment plan revealed a lack of documentation regarding monitoring for side effects or behavioral observations related to the antidepressant medication. During a record review and interview, a registered nurse confirmed that there was no physician order for behavioral monitoring associated with the Fluoxetine prescription. It was also noted that the resident frequently refused her medications, with the last administration recorded several days prior. The electronic record showed no evidence of behavioral monitoring for this resident, and the nurse agreed that such monitoring should have been in place.
Medication Error Rate Exceeds Acceptable Threshold
Penalty
Summary
A medication error rate of 7.14% was identified during a survey, with 2 errors observed out of 28 medication administration opportunities, affecting one resident. The facility's policy required staff to obtain and record vital signs and to hold medications if the resident's vital signs were outside physician-prescribed parameters. On the observed occasion, a registered nurse prepared Amoxicillin and Carvedilol for a resident whose blood pressure and heart rate were below the parameters set for Carvedilol administration. The nurse also prepared an incorrect dose of Amoxicillin. The surveyor intervened before the medications were administered, prompting the nurse to review the orders and acknowledge the errors.
Medication Cart Security and Improper Drug Disposal
Penalty
Summary
Facility staff failed to adhere to medication security protocols during medication administration. Specifically, a Registered Nurse (RN) was observed leaving the medication cart unlocked while administering medications to multiple residents. The cart remained unlocked while the RN entered resident rooms, took vital signs, and washed hands, with the cart unattended in the hallway. During this time, other staff and residents were present in the area, and the cart was accessible to individuals other than the RN. The cart was only locked after several residents had received their medications. Additionally, the RN did not follow proper procedures for disposing of a wasted medication. After spilling a dose of Glipizide ER 5 mg, the RN placed the medication directly into a trash receptacle instead of using the designated pill buster for disposal, as required by facility policy. The RN acknowledged the error when questioned by the surveyor. These actions were observed and discussed with the facility administrator.
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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 Plantation
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Broward Oaks Nursing And Rehabilitation | 1.2 mi | ★★★★★ | 2 | 0 |
| Nspire Healthcare Plantation | 2.5 mi | ★★★★★ | 0 | 0 |
| Regents Park Of Sunrise | 3.4 mi | ★★★★★ | 4 | 1 |
| Springtree Rehabilitation & Health Care Center | 3.8 mi | ★★★★★ | 0 | 0 |
| Nspire Healthcare Lauderhill | 3.9 mi | ★★★★★ | 0 | 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.