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 July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Winter Garden Rehabilitation And Nursing Center during CMS and state inspections, most recent first.
Missed anticonvulsant doses without physician notification or monitoring. Three residents with seizure disorders had repeated missed doses of ordered anti-seizure meds documented on the EMAR as medication on order from pharmacy/MD aware. The record showed no documentation of MD notification, follow-up orders, or seizure monitoring, and the attending MD stated he was not aware the doses had been missed.
The facility failed to include pressure and surgical wounds in comprehensive, person-centered care plans for two residents receiving wound care. One resident with a hip fracture, dementia, and a documented stage 2 pressure ulcer had no care plan focus, goals, or interventions addressing pressure or surgical wounds, and an MDS later incorrectly indicated the ulcer was not present on admission. Another resident with multiple comorbidities and a recurrent stage 3 sacral pressure ulcer had physician-ordered wound treatments documented, but the comprehensive care plan lacked any pressure ulcer focus. These omissions occurred despite facility standards requiring comprehensive care plans with measurable objectives and timeframes for needs identified in the MDS assessments.
A resident with dementia, muscle weakness, a hip fracture, and an existing stage 2 pressure ulcer developed a deteriorating pressure injury that progressed from stage 3 to stage 4 with exposed bone after the facility failed to implement revised wound specialist orders. The Wound Care PA ordered changes from collagen and honey gel to Santyl with calcium alginate and later added Xeroform and recommended imaging for suspected osteomyelitis, but the LPN responsible for wound care did not enter or implement these revised orders, and the TARs continued to show the original treatment. The LPN later claimed the PCP verbally overrode the PA’s orders, yet there was no documentation of such orders, no notification to the PA, and no care plan update for the pressure wound. The DON confirmed that the revised orders and imaging were never entered, while the Medical Director stated he relied on the wound specialist and did not order an X-ray, deferring to an orthopedic visit that did not address the wound. Facility policies requiring adherence to physician orders, documentation when orders are not followed, and revision of the care plan based on the resident’s condition were not followed, and the resident was ultimately hospitalized with an infected mid-back pressure wound and MRSA bacteremia.
A high fall risk resident with severe cognitive impairment and multiple comorbidities experienced a fall resulting in a visibly turned leg and pain. Staff assisted the resident back to bed without a documented full post-fall or neurological assessment, and pain medication was delayed for over three hours. Multiple attempts to reach the on-call provider were unsuccessful, and EMS was not contacted until more than four hours after the incident, resulting in a significant delay in emergency medical intervention.
A resident with multiple medical conditions and intact cognition was frustrated by inconsistent and cold meal service. After attempting to serve food to others in the absence of staff, the resident was told not to do so and subsequently became upset. The resident was then restricted from eating in the dining room and participating in certain activities for up to 30 days, a decision confirmed by staff and other residents. This restriction was not in line with the resident's care plan preferences and was not communicated as a voluntary choice, resulting in a failure to honor the resident's right to dignity and respect.
The facility failed to ensure that milk, a potentially hazardous food, was at a safe cold holding temperature before distribution. During lunch trayline observation, the cook did not take the milk's temperature, and the CDM confirmed it should have been checked before starting. The required cold holding temperature is at or below 41°F.
The facility administration failed to ensure safe water temperatures in resident areas, as evidenced by excessively high water temperatures in two resident bathrooms. A resident reported the bath water was too hot, and checks by the Maintenance Director confirmed temperatures of 151.7°F and 149.1°F, well above the acceptable limit of 115°F. The Administrator was unaware of the Maintenance Director's actions and lacked documentation on performance monitoring, contributing to the deficiency.
The facility failed to maintain safe water temperatures and a sanitary environment. A resident reported excessively hot bath water, confirmed by the Maintenance Director's measurements. The Director adjusted the mixing valve without proper training, leading to unsafe temperatures. Additionally, room maintenance was inadequate, with damaged walls and pest issues reported by residents. The Administrator was unaware of these issues, indicating a communication gap.
A resident was found self-administering an antibiotic ointment without a physician's order or care plan, contrary to facility policy. Despite the resident's cognitive capability, the facility failed to conduct a necessary assessment for self-administration, as confirmed by the RN and DON.
A facility failed to revise a care plan for a resident with an ADL self-care deficit to accurately reflect toileting interventions. Despite being incontinent and not on a toileting program, the care plan indicated the need for assistance to use a commode or bedpan, which the resident did not use. Both the LPN and CNA confirmed the resident remained in bed, and the care plan was not updated to reflect this.
A facility failed to provide adequate grooming for a resident with Huntington's disease and dementia, who required substantial assistance with ADLs. The resident's care plan did not include interventions for shaving her legs, despite her preference and dependency on staff for personal hygiene. Observations revealed her legs were unshaven for over a week, and discussions with staff confirmed the omission in her care plan.
A resident with a history of stroke and chronic kidney disease had a physician's order for Calamine lotion to treat a rash, but the treatment was not administered in January or February. Skin checks revealed scratch marks, but no additional treatment was provided, nor was the physician notified. On observation, multiple scabbed and open areas were found on the resident's skin, which had been present for about a month.
A resident with type 2 diabetes mellitus experienced a breach in infection control practices during medication administration. An RN failed to disinfect a tray used for blood glucose monitoring supplies and did not clean the Humalog KwikPen's rubber seal before attaching a needle, contrary to best practices and manufacturer's instructions. The DON confirmed these lapses in protocol.
Missed anticonvulsant doses without physician notification or monitoring
Penalty
Summary
The facility failed to provide pharmaceutical services consistent with professional standards of practice for three residents receiving anticonvulsant medications. One resident with hemiplegia and hemiparesis following a cerebral infarction, epilepsy, dementia, dysphagia, and type 2 diabetes was hospitalized after an episode of unresponsiveness and returned with a diagnosis of breakthrough seizure. After discharge, the resident was ordered Brivaracetam 100 mg twice daily, but the EMAR showed 20 of 24 scheduled doses were not given in January 2026 and 14 of 37 scheduled doses were not given in February 2026, with the missed-dose code indicating the medication was on order from pharmacy/MD aware. The record contained no documentation of physician notification, follow-up orders, or seizure monitoring, and no physician documentation showing awareness of the repeated missed doses. A second resident with epilepsy without status epilepticus, type 2 diabetes mellitus, heart failure, cognitive communication disorder, and dysphagia had orders for multiple anti-seizure medications, including Cenobarmate and Lacosamide. The EMAR showed repeated missed doses of Cenobarmate and Lacosamide across January and February 2026, again charted as medication on order from pharmacy/MD aware, with no documentation of physician notification, subsequent orders, or seizure monitoring, and no physician record of awareness of the missed doses. A third resident with quadriplegia, vascular dementia, spinal stenosis, and seizures had an order for Levetiracetam solution twice daily, but the EMAR showed 6 missed doses out of 39 in May 2026, with the same missed-dose code and no documentation of physician notification, follow-up orders, seizure monitoring, or physician awareness. The DON acknowledged the missed doses, and the attending physician stated he was not aware the residents had missed multiple doses and expected notification and documentation when seizure medications were unavailable.
Failure to Include Pressure and Surgical Wounds in Comprehensive Care Plans
Penalty
Summary
The facility failed to develop and implement comprehensive, person-centered care plans that included pressure and surgical wounds for two residents receiving wound care. For one resident, an older female with diagnoses including a right femur fracture, dementia, muscle weakness, and a pressure ulcer of the left lower back, the admission MDS documented one unhealed stage 2 pressure ulcer present on admission. However, the resident’s most recent comprehensive care plan did not include any focus, goals, or interventions related to pressure or surgical wounds. Additionally, the discharge return anticipated MDS later incorrectly documented that the unhealed stage 2 pressure ulcer was not present upon admission or reentry during the look-back period. During a joint interview, the MDS nurse who completed the admission MDS recalled a decision to address pressure wounds in the care plan but was unable to locate such a care plan in the record, and the DON confirmed she was not aware the wounds were missing from the comprehensive care plan. For another resident, an older female with metabolic encephalopathy, type 2 diabetes mellitus, malnutrition, anemia, dementia, and bilateral knee contractures, a recurrent stage 3 sacral pressure ulcer was diagnosed by the wound care PA, and the quarterly MDS documented an unhealed pressure ulcer not present on admission or reentry during the look-back period. Physician’s orders for sacral wound care treatment were implemented and documented on the Treatment Administration Record. Despite this, review of the current comprehensive care plan showed no focus for the resident’s pressure ulcer. In a joint interview, the DON and Nursing Home Administrator acknowledged that the pressure ulcer care plan for this resident had been missing from the comprehensive care plan. The facility’s own standards and guidelines required comprehensive person-centered care plans with measurable objectives and timeframes to meet residents’ medical and nursing needs identified in the comprehensive assessment, which were not followed in these cases.
Failure to Implement Revised Wound Specialist Orders for Deteriorating Pressure Ulcer
Penalty
Summary
The deficiency involves the facility’s failure to implement revised wound specialist orders for a deteriorating pressure injury, and failure to update the care plan and documentation accordingly. A female resident with dementia, muscle weakness, a right femur fracture, and a stage 2 pressure ulcer on the left lower back was admitted and later re-admitted after hip fracture surgery. The admission MDS identified one unhealed stage 2 pressure ulcer present on admission, and a subsequent discharge-return-anticipated MDS identified one unhealed stage 2 pressure ulcer not present on admission during the look-back period. Despite this, the resident’s most recent care plan did not include a pressure wound. The Wound Care Specialist PA assessed the back wound as a stage 3 pressure injury and ordered treatment with Normal Saline, collagen, and honey gel, covered with border gauze. The Wound Care Nurse’s weekly evaluation documented only collagen as the current treatment. A week later, the Wound Care PA documented that the wound was deteriorating and revised the orders to cleanse with Normal Saline, pat dry, apply Santyl nickel thick to the wound bed, then apply calcium alginate and cover with border gauze daily and as needed. Subsequent PA documentation showed further deterioration, with bone exposure and restaging of the wound to stage 4, along with a significant increase in wound size and volume. The PA ordered continued treatment with Santyl, calcium alginate, and Xeroform over the exposed bone, and requested imaging to rule out suspected osteomyelitis. However, review of the physician’s orders and TARs showed that the only wound treatment orders in place from the time of the revised orders until the resident’s discharge to the hospital remained the original regimen of Normal Saline, barrier cream to the peri-wound, collagen to the wound bed, and border gauze. None of the PA’s revised orders, including the imaging recommendation, were entered or implemented. The Wound Care Nurse, an LPN, stated that her usual practice was to receive verbal orders from the Wound Care PA and transcribe them from his progress notes within a day, and that timely entry of treatment orders was important so they could be carried out. She acknowledged that a weekly wound evaluation note was entered two weeks late and stated she had “got a little behind.” In a joint interview with the DON, the LPN reported that she recalled receiving verbal orders from the resident’s PCP to override the Wound Care PA’s revised treatment orders and to leave the previous orders unchanged, but she had not documented these verbal orders, did not recall informing the PA, and there were no progress or treatment notes reflecting this. The DON confirmed that the PA’s revised orders were not entered, that the X-ray to rule out osteomyelitis was never ordered, and that she could not explain why these orders were missed. The Medical Director stated he relied on the Wound Care Specialist for pressure wound care and that an X-ray was not ordered because he believed it could not detect osteomyelitis and the resident was scheduled to see the orthopedic surgeon, whose office note later did not address suspected osteomyelitis or the pressure wound. The facility’s policies required that physician orders be followed as prescribed, that any orders not followed be recorded in the medical record with physician notification, and that the plan of care include revised interventions as indicated by the resident’s condition; these requirements were not met in this case. During this period, the Wound Care Nurse’s weekly wound evaluations documented wound decline and listed “n/a” under other interventions, while current treatment entries eventually reflected Xeroform, Santyl, and calcium alginate but were completed two weeks after the evaluation date. The Wound Care PA reported that he gave verbal orders during assessments, printed notes for transcription the same day, and relied on the nurse to enter and implement the orders; he did not recall any of his orders being overridden by the PCP and noted that dressings were typically removed before his assessments, preventing him from knowing what dressing was in place. The resident’s PCP follow-up notes over multiple visits did not address pressure wound assessment or care, listing only other medical diagnoses. The resident was ultimately admitted to the hospital, where records showed treatment for an infected mid-back pressure wound, MRSA bacteremia, and sepsis, and she later died. A letter from the Medical Director and PCP written after the survey stated that, seeing the previous treatment had worked well, an order was given to continue the previous treatment, but this was not contemporaneously documented in the resident’s record. The facility’s failure to implement the wound specialist’s revised orders, to document and communicate any overriding PCP orders, to update the care plan, and to follow its own policies on physician orders and pressure injury prevention constituted the identified deficiency. The resident’s daughter reported that she was informed by the facility’s Wound Care Nurse that the wound measured 2 cm about a week before the resident’s rehospitalization, and later learned from hospital staff that her mother had a severe, large, infected spinal wound with exposed bone requiring six weeks of IV antibiotics and a special infusion catheter. She described that her mother looked terrible, rapidly declined, and was unable to communicate while hospitalized. These accounts, along with the hospital documentation of an infected mid-back pressure wound and MRSA bacteremia, were part of the surveyors’ findings related to the facility’s failure to provide appropriate pressure ulcer care and to prevent the development and worsening of pressure injuries.
Delayed Post-Fall Assessment and Emergency Response for High-Risk Resident
Penalty
Summary
A high fall risk resident with severe cognitive impairment and multiple comorbidities, including Alzheimer's dementia, osteoporosis, and a history of falls, was admitted for short-term rehabilitation. The resident required supervision and assistance for mobility and was identified as needing assistance at all times. On the evening of the incident, a CNA found the resident on the floor with her leg turned inward, a sign that may indicate the need for immediate medical attention. The LPN and two CNAs assisted the resident back into bed without a documented full post-fall or neurological assessment. The nurse noted the resident had limited movement in one leg and reported pain, but only provided a pillow for comfort initially. There was no documentation of a comprehensive assessment following the fall. Over the next several hours, nursing staff made multiple unsuccessful attempts to contact the on-call provider. Pain medication was not administered until more than three hours after the fall, and EMS was not contacted during this period. The LPN did not call 911, believing a provider order was required, despite the resident's visible injury. The resident was ultimately transported to the hospital over four hours after the fall, following a delayed response from the on-call provider. Interviews with staff and the resident's family confirmed concerns about the delay in assessment, pain management, and emergency intervention.
Failure to Treat Resident with Dignity and Respect During Meal Service Incident
Penalty
Summary
A cognitively intact resident with multiple medical diagnoses, including atrial fibrillation, type 2 diabetes, orthostatic hypotension, and a history of falls, experienced issues related to the timeliness and temperature of meal service. The resident expressed frustration that meals were not consistently served at the same time and were often cold. On one occasion, due to the absence of nursing staff in the dining room, the resident began serving trays to others, which led to staff intervention and the resident being told he was not permitted to serve other residents. The resident became upset, raised his voice to get staff attention, and subsequently reported feeling punished by being required to eat in his room for four weeks. The resident's care plan indicated a preference for both social and independent leisure activities, with goals and interventions focused on encouraging participation and honoring his choices. However, following the dining room incident, documentation and interviews revealed that the resident was restricted from eating in the dining room and from participating in certain activities, such as outings, for a period of up to 30 days. Multiple staff members, including a CNA, RN, and the DON, as well as other residents, confirmed the existence of this restriction. The restriction was reportedly announced to other residents, and the resident himself stated he felt treated like a child as a result. Despite the administrator's statement that she was unaware of a formal restriction and believed the resident had chosen to take a break from the dining room, consistent accounts from staff and residents indicated that the resident was not allowed to eat in the dining room or participate in group activities for a set period. The facility's policy requires treating residents with respect and dignity and promoting their rights, but the actions taken in response to the resident's behavior did not align with these requirements, resulting in a failure to treat the resident in a dignified and respectful manner.
Failure to Monitor Cold Holding Temperature of Milk
Penalty
Summary
The facility failed to ensure that potentially hazardous foods were at a safe cold holding temperature before distribution. During an observation of the lunch trayline, the cook was seen taking temperatures of hot food items on the steam table. However, the cold holding temperature for milk, a potentially hazardous food, was not obtained. The cook acknowledged this oversight after the lunch trayline had started, and the Certified Dietary Manager (CDM) confirmed that the temperature should have been checked before the trayline began. Both the cook and the CDM confirmed that the cold holding temperature for potentially hazardous foods is required to be at or below 41 degrees Fahrenheit.
Failure to Ensure Safe Water Temperatures
Penalty
Summary
The administration of the facility failed to ensure safe water temperatures in resident areas, as evidenced by the findings from interviews and record reviews. During an interview, a resident reported that the bath water provided by a CNA was too hot, requiring adjustment. Subsequent checks by the Maintenance Director revealed that the water temperatures in two resident bathrooms were excessively high, measuring 151.7 degrees Fahrenheit and 149.1 degrees Fahrenheit, respectively. These temperatures were significantly above the acceptable limit of 115 degrees Fahrenheit, as acknowledged by the Administrator. The Administrator admitted to being unaware of the Maintenance Director's actions, including the adjustment of the mixing valve and the use of an infrared thermometer for temperature checks. The Administrator also lacked documentation on how the Maintenance Director's performance was monitored or evaluated, despite the Maintenance Director reporting directly to him. The job descriptions for both the Administrator and the Maintenance Director highlighted responsibilities for maintaining a safe environment, yet the Administrator did not provide evidence of oversight or training for the Maintenance Director, contributing to the deficiency in ensuring safe water temperatures.
Unsafe Water Temperatures and Poor Maintenance Practices
Penalty
Summary
The facility failed to maintain a safe environment by not adequately monitoring and controlling hot water temperatures in resident rooms. On a specific day, a resident reported that the bath water was too hot, which was confirmed by the Maintenance Director using a digital probe thermometer, showing temperatures of 151.7°F and 149.1°F in two different rooms. The Maintenance Director admitted to adjusting the mixing valve to provide hotter water without proper documentation or training, leading to unsafe water temperatures. The facility's policy required water temperatures to be maintained between 105°F and 115°F, but the Maintenance Director was not aware of the correct procedures and used an inappropriate infrared thermometer for measurements. Additionally, the facility failed to maintain the physical environment in a sanitary and safe manner. In one resident's room, the wall behind the headboard was damaged with deep scratches, exposing the drywall. The Administrator presented a schedule for room renovations but could not provide a plan for routine repairs. Another resident reported roaches in her bathroom, and observations confirmed the presence of insects and water damage under the sink. The Visiting Maintenance Director from a sister facility verified the extent of the damage, noting that the vanity needed removal due to extensive water damage and that caulking was required around the air conditioner to prevent exposure to the outside. The facility's maintenance practices were inadequate, as evidenced by the lack of a regular schedule for room repairs and the improper handling of water temperature adjustments. The Maintenance Director's lack of training and the absence of a backup system for monitoring water temperatures contributed to the unsafe conditions. The Administrator was unaware of the adjustments made to the mixing valve and the use of an inappropriate thermometer, highlighting a communication gap within the facility's management.
Failure to Conduct Medication Self-Administration Assessment
Penalty
Summary
The facility failed to conduct a medication self-administration assessment for a resident who was self-administering a multipurpose antibiotic ointment without a physician's order or a care plan in place. The resident, who had diagnoses including heart failure, hyperlipidemia, hypertension, and prostate cancer, was observed with the ointment on his bedside table and admitted to using it for a rash on his right ear. Despite the resident's cognitive capability, as indicated by a perfect score on the Brief Interview of Mental Status, the facility did not have an order or care plan for self-administration, which is against their policy. The Registered Nurse (RN) confirmed that the resident was not supposed to have medications at the bedside and acknowledged the need for a physician's order for self-administration. The Director of Nursing (DON) validated the facility's policy, which prohibits medications at the bedside without an evaluation and physician's order. The facility's Welcome Packet also states that prescription and over-the-counter medications may not be brought into the facility without approval, highlighting the oversight in this case.
Inaccurate Care Plan for ADL Self-Care Deficit
Penalty
Summary
The facility failed to ensure the care plan for a resident with an activities of daily living (ADL) self-care deficit was accurately revised to reflect the necessary interventions for toileting. The resident, who was always incontinent and not on a bladder or bowel toileting program, had a care plan indicating the need for extensive assistance to use a commode or bedpan. However, both the resident's LPN and CNA confirmed that the resident did not use a commode or bedpan and remained in bed. The MDS assessment and care plan were reviewed, and it was confirmed that the care plan had not been updated to accurately reflect the resident's needs and interventions for toileting.
Failure to Provide Adequate Grooming for Resident
Penalty
Summary
The facility failed to provide adequate grooming and personal hygiene care for a resident who required substantial assistance with activities of daily living (ADLs). The resident, who was non-geriatric and diagnosed with Huntington's disease, respiratory failure, neuromuscular dysfunction, and dementia, was observed with unshaven legs on multiple occasions. Despite being able to communicate her needs, the resident had poor memory and was unable to recall when her legs were last shaved. Her care plan, which was revised recently, did not include any interventions for shaving her legs, although it noted her dependency on staff for bathing. The resident's shower schedule indicated she was bathed twice a week, but there was no specific mention of shaving her legs. During discussions with the Care Plan staff and the Social Worker, it was confirmed that the intervention for shaving the resident's legs was not included in her care plan or kardex. The Social Worker acknowledged the resident's legs had more than a week's growth, indicating a lack of attention to her grooming needs. This oversight in the care plan and failure to address the resident's grooming preferences led to the deficiency identified by the surveyors.
Failure to Address Skin Integrity Issues
Penalty
Summary
The facility failed to address an alteration in a resident's skin integrity in a timely manner. A resident with a history of cerebral infarction, chronic kidney disease, and cervicalgia was noted to have a physician's order for Calamine lotion to be applied to a rash on the arms every eight hours as needed for itching. Despite this order, the Treatment Administration Record showed that the Calamine lotion was not applied in January or February 2025. Weekly skin checks conducted in January 2025 indicated scratch marks on the resident's legs, right arm, and right chest, but no additional treatment was administered, nor was the physician notified of these findings. On February 7, 2025, a CNA observed multiple scabbed and open areas on the resident's chest and legs, which had been present for approximately a month due to scratching. The DON and East Unit Manager confirmed the presence of these skin issues, which included scabbed areas and open wounds on the chest, arms, and legs. The DON acknowledged that the skin checks from January 2025 indicated problems that warranted further action, such as notifying the physician and applying the prescribed treatment, which was not done.
Infection Control Breach in Medication Administration
Penalty
Summary
The facility failed to adhere to proper infection control practices during medication administration for a resident diagnosed with type 2 diabetes mellitus with hyperglycemia. The resident had a physician's order for Humalog Kwikpen insulin to be administered subcutaneously before meals and at bedtime according to a sliding scale. During an observation, a Registered Nurse (RN) used a small plastic tray to transport blood glucose monitoring supplies from the medication cart to the resident's room and back without disinfecting the tray after it had been in the resident's room. This action risked contamination of the medication cart. Additionally, the RN did not follow the manufacturer's instructions for the Humalog KwikPen, which required wiping the rubber seal with an alcohol swab before attaching the needle. The RN admitted to forgetting to disinfect the rubber seal of the insulin pen before use. The Director of Nursing confirmed that the RN did not disinfect the tray or the insulin pen's rubber seal, acknowledging that these actions were against best practices for infection control.
What surveyors are citing around you — mapped
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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 212 citations issued within 25 miles in the last 12 months — including the 11 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
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Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Winter Garden
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Health Central Park | 1.6 mi | ★★★★★ | 0 | 0 |
| Vivo Healthcare West Orange | 1.7 mi | ★★★★★ | 2 | 2 |
| Lake Bennet Center For Rehabilitation & Healing | 2.3 mi | ★★★★★ | 0 | 0 |
| Aviata At Colonial Lakes | 2.8 mi | ★★★★★ | 5 | 0 |
| Orlando Health Center For Rehabilitation | 2.9 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.