Above average — CMS composite of the measures below.
The next survey window likely opens around October 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 Middletown Nursing And Rehabilitation Center during CMS and state inspections, most recent first.
A resident with paranoid personality disorder, depression, and anxiety, and with intact cognition, was subjected to undignified and disrespectful communication by an LPN, contrary to the facility’s Resident Rights policy requiring kindness, respect, and dignity. A CNA reported that the LPN told the resident, who was noted to be weaker than before, that she had two hands and could pour her own water, and also referred to the resident as fat during shift report in a tone that could be heard by others. During an investigation into another matter, the ED learned that staff had overheard the LPN call the resident a fat a-s, while the LPN later stated the resident had called her the same term and that she discussed this with another CNA in the hallway.
Dented cans were found in dry storage, including multiple cans of fruit, pudding, and soup with dented top seals, and the DON stated staff still used the contents by opening the cans halfway to avoid the dented areas. Surveyors also observed a dish rag covered in grease placed between the stove hood and sprinkler pipe, and the hood was marked as last serviced in May 2025.
Dignified dining was not provided for three residents during meal service. CNAs stood while feeding or cueing residents, walking back and forth between tables instead of sitting at eye level; one CNA assisted a resident with Alzheimer’s disease and another assisted residents needing meal help while standing. The DON stated staff should be seated at eye level when assisting with meals, and the facility policy said staff should not stand over residents while feeding them.
A facility failed to ensure appropriate GDR attempts and documented clinical justification for continued antipsychotic use for two residents. One resident with dementia-related diagnoses remained on Abilify, risperidone, and vilazodone despite being calm and having no documented behaviors, while pharmacy recommendations to reduce the medications were declined without rationale. Another resident with dementia and agitation had episodes of verbal abuse, physical aggression, and resistance to care, but the physician increased quetiapine and added risperidone without documenting sufficient clinical justification for continued use of multiple antipsychotics.
Lack of Documentation for Updated Pneumococcal Vaccine Offers: The facility failed to ensure two residents were offered current pneumococcal vaccine information. One resident with DM, CKD, dyspnea, and CAD had documentation of PPSV23 and PCV13, but no record of consent or declination for PCV20 or PCV21. Another resident with CHF and CAD had documentation of PCV13 and PPSV23, but likewise no documentation that PCV20 or PCV21 was offered. The DON stated she could not locate the documentation and agreed both residents should have been offered PCV20.
The facility failed to maintain the stove hood in a clean manner, potentially affecting all 12 residents. Cobwebs and debris were observed on the hood during a kitchen tour with the DM. Dietary Aide 5 noted that an external company was responsible for cleaning, and it had been a couple of months since the last cleaning. The DM provided a service report from March as the last cleaning date but was unsure of the required frequency and confirmed no facility policy on stove hood cleaning.
The facility failed to implement enhanced barrier precautions (EBP) for three residents requiring them, including one with an indwelling urinary catheter and another with a gastrostomy tube. A CNA was unaware of EBP, and the DON confirmed the facility did not utilize it. Additionally, a piston syringe for a resident's gastrostomy tube was not dated, and no PPE was visible in the resident's room. The facility lacked a policy for EBP.
Failure to Ensure Dignified and Respectful Communication Toward a Resident
Penalty
Summary
The deficiency involves the facility’s failure to honor a resident’s rights to dignity and respectful communication when staff spoke to and about the resident in a rude and derogatory manner. A CNA reported that an LPN told her about an interaction in which the resident had requested the LPN to pour a cup of water, and the LPN responded that the resident had two hands and could do it herself, despite the CNA noting the resident was no longer as strong as she used to be. The CNA stated she perceived this response as really rude. The same CNA also reported witnessing the LPN refer to the resident as fat during a shift-change report, using a regular or louder-than-usual tone that could have been heard by others if they were nearby. During the facility’s investigation into a separate possible abuse situation, the Executive Director learned from staff that the LPN had been overheard calling the resident a fat a-s, with the exact date uncertain but believed to have occurred over a recent weekend when the LPN worked night shift. In a subsequent telephone interview, the LPN acknowledged that the resident had called her a fat ass on more than one occasion and stated that she and another CNA later discussed the resident’s comment quietly in the hallway. The resident’s record showed diagnoses including paranoid personality disorder, depression, and anxiety, with intact cognition and a care plan noting behavioral concerns such as making false accusations against staff and believing staff ignores or tries to hurt her. The facility’s Resident Rights policy required employees to treat all residents with kindness, respect, and dignity and to assist residents in exercising their rights, but the reported staff conduct toward this resident did not align with those standards.
Dented Cans Kept in Storage and Grease Accumulation on Stove Hood
Penalty
Summary
The facility failed to store, prepare, and distribute food under safe sanitary conditions when surveyors observed several severely dented cans in the dry storage area and a dirty stove hood in the kitchen. During the kitchen observation, five cans of Mandarin oranges were severely dented on the top seal, along with a dented can of butterscotch pudding, a dented can of sliced apples, and a dented can of cream of mushroom soup. The Dietary Manager stated that staff avoided the dented area when opening the cans and still used the food, opening the cans halfway to avoid the dented area before serving the contents. Surveyors also observed a dish rag placed between the stove hood and the fire sprinkler pipe, covered in dark brown and black grease, and the stove hood was marked as last serviced in May 2025. The Dietary Manager stated the stove hood should have been free of debris.
Dignified Dining Assistance Not Provided
Penalty
Summary
The facility failed to provide dignified dining for 3 of 8 residents reviewed for dining, including Residents 3, 4, and 11. During a breakfast observation on 11/20/25 at 8:25 a.m., CNA 7 stood to the right of Resident 3 while assisting her with eating, then walked over to Resident 4 and offered him a bite of food while standing on his left side. CNA 7 continued walking back and forth between Residents 3 and 4 while offering bites of food and did not sit down during the continuous meal service observation. CNA 6 also stood next to Resident 11 while offering him a bite of oatmeal and then walked around the dining room cueing semi-dependent residents to eat their meals. Resident 3’s record showed diagnoses of Alzheimer’s disease, neurocognitive disorder, dementia, and mood disturbance, and a 10/1/25 significant change MDS indicated she was dependent on staff with meals. Resident 11’s record showed diagnoses of history of stroke, age related physical disability, and cognitive decline, and an 11/12/25 quarterly MDS indicated he needed touching assistance with meals. Resident 4’s record showed weakness, lack of coordination, and contracture of the left hand, and a 10/29/25 quarterly MDS indicated he was a partial staff assist with meals. CNA 7 stated she stood while assisting residents because there was not enough room to feed all dependent residents at the same table and staff still needed to walk between residents so everyone could be fed without their food getting cold. CNA 6 stated she sometimes stood during breakfast meal service because there was not enough help assisting residents with meals. The DON stated staff should be sitting down at eye level with residents when assisting with meals, and usually staff sat between two residents to assist with meal service.
Unjustified Continued Use of Antipsychotic Medications Without GDR
Penalty
Summary
The facility failed to ensure that two residents prescribed antipsychotic medications received appropriate gradual dose reduction (GDR) attempts and failed to provide documented clinical justification for continued use of those medications. For one resident with diagnoses including Alzheimer’s disease, neurocognitive disorder with Lewy Bodies, anxiety disorder, major depressive disorder with psychotic symptoms, and dementia, the record showed current orders for Abilify and risperidone, along with vilazodone. The resident was observed repeatedly sitting quietly, lying quietly in bed, and having no documented hallucinations, delusions, or behavioral symptoms during the assessment period. The MDS indicated she did not exhibit physical, verbal, or other behavioral symptoms during the assessment period, and multiple staff interviews described her as calm with no current behaviors. Despite the absence of documented behaviors, the resident remained on two antipsychotics and an antidepressant. The record included pharmacy recommendations to review Abilify and risperidone for GDR and to consider a trial dose reduction, as well as a later recommendation to reduce vilazodone. The physician responses checked that GDR was clinically contraindicated, but the forms contained blank lines and did not provide a rationale for declining the reductions. The physician progress note also lacked a rationale for continuing the antipsychotics and antidepressant at the same doses. The SSD and DON stated the resident had no behavioral symptoms, but the resident’s representative and family physician declined reductions. For the second resident, diagnoses included other specified depressive episodes and dementia with agitation, and current orders included risperidone and quetiapine. The resident was observed sitting quietly, feeding himself, and lying quietly in bed, although one observation noted him repeatedly stating, “I need help,” before calming after speaking with an LPN. The MDS indicated no hallucinations, delusions, or behavioral symptoms during the assessment period. The record documented episodes of sexually inappropriate remarks, verbal aggression, physical aggression, and resistance to care, including threats, hitting, kicking, grabbing staff, and combative behavior during incontinence care and morning care. After these behaviors, the physician increased quetiapine and added risperidone, but the progress note did not include additional rationale for the psychotropic changes. A pharmacy consultant later questioned the use of multiple antipsychotics and recommended considering discontinuation of quetiapine, but the physician documented only that the resident was stable and that changes would be disruptive, without further clinical justification for continued use.
Lack of Documentation for Updated Pneumococcal Vaccine Offers
Penalty
Summary
The facility failed to ensure residents were offered up-to-date information on current pneumococcal vaccinations for 2 of 5 residents reviewed for immunizations. Resident 4’s record showed diagnoses of type 2 diabetes mellitus with hyperglycemia, dyspnea, presence of coronary angioplasty implant and graft, and chronic kidney disease stage 4. The record documented PPSV23 on 11/30/2007 and PCV13 on 9/14/15, but it lacked documentation that the resident was offered consent or declination for PCV20 or PCV21. Resident 6’s record showed diagnoses of chronic diastolic congestive heart failure, presence of coronary angioplasty implant and graft, and atherosclerotic heart disease of native coronary artery without angina pectoris. The record documented PCV13 on 6/24/15 and PPSV23 on 11/27/19, but it also lacked documentation that the resident was offered consent or declination for PCV20 or PCV21. During interview, the DON stated she was unable to locate documentation that PCV20 or PCV21 was offered to either resident, and later stated both residents should have been offered PCV20. The facility policy stated pneumococcal vaccination or revaccination would be made in accordance with current CDC recommendations.
Failure to Maintain Clean Stove Hood
Penalty
Summary
The facility failed to maintain the stove hood in a clean manner, which had the potential to affect all 12 residents. During a kitchen tour with the Dietary Manager (DM), cobwebs and fuzzy debris were observed on the stove hood, directly above the stove. Dietary Aide 5 mentioned that an external company was responsible for cleaning the hood, and it had been a couple of months since the last cleaning. The DM provided a service report from March, indicating the last cleaning date, but was unsure of the required cleaning frequency. Additionally, the DM confirmed there was no facility policy on stove hood cleaning, although they were due for a cleaning in the current month.
Failure to Implement Enhanced Barrier Precautions and Date Enteral Feeding Equipment
Penalty
Summary
The facility failed to implement enhanced barrier precautions (EBP) for three residents who required them. Resident 3, who had an indwelling urinary catheter, did not have EBP included in their care plan. A Certified Nursing Assistant (CNA) was unaware of EBP and only used gloves when providing care to residents with indwelling medical devices. The Director of Nursing (DON) confirmed that the facility did not currently utilize EBP. Resident 2, who required catheter care and pleural drain care, had no EBP signage or personal protective equipment (PPE) in or near their room. Resident 11, who had a gastrostomy tube, had a piston syringe that was not dated, and there was no PPE visible in their room. The DON verified the lack of dating on the syringe and the absence of PPE. The facility did not have a policy for EBP, as confirmed by a Registered Nurse (RN). The enteral nutrition policy indicated that staff should be trained on potential adverse effects of tube feeding, but there was no mention of EBP in the policy.
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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 Middletown
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Waters Of Middletown Skilled Nursing Facility, The | 0.7 mi | ★★★★★ | 10 | 0 |
| Waters Of Chesterfield Skilled Nursing Facility | 5 mi | ★★★★★ | 4 | 0 |
| Envive Of Anderson | 7.6 mi | ★★★★★ | 9 | 0 |
| Countryside Manor Health & Living Community | 7.8 mi | ★★★★★ | 20 | 0 |
| Bethany Pointe Health Campus | 8 mi | ★★★★★ | 4 | 1 |
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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.