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 Fouraker Hills Rehab And Nursing Center during CMS and state inspections, most recent first.
The facility failed to maintain a safe, clean, and homelike environment, with issues such as detached baseboards, stained floors and walls, and significant pest control problems, including live roaches in resident rooms. Residents reported awareness of the pest issues, and staff acknowledged breakdowns in reporting and cleaning procedures. The facility's cleaning policy was not adequately reviewed or implemented, contributing to the deficiencies.
The facility failed to maintain an effective pest control program, resulting in the presence of pests in several resident rooms. Live roaches and other pests were observed during a facility tour, and residents reported ongoing issues despite pest control measures. The Maintenance Director and Housekeeping Supervisor acknowledged reporting inconsistencies and the need for additional staff training. Pest control service reports highlighted unaddressed recommendations, such as fixing gaps around AC units and improving sanitation, contributing to the persistent pest problem.
A resident with significant communication challenges due to hearing and vision impairments was inaccurately assessed in the MDS as having adequate hearing. Despite staff observations and interviews confirming the resident's difficulties, the MDS assessments did not reflect these issues, indicating a failure in accurately completing the assessment.
A resident in an LTC facility did not receive necessary grooming and personal hygiene services, as evidenced by matted, greasy hair and a foul odor. Despite being scheduled for showers twice a week, the resident reported not having a shower in over 10 days. Staff interviews revealed inconsistencies in documentation and provision of showers, with no evidence of refusals documented. The resident's care plan required assistance with ADLs, but only two out of 14 scheduled showers were provided in the past month.
A resident with significant hearing impairment did not receive necessary audiology services or hearing aids, despite expressing the need and the presence of a visiting audiologist. Staff interviews revealed a lack of awareness and understanding of the referral process, and the resident's care plan did not address her hearing needs. The facility's policy on coordinating referrals was not effectively implemented, leading to unmet needs for the resident.
The facility failed to administer medications within the specified timeframe for several residents, leading to significant medication errors. Despite staff training, medications were consistently given outside the acceptable one-hour window, affecting residents with conditions like diabetes, hypertension, and Alzheimer's.
Facility Fails to Maintain Safe and Clean Environment
Penalty
Summary
The facility failed to ensure a safe, clean, comfortable, and homelike environment for its residents, as evidenced by multiple deficiencies observed during a survey. The survey revealed that several baseboards were detached from the walls, and there were miscellaneous stains on the laminated floors in the main hallways. Additionally, walls in the hallways and resident rooms were stained and had chipped or tearing paint. Live roaches were observed in multiple resident rooms, along with spider webs and dead roaches, indicating a significant pest control issue. Privacy curtains were heavily stained, and there was debris in the hallways and resident rooms. Interviews with residents revealed that they were aware of the pest issues, with one resident reporting seeing roaches inside dresser drawers and another resident employing personal methods to control the roach problem. The facility's staff, including the Housekeeping Supervisor and Maintenance Director, acknowledged the issues but cited breakdowns in reporting and staff inconsistency as contributing factors. The Maintenance Director admitted to being aware of some concerns but stated that not all issues were reported to him, leading to delays in addressing them. The facility's 5-Step Daily Room Cleaning policy was not adequately reviewed or implemented, as evidenced by the lack of training on pest control reporting and cleaning procedures. The Housekeeping Supervisor admitted that his staff was not performing as expected and that additional training was needed. Despite acknowledging the presence of mold and pest activity, the facility staff did not provide a plan or timeframe for resolving these issues, highlighting a significant deficiency in maintaining a safe and clean environment for residents.
Pest Control Deficiency in Facility
Penalty
Summary
The facility failed to maintain an effective pest control program, resulting in the presence of pests and rodents in five of the 66 resident rooms. During a tour of the facility, live roaches were observed in multiple rooms, including rooms 204, 205, 208, 510, and 512. Photographic evidence was obtained to document the presence of live roaches, spider webs, and dead roaches in these areas. Interviews with residents revealed that they were aware of the pest issue, and some had even resorted to using their own methods to control the pests due to the ineffectiveness of the facility's pest control measures. The facility's Maintenance Director and Housekeeping Supervisor acknowledged the breakdown in the reporting and management of pest control issues. Staff were supposed to report pest sightings in an electronic maintenance reporting system, but inconsistencies in reporting were noted. The Housekeeping Supervisor admitted that additional staff training was needed and that there were times when pest activity was not properly documented or addressed. The facility's policy for pest management involved contracting with a licensed exterminator to visit twice monthly, but the policy was not effectively implemented, as evidenced by the ongoing pest issues. A review of the pest control service reports revealed that the exterminator had made several recommendations, such as fixing gaps around AC units and addressing sanitation issues in guest rooms. However, these recommendations were not adequately followed, contributing to the persistent pest problem. The reports also noted conducive conditions for pest activity, such as excessive clutter, gaps in baseboards, and food left out, which were not addressed by the facility. The failure to implement an effective pest control program and follow the exterminator's recommendations led to the deficiency observed by the surveyors.
Inaccurate MDS Assessment for Resident with Communication Challenges
Penalty
Summary
The facility failed to ensure the Minimum Data Set (MDS) assessment was completed accurately for a resident reviewed for communication. Observations and interviews revealed that the resident, who was admitted with multiple diagnoses including chronic respiratory failure and diabetes, had significant communication challenges due to being hard of hearing and blind. Despite these challenges, the resident's Quarterly and Comprehensive Annual MDS assessments inaccurately documented that she had adequate hearing and no difficulty with normal conversation or listening to the TV without hearing aids. Interviews with staff, including a CNA and an LPN, confirmed the resident's communication difficulties, noting that she did not have hearing aids but would benefit from them. The MDS coordinator and MDS nurse, responsible for completing the assessments, denied any communication challenges during their evaluations. The facility's policy for resident assessments and care plans was based on the Resident Assessment Instrument (RAI) manual, but the assessments did not reflect the resident's actual hearing impairments.
Failure to Maintain Resident Hygiene and Grooming
Penalty
Summary
The facility failed to ensure that a resident received necessary services to maintain grooming and personal hygiene, as evidenced by the condition of Resident #14. Observations revealed that the resident had matted, greasy hair and a strong, foul odor, with small gnats flying around her. The resident reported not having had a shower in more than 10 days, despite being scheduled for showers twice a week. The lack of shower sheets in the shower binder further indicated that the resident had not been receiving her scheduled showers. Interviews with staff members, including CNAs and an RN, revealed inconsistencies in the documentation and provision of showers. CNA A stated that showers were offered on assigned days, and refusals were documented, but no such documentation was found for Resident #14. RN B mentioned that the resident rarely refused care and was offered an extra shower, which she reportedly declined. However, there was no evidence of refusals documented in the shower binder. CNA C, who had recently worked with the resident, was unaware of the shower schedule and could not confirm if the resident had refused showers. A review of Resident #14's medical records showed that she required partial to moderate assistance with bathing due to her medical conditions, including chronic respiratory failure and diabetes. The resident's care plan indicated a need for assistance with ADLs, but no refusals of care were documented. The Director of Nursing confirmed that the resident had only received two out of approximately 14 scheduled showers in the past 30 days, highlighting a failure in the facility's adherence to its policy on maintaining residents' hygiene.
Failure to Provide Audiology Services for Hearing-Impaired Resident
Penalty
Summary
The facility failed to ensure that a resident with significant hearing impairment received proper treatment and assistive devices to maintain hearing ability. The resident, who was very hard of hearing, had not been referred for an audiology evaluation despite the presence of a visiting audiologist. During observations, the resident was unable to respond to normal conversation and expressed a desire for hearing aids, stating that she had communicated this need but had not received assistance. Interviews with staff, including the Social Services Director and nursing staff, revealed a lack of awareness and understanding of the referral process for audiology services, contributing to the resident's unmet needs. The resident's medical record indicated she was admitted with multiple diagnoses, including chronic respiratory failure and diabetes with retinopathy, yet her care plan did not address her hearing or communication needs. The facility's policy required Social Services to coordinate referrals for ancillary services, but this was not effectively implemented. The Director of Nursing and Assistant Director of Nursing were unaware of the resident's hearing impairment and acknowledged a breakdown in the process for addressing such needs. The resident's care plan meetings did not document discussions on audiology services, highlighting a gap in the facility's care coordination and communication processes.
Medication Administration Timing Deficiency
Penalty
Summary
The facility failed to ensure that residents were free from significant medication errors by not administering medications within the specified timeframe according to physicians' scheduling orders. This deficiency was identified for four out of six sampled residents, affecting their ability to maintain proper medication levels in the bloodstream. The report highlights multiple instances where medications were administered outside the acceptable one-hour window before or after the scheduled time, as per the facility's policy. One resident, admitted for respite care, had a series of medications and enteral water flushes administered late over several days. These included critical medications for diabetes, seizures, and depression, which were documented as being administered hours after the scheduled time. Another resident with diagnoses including diabetes, hypertension, and major depressive disorder also experienced late administration of medications over four consecutive days, with some medications being administered more than an hour after the scheduled time. Additional residents with conditions such as spinal stenosis, hypertension, and Alzheimer's disease also had medications administered outside the prescribed timeframe. The report notes that several nursing staff members were responsible for these late administrations, despite having received in-service education on the facility's medication administration policy. Interviews with staff confirmed their awareness of the policy, yet the deficiency persisted, indicating a systemic issue in adhering to medication administration schedules.
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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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Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Jacksonville
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Vivo Healthcare Normandy | 0.7 mi | ★★★★★ | 9 | 0 |
| Westside Oaks Rehabilitation & Nursing Center | 2.2 mi | ★★★★★ | 19 | 4 |
| Cedar Hill Nursing And Rehab Center | 4.1 mi | ★★★★★ | 7 | 0 |
| Riverside Post Acute | 5.7 mi | ★★★★★ | 11 | 0 |
| Park Ridge Nursing Center | 6.2 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.