Below 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 August 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Solaris Healthcare Lely Palms during CMS and state inspections, most recent first.
A deficiency was cited for failing to protect residents from all forms of abuse and neglect, including physical, mental, and sexual abuse, as well as physical punishment. The facility did not ensure adequate safeguards were in place to prevent mistreatment by any individual.
A deficiency was cited due to the facility's failure to keep an area free from accident hazards and to provide adequate supervision to prevent accidents. The environment did not meet safety standards, and there was insufficient monitoring in the affected area.
A resident in an LTC facility suffered moisture-associated skin damage due to neglect in incontinent care. Despite being incontinent of urine and feces, the resident's briefs were not changed for over six hours, leading to prolonged skin exposure to urine. The facility's policy required CNAs to check and change residents' briefs every two hours, but this was not followed. The resident's medical history included chronic kidney disease and Alzheimer's, contributing to her incontinence. The Director of Nursing acknowledged the incident but did not consider it neglect.
The facility failed to create individualized care plans for residents in the memory care unit, affecting their quality of life and care. A resident with severe dementia was observed wandering without staff intervention, while another with severe cognitive impairment had a care plan that did not reflect their needs. Two other residents were not engaged in meaningful activities, and the Activity Director confirmed the care plans were not individualized.
The facility failed to provide individualized activity programs for residents with severe cognitive impairments, as evidenced by observations of residents not engaged in meaningful activities and lacking appropriate interventions. Residents were observed wandering, yelling, or sitting unengaged, with care plans not being followed or assessments not completed.
A resident with severe cognitive impairment was not treated with dignity during medication administration. An RN physically manipulated the resident's head to administer medication, while an LPN gave audible instructions in a public setting, compromising the resident's dignity and privacy.
A resident admitted for rehabilitation with orders for Physical and Occupational therapy did not receive the prescribed evaluations and treatments. Despite having multiple diagnoses, including Multiple Sclerosis and a history of falling, the resident reported feeling neglected and abandoned. The Regional PT Consultant confirmed the lack of therapy evaluations, highlighting a failure in the facility's care provision.
Failure to Protect Residents from Abuse and Neglect
Penalty
Summary
A deficiency was identified regarding the facility's failure to protect each resident from all types of abuse, including physical, mental, sexual abuse, physical punishment, and neglect by any individual. The report notes that residents were not adequately safeguarded from these forms of mistreatment, indicating lapses in the facility's protective measures and oversight. Specific details about the actions or inactions leading to the deficiency, as well as information about the residents involved or their conditions at the time, are not provided in the report. The deficiency centers on the lack of comprehensive protection for residents against abuse and neglect, as required by regulatory standards.
Failure to Maintain Accident-Free Environment and Adequate Supervision
Penalty
Summary
A deficiency was identified in the facility's failure to ensure that an area was free from accident hazards and that adequate supervision was provided to prevent accidents. The report notes that the environment did not meet safety standards, which could contribute to the risk of accidents for residents. Specific actions or inactions leading to this deficiency include the lack of proper hazard identification and insufficient monitoring or supervision in the affected area. No additional details about specific residents, their medical history, or their condition at the time of the deficiency are provided in the report.
Neglect in Incontinent Care Leads to Skin Damage
Penalty
Summary
The facility failed to protect a resident's right to be free from neglect by not providing adequate incontinent care, resulting in prolonged skin exposure to urine and subsequent moisture-associated skin damage. The resident, who was incontinent of urine and feces, reported that her incontinent briefs were not changed frequently, leading to redness and irritation on her buttocks. Observations and interviews revealed that the resident's briefs were not changed for over six hours, and the staff did not check on her regularly throughout the day. The resident expressed that she was not changed from midnight until 5:00 a.m. and then not again until the afternoon, despite her complaints of moisture and pain under the foam bandage applied to her buttocks. The CNA responsible for the resident admitted to not changing her briefs during the morning shift, and the RN confirmed that the resident's briefs were wet with urine. The facility's policy required CNAs to check and change residents' briefs at least every two hours, which was not adhered to in this case. The resident's medical history included chronic kidney disease, Alzheimer's disease, and overactive bladder, which contributed to her incontinence. The facility's documentation showed that the resident received toileting assistance only 2-3 times within a 24-hour period, which was insufficient given her needs. The wound care physician noted that the resident's buttocks had moisture-associated skin damage, and the prolonged exposure to urine was detrimental to her skin health. The Director of Nursing acknowledged the incident but did not consider it neglect, despite the clear evidence of inadequate care.
Failure to Develop Individualized Care Plans in Memory Care Unit
Penalty
Summary
The facility failed to develop and implement individualized care plans for residents in the memory care unit, impacting their quality of life and care. Resident #42, with severe dementia and anxiety, was observed wandering and engaging in behaviors such as picking up items from the floor and wiping walls, without staff intervention. The care plan did not adequately address these behaviors or provide effective interventions. Resident #46, diagnosed with dementia and severe cognitive impairment, had a care plan that inaccurately stated the resident could choose independent leisure activities, despite a BIMS score indicating severe impairment. The Activity Director acknowledged the resident's preference for holding a baby doll, which was not documented in the care plan, highlighting a disconnect between the resident's needs and the care plan. Residents #54 and #55, both with severe cognitive impairments, had care plans that failed to reflect their inability to choose activities. Observations showed these residents were not engaged in meaningful activities, with Resident #54 calling out loudly and Resident #55 attempting to stand from a wheelchair. The Activity Director and Unit Manager confirmed the care plans were not individualized, and activity preference assessments were not completed, leading to inadequate care planning for these residents.
Failure to Provide Individualized Activity Programs for Residents
Penalty
Summary
The facility failed to provide an ongoing program of activities that met the individual needs and preferences of residents, as evidenced by observations and interviews with staff. Several residents, including those with severe cognitive impairments and behavioral disturbances, were not engaged in meaningful activities tailored to their interests and abilities. For instance, Resident #42, who had severe dementia and anxiety, was observed wandering the hallways without redirection or engagement in activities, despite her care plan indicating a preference for independent leisure activities. Resident #46, who also had severe cognitive impairment, was observed sitting alone with a coloring book and later a busy book, neither of which engaged her. She frequently yelled out, and staff did not provide appropriate interventions such as sensory stimulation or aromatherapy, which were noted in her care plan. Similarly, Resident #54, with severe cognitive impairment, was observed not participating in group activities and was not offered individualized activities to address her agitation and yelling. Resident #55, who was Spanish-speaking and had severe cognitive impairment, was not provided with activities in his preferred language or interests, such as Spanish television or war movies. He was observed repeatedly attempting to stand from his wheelchair without staff offering appropriate interventions. Additionally, Resident #5, who had multiple diagnoses including dementia and depression, did not have an activity assessment or care plan initiated, and was not observed participating in any activities. The facility's failure to conduct activity preference assessments and provide individualized activities contributed to the deficiency.
Failure to Maintain Resident Dignity During Medication Administration
Penalty
Summary
The facility failed to treat a resident with respect and dignity during medication administration. The incident involved a resident with severe cognitive impairment, diagnosed with dementia with behavioral disturbance and seizures. During a medication administration session in the dining room, a Registered Nurse (RN) was observed instructing the resident to lift her head to take her medications. When the resident did not comply, the RN placed two capsules in pudding and physically lifted the resident's head to administer the medication. The resident resisted by pushing the capsule out of her mouth, but the RN repeatedly scraped the capsule and pudding from the resident's mouth and placed it back in her mouth, holding her head until she swallowed the medications. On a separate occasion, a Licensed Practical Nurse (LPN) was observed administering medications to the same resident in the dining room during an activity program. The LPN instructed the resident to open her mouth and placed the medications in her mouth, instructing her to swallow them. These instructions were audible to other residents sitting at the table, further compromising the resident's dignity and privacy. The actions of both the RN and LPN were inconsistent with the facility's policies on promoting dignity and providing privacy during medication administration.
Failure to Provide Rehabilitative Services
Penalty
Summary
The facility failed to provide necessary Physical and Occupational therapy services to a resident who was admitted for rehabilitation. The resident, who has diagnoses including Multiple Sclerosis, Urinary Tract Infection, Depression, Anxiety Disorder, and a history of falling, was admitted with physician's orders for evaluations and treatments in both Physical and Occupational therapy. Despite these orders, the resident reported not receiving any rehabilitative services since admission. Interviews with the resident revealed feelings of neglect and abandonment, as she expressed that staff were not attending to her needs. The Regional Physical Therapy Consultant confirmed that the resident had not been evaluated by either therapy service as ordered, indicating a lapse in the facility's adherence to the prescribed care plan.
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 34 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 Naples
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Oakton Place Health And Rehabilitation At The Arli | 1.5 mi | ★★★★★ | 0 | 0 |
| Gardens At Terracina Health & Rehabilitation | 2.2 mi | ★★★★★ | 0 | 0 |
| Woodside Health And Rehabilitation Center | 2.5 mi | ★★★★★ | 5 | 0 |
| Naples Health And Rehabilitation Center | 7.1 mi | ★★★★★ | 14 | 3 |
| Chateau At Moorings Park, The | 8.1 mi | ★★★★★ | 1 | 0 |
Every risk area ranked, a do-first checklist, and your local survey patterns
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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 August 2026) and official state health department websites.