Below average — CMS composite of the measures below.
The next survey window likely opens around February 2027
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 Jml Care Center Inc during CMS and state inspections, most recent first.
Failure to Offer and Administer Pneumococcal Vaccines: The facility did not ensure up to date pneumococcal immunizations were offered and/or administered for several residents after consent was obtained. One resident had prior pneumococcal vaccines on file but was not offered an additional dose, while three other residents had consented to vaccination yet had no documented vaccination history. The IP and DON stated the residents were not up to date and that pneumonia vaccines had not been offered during the fall flu clinic.
Failure to Offer Updated COVID-19 Vaccination: The facility did not offer the COVID-19 2025/2026 vaccine to 4 residents reviewed for immunizations. Records showed the residents were not up to date, and one resident had declined the prior season vaccine while having no COVID-19 vaccine history on file. The IP and DON stated the updated vaccine had been available and should have been offered, but the facility did not provide it during the flu clinic or otherwise track and offer it as expected.
Failure to timely notify the HCP after a resident with Alzheimer’s disease and dementia was found ingesting and coughing up large chunks of a Styrofoam plate. The NP evaluated the resident for ingestion of a non-food item, and the chart later showed a change in care to remove all non-food items from meal trays, but the HCP was not documented as notified until several days later.
A resident with Alzheimer's disease and dementia, severe cognitive impairment, and an activated HCP was found ingesting pieces of a Styrofoam plate during lunch. Although staff updated the meal ticket to remove non-food items from the tray, the care plan and CNA care card were not revised to include this safety instruction, and the DON later confirmed the care plan was not accurate.
The facility failed to maintain infection control practices for two residents. A CNA entered a resident’s COVID-19 isolation room without the required N95 and eye protection, even though the PPE was available and the posted sign required both. In another observation, an RN provided PICC line care for a resident with sepsis and a liver abscess, scrubbed the hub for only about 2 seconds, and changed gloves without observed hand hygiene between glove changes, despite the facility’s policy and the nurse’s own statement that longer hub disinfection and hand hygiene were expected.
The facility failed to develop individualized care plans for four residents, leading to deficiencies in addressing their needs. One resident's care plan lacked targeted behaviors and measurable goals for Fluvoxamine use. Another resident's plan omitted Zyprexa and specific behaviors for psychotropic medications. A third resident's wound care was not documented, and a fourth resident's plan lacked details for Seroquel use. Staff acknowledged these oversights.
The facility failed to secure treatment supplies and manage sharps containers across three units. Unlocked utility rooms and supply closets allowed resident access to medicated supplies and hazardous items. Additionally, sharps containers were improperly managed, with protruding contaminated materials posing safety risks. Staff interviews confirmed these areas should have been secured to prevent resident access and ensure safety.
A facility failed to ensure proper monitoring of psychotropic medications for three residents. One resident was on Seroquel without clear target behaviors being documented, making it difficult to assess the medication's effectiveness. Another resident on fluvoxamine was not monitored for side effects during all shifts. A third resident on multiple psychotropic medications was not monitored for side effects of Escitalopram and Strattera, and monitoring for other medications was only done during the day shift. The DON acknowledged the need for consistent monitoring across all shifts.
A resident with Alzheimer's and vascular dementia fell, resulting in a large bruise, but the facility failed to notify the resident's Health Care Proxy as required by policy. Although the physician was informed, documentation did not show that the Health Care Proxy was notified, leading to a deficiency.
A facility failed to report an allegation of physical abuse involving a resident to the State Agency within the required timeframe. The resident, who had multiple medical conditions, reported being pushed and shoved by staff, and a family member observed fingerprint marks on the resident's arm. Despite the facility's policy to report such allegations within two hours, the administrator did not report it, citing a lack of further details from the resident and family member.
A resident admitted with multiple health conditions did not receive a written summary of their baseline care plan, as required by facility policy. Interviews revealed that the resident and their family were not informed about the care plan, and there was no documentation of its receipt. Staff interviews indicated a lack of clarity and documentation regarding the process for reviewing and providing the baseline care plan to residents.
A facility failed to obtain a physician's order for oxygen administration for a resident receiving continuous oxygen therapy. The resident, who had chronic respiratory conditions, was observed using oxygen without a current order. Staff interviews revealed that the resident was on hospice care, and the oxygen was for comfort, but the Director of Nursing acknowledged that an order should have been in place.
The facility failed to screen and offer pneumococcal vaccinations to two residents upon admission, as required by policy and CDC guidelines. Both residents lacked signed consent forms and documentation of vaccine education. The Infection Preventionist confirmed the absence of follow-up processes with medical staff and residents regarding vaccination history and education.
The facility failed to accurately complete MDS assessments for three residents, leading to deficiencies in documenting their care needs. A resident receiving dialysis was not coded for it, another receiving hospice services was not documented as such, and a third with a dementia diagnosis was not coded for dementia. These errors were confirmed by the MDS Nurse and acknowledged by the DON.
The facility failed to ensure that residents were seen by a physician every 60 days, as required. Medical records showed that residents had not been seen by a physician for extended periods, with all visits conducted by NPs. Interviews with staff revealed a lack of awareness regarding the schedule of physician visits, and the DON confirmed the required schedule was not being followed.
Failure to Offer and Administer Pneumococcal Vaccines
Penalty
Summary
The facility failed to ensure that up to date pneumococcal immunizations were offered and/or administered after consent had been obtained for 4 of 5 residents reviewed for immunizations. The facility’s Infection Control Plan stated that pneumococcal vaccines would be assessed for all residents and offered if needed, and that licensed staff would follow CDC and APIC guidelines. Its Pneumococcal Immunization Program also stated that residents in LTC would be assessed for and receive pneumococcal immunization if eligible. Resident #7, admitted in March 2022, was not offered an additional pneumococcal vaccination, and the last vaccines on file were 12/1/15 and 5/10/23. Resident #5, admitted in October 2023, had HCP consent for vaccination on 6/3/25 but no vaccination history on file. Resident #48, admitted in December 2023, signed consent for vaccination on 8/15/25 and had no vaccination history on file. Resident #99, admitted in February 2024, signed consent for vaccination on 8/15/25 and the last pneumococcal vaccination on file was 9/10/20. The IP stated these residents were not up to date and had not been offered and/or administered the pneumococcal vaccination or additional doses if eligible, and the DON stated the facility had not offered pneumonia vaccines during the fall flu clinic and did not know why the vaccination tracking and offering plan was not done.
Failure to Offer Updated COVID-19 Vaccination
Penalty
Summary
The facility failed to offer the COVID-19 2025/2026 vaccination to 4 of 5 residents reviewed for immunizations: Residents #7, #5, #48, and #99. Facility policy stated that residents would be assessed for COVID-19 vaccine need, offered up-to-date vaccines when available, and educated on the benefits and potential side effects of vaccination. The record review showed that Resident #7, admitted in March 2022, had a last COVID-19 vaccination on 10/22/24 and was not offered the 2025/2026 vaccine. Resident #5, admitted in October 2023, had a last COVID-19 vaccination on 11/22/24 and was not offered the 2025/2026 vaccine. Resident #48, admitted in December 2023, had a last COVID-19 vaccination on 11/22/24 and was not offered the 2025/2026 vaccine. Resident #99, admitted in February 2024, was not offered the COVID-19 2025/2026 vaccine, had declined the 2024/2025 vaccine, and had no COVID-19 vaccination history in the file. The Infection Control Preventionist stated that Residents #7, #5, #48, and #99 were not up to date and had not been offered the 2025/2026 vaccine, and that they should have been offered it because it had been available since 2025. The DON stated the facility had completed a flu clinic in the fall but did not offer COVID-19 vaccines at that time, and said the vaccines should be offered on admission, reviewed quarterly at care plan meetings, or at least annually, with new vaccines offered as they become available if eligible.
Failure to Timely Notify HCP After Resident Ingested Styrofoam
Penalty
Summary
The facility failed to notify the resident’s Health Care Proxy in a timely manner after Resident #8 was found ingesting pieces of a Styrofoam plate, an event that led to changes in the plan of care to reduce the risk of recurrence. Resident #8 was admitted with diagnoses including Alzheimer’s disease and dementia, and the MDS assessment indicated severe cognitive impairment with an activated Health Care Proxy. On 3/17/26, the NP evaluated the resident for ingestion of a non-food item and documented that the resident may have ingested part of a Styrofoam plate. Later that same day, a nurse documented that the resident was found coughing up large chunks of a Styrofoam plate at lunchtime. The record did not show that the Health Care Proxy, Family Member #1, was notified of the incident or the related change in care at the time it occurred. An interdisciplinary therapy screen request form documented that all non-food items were to be removed from the food tray for safety, and the dietary ticket included instructions to not send condiments, packets, creamers, butters, or napkins on the tray. During interview, Family Member #1 stated she was never notified that the resident had coughed up large chunks of Styrofoam or that the NP had evaluated the resident. The nurse stated the physician or NP and the HCP should be made aware of such incidents, but she did not notify the HCP because she thought the unit manager had done so. The unit manager later stated she notified the HCP six days after the incident, and the DON confirmed there was no documentation showing the HCP had been notified until that time.
Care Plan Not Updated After Meal Tray Safety Change
Penalty
Summary
The facility failed to ensure that the individualized, comprehensive care plan for one resident was reviewed and revised after a change in condition related to meal tray safety. Resident #8, who was admitted in November 2024 and had diagnoses including Alzheimer's disease and dementia, had a February 2026 MDS showing a BIMS score of 4 out of 15, indicating severe cognitive impairment, and had an activated Health Care Proxy. An Interdisciplinary Therapy Screen Request Form indicated that all non-food items were to be removed from the food tray for safety, and the dietary ticket also instructed staff not to send condiments, packets, creamers, butters, or napkins on the tray. Review of the resident's comprehensive care plan showed interventions for nutritional status, including a ground diet, monitoring intake, and safe swallowing guidelines, but it was not revised to reflect removal of all non-food items from meal trays. The CNA care card also did not include this instruction. During interviews, the FSD stated she received an email on 3/17/26 to remove all non-food items from Resident #8's meal trays and updated the meal ticket, and the UM said Resident #8 was observed coughing up pieces of a Styrofoam plate during lunch on 3/17/26 and that she should have updated the care plan and CNA care card. The DON later reviewed the care plan and stated it was not accurate and should have included removal of all non-food items from meal trays.
Infection Control Failures During Isolation Care and PICC Line Access
Penalty
Summary
The facility failed to establish and maintain an infection prevention and control program for two residents. For a resident admitted with cough, COVID-19, and fever and placed on isolation precautions for positive COVID-19, a CNA entered the room without donning an N95 respirator or eye protection. The isolation sign posted outside the room required staff to use an N95 respirator and eye protection, and the PPE bin outside the room contained N95 respirators, face shields, and goggles. The CNA later acknowledged she should have worn both items but did not because they interfered with writing and seeing clearly. The DON stated staff were expected to follow the posted precaution signs and that the CNA should have worn both the N95 and eye protection. For another resident with diagnoses including sepsis and a liver abscess, and with a PICC line and enhanced barrier precautions ordered, a nurse was observed administering IV therapy and flushing the PICC line. The nurse used an alcohol wipe on each hub for only about 2 seconds before flushing, despite stating she was supposed to scrub the hub for about 5 to 10 seconds. She then removed her gloves, prepared the IV antibiotic, donned new gloves without being observed performing hand hygiene in between glove changes, and connected the IV tubing to the PICC line. The facility’s policies and referenced standard described glove use, hand hygiene after removing gloves, and disinfection of needleless connectors with alcohol. During interview, the nurse said she did not perform hand hygiene between glove changes because it would have made it too hard to put on new gloves after sanitizing her hands. The DON stated the nurse should have scrubbed the hub before connecting anything to the PICC line and should have performed hand hygiene between glove changes, and said those expectations were not met during the observation.
Deficiencies in Individualized Care Plans for Residents
Penalty
Summary
The facility failed to develop and implement individualized, person-centered care plans for four residents, leading to deficiencies in addressing their physical, psychosocial, and functional needs. For one resident with obsessive-compulsive disorder and depression, the care plan did not specify targeted behaviors for the use of Fluvoxamine, an antidepressant, nor did it include measurable goals to evaluate the medication's effectiveness and non-pharmacological interventions. This oversight was confirmed by the Unit Manager and the Director of Nursing (DON), who acknowledged the absence of specific, targeted behaviors and measurable goals in the care plan. Another resident with Alzheimer's disease, vascular dementia, and anxiety disorder was receiving multiple psychotropic medications, including Zyprexa, which was not included in the care plan. The care plan also lacked identification of resident-specific targeted behaviors for the use of antianxiety and antidepressant medications, as well as measurable goals to assess the effectiveness of these medications and non-pharmacological interventions. The Unit Manager and the DON both recognized the need for the inclusion of Zyprexa and the identification of targeted behaviors in the care plan. A third resident with peripheral vascular disease had an unhealed wound on the right medial calf, but the care plan did not include documentation related to this active wound or the resident's treatment by the Wound Clinic. The Unit Manager and the DON noted that the care plan should have been updated to reflect the resident's specific needs and treatment. Lastly, a resident with anxiety and Parkinson's disease was receiving Seroquel, an antipsychotic medication, but the care plan did not include a comprehensive plan for its use, including targeted signs/symptoms, resident-specific interventions, and measurable goals. The Unit Manager and the DON acknowledged the lack of an individualized care plan for the antipsychotic medication.
Facility Fails to Secure Treatment Supplies and Manage Sharps Containers
Penalty
Summary
The facility failed to maintain a safe environment free from accident hazards across three units, as observed by surveyors. On the Naushon Unit, the Clean Utility Room was found unlocked, allowing access to medicated treatment supplies and an unlocked treatment cart. These supplies included various creams, ointments, and disinfectants, which should have been secured to prevent resident access. Interviews with staff revealed that the room lacked a lock due to the presence of an eye wash station, but treatment supplies should have been stored in a locked cabinet. On the Nobska Unit, similar issues were observed with the Clean Utility Room being unlocked and accessible, containing medicated treatment supplies and an unlocked treatment cart. Additionally, the Daily Supply Closet was found with the key left in the lock, making it accessible to residents. This closet contained items such as razors and alcohol-based products, posing a safety risk. Staff interviews confirmed that these areas should have been secured to prevent resident access. For Resident #33 on the Nobska Unit, a sharps container was observed with a blood-filled tubing protruding, posing a risk of needlestick injuries and exposure to bloodborne pathogens. Similarly, in Resident #73's room on the Penzance Unit, a sharps container was overfilled with contaminated materials protruding, increasing the risk of exposure. Interviews with staff indicated a lack of routine checks and replacement of sharps containers, contributing to these safety hazards.
Failure to Monitor Psychotropic Medication Use and Side Effects
Penalty
Summary
The facility failed to ensure that three residents' drug regimens were free from unnecessary psychotropic medications. For one resident, the facility did not adequately identify and monitor target behaviors related to the use of Seroquel, an antipsychotic medication. The resident, who had diagnoses including anxiety and Parkinson's disease, was receiving Seroquel without a clear indication for its use. Interviews with staff revealed inconsistencies in understanding and documenting the resident's behaviors, such as hallucinations and calling out, which were not accurately reflected in the behavior monitoring sheets. This lack of specific documentation made it difficult to assess the effectiveness of the medication. Another resident, diagnosed with obsessive-compulsive disorder and depression, was receiving fluvoxamine, an antidepressant, with an increased dose. However, the facility failed to monitor the resident for potential side effects of the medication during all shifts. Monitoring was only conducted during the evening shift, neglecting the day and night shifts. This oversight in monitoring could potentially overlook adverse effects that may occur outside the evening shift. A third resident, with diagnoses including Alzheimer's disease, vascular dementia, and anxiety disorder, was on multiple psychotropic medications, including Ativan, Depakote, Remeron, Zyprexa, and Strattera. The facility failed to monitor for side effects of Escitalopram and Strattera and only monitored for side effects of other medications during the day shift. The Director of Nursing acknowledged that monitoring should occur during all shifts and for all medications, indicating a lapse in the facility's adherence to its own policies regarding medication monitoring.
Failure to Notify Health Care Proxy of Resident Fall
Penalty
Summary
The facility failed to notify the Health Care Proxy of a resident who experienced a fall, resulting in a deficiency. The resident, who was admitted in October 2023, had diagnoses including Alzheimer's disease, vascular dementia, and anxiety disorder. The Minimum Data Set (MDS) assessment indicated the resident had moderate cognitive impairment and an activated Health Care Proxy. On January 19, 2025, the resident fell and sustained a large bruise on the midback. Although the resident's physician was notified, there was no documentation indicating that the Health Care Proxy was informed of the incident. The facility's policies require that both the physician and the responsible party be notified at the time of such occurrences, with documentation in the incident report and nurse's notes. However, a review of the medical record and fall incident report revealed a lack of evidence that the Health Care Proxy was notified. Interviews with the Unit Manager and the Director of Nursing confirmed that the notification should have been made and documented, but it was not, leading to the deficiency.
Failure to Report Alleged Abuse in a Timely Manner
Penalty
Summary
The facility failed to report an allegation of physical abuse involving a resident to the State Agency within the mandated timeframes. The facility's policy requires that all alleged violations involving abuse, neglect, exploitation, or mistreatment be reported immediately, but no later than two hours after the allegation is made. In this case, a resident reported to a surveyor that staff were pushing and shoving them late at night, and a family member observed fingerprint marks on the resident's arm, suggesting possible abuse. However, the facility did not report this allegation to the State Agency as required. The resident involved had a history of multiple medical conditions, including an open wound, atrial fibrillation, sleep apnea, major depressive disorder, venous insufficiency, falls, and hearing loss. Despite the resident being cognitively intact, as indicated by a BIMS score of 13 out of 15, the facility's administrator did not report the allegation because the resident and family member did not provide further details. The administrator acknowledged that the report should have been made within two hours but was not, and an investigation was in progress at the time of the surveyor's interview.
Failure to Provide Baseline Care Plan Summary to Resident
Penalty
Summary
The facility failed to provide a resident with a written summary of the baseline care plan upon admission, as required by their policy. The baseline care plan should include initial goals, physician orders, dietary orders, therapy services, social services, and PASARR recommendations if applicable. The resident, who was admitted with diagnoses including morbid obesity, type 2 diabetes mellitus, uncontrolled hypertension, coronary artery disease, and a history of falls, did not receive this summary, nor was there documentation of its receipt in the resident's clinical record. Interviews with the resident and their daughter revealed that no care plan meeting occurred within the first several days of admission, and they did not receive a copy of the care plan. The resident expressed that they had not been informed about their care plan and had not seen the social worker until much later. The social worker confirmed that while she met with the resident for an assessment, she did not review a summary of the baseline care plan with them, and there was no documentation to indicate that the resident or their representative received this information. Further interviews with facility staff, including a nurse and the Director of Nurses (DON), indicated a lack of clarity and documentation regarding the process for reviewing and providing the baseline care plan to residents. The DON acknowledged the absence of a signed or dated baseline care plan in the resident's record, which would have confirmed that the plan was reviewed with the resident. This deficiency highlights a failure in the facility's process to ensure that residents are informed of their care plans upon admission.
Failure to Obtain Physician's Order for Oxygen Administration
Penalty
Summary
The facility failed to provide respiratory care consistent with professional standards of practice for a resident who was receiving continuous oxygen therapy. The resident, who had multiple diagnoses including chronic respiratory failure and chronic obstructive pulmonary disease, was observed using a nasal cannula connected to an oxygen concentrator delivering 2 liters per minute of oxygen. However, a review of the resident's current physician's orders revealed that there was no order for the administration of oxygen, which is considered a medication and should be prescribed. Interviews with nursing staff and the Director of Nurses (DON) revealed that the resident was admitted to hospice care for symptom management, and the oxygen was being used for comfort. Despite this, the DON acknowledged that there should have been an order for oxygen, as it is a medication. The order for oxygen was initially entered and signed off by the physician but was discontinued the same day without a clear reason. The DON explained that the Unit Manager discontinued the order because it was a titrated order requiring monitoring and forgot to enter a new order for oxygen for comfort measures.
Failure to Screen and Offer Pneumococcal Vaccination
Penalty
Summary
The facility failed to ensure that two residents were properly screened and offered the pneumococcal vaccination upon admission, as required by their own policy and CDC guidelines. Resident #33, admitted in February 2024, did not have a signed Immunization Consent form indicating consent or declination of the pneumococcal vaccine. Additionally, the Medication Reconciliation form for this resident did not indicate a history of pneumococcal vaccination and was not signed by a physician or nurse practitioner. There was also no documentation of education provided to the resident about the vaccine. The Massachusetts Immunization Information System (MIIS) form indicated that Resident #33 had received a pneumococcal vaccine in June 2016. Similarly, Resident #67, admitted in June 2024, also lacked a signed Immunization Consent form and the Medication Reconciliation form did not reflect any history of pneumococcal vaccination. There was no evidence that education about the vaccine was provided to this resident either. The MIIS form showed that Resident #67 had received a pneumococcal vaccine in February 2016. During an interview, the Infection Preventionist acknowledged the lack of follow-up with the physician or nurse practitioner regarding vaccination history and recommendations, and the absence of a process to follow up with residents or their representatives about vaccination history and education after admission.
Inaccurate MDS Assessments for Residents
Penalty
Summary
The facility failed to accurately complete the Minimum Data Set (MDS) assessments for three residents, leading to deficiencies in the documentation of their care needs. Resident #70, who was admitted with end-stage renal disease and vascular dementia, was receiving dialysis as per physician's orders. However, the MDS assessment did not reflect this, indicating a failure to accurately code for dialysis. During an interview, MDS Nurse #1 acknowledged the error and stated that the assessment needed modification. Similarly, Resident #6, admitted with dementia and anxiety, was receiving hospice services as indicated by physician's orders. Yet, the MDS assessment failed to document this, which was confirmed by MDS Nurse #1 during an interview. Additionally, Resident #33, who had a documented diagnosis of dementia in multiple physician's progress notes, was not coded for dementia in the MDS assessment. MDS Nurse #1 confirmed the oversight after reviewing the resident's notes. The Director of Nursing stated that the expectation was for all MDS assessments to be completed accurately.
Failure to Ensure Timely Physician Visits for Residents
Penalty
Summary
The facility failed to ensure that five residents were seen by a physician every 60 days, as required by regulations. The facility's policy stated that after the first 90 days, residents should be seen by a physician every 60 days, with visits alternating between a physician and a nurse practitioner (NP). However, the review of medical records indicated that these residents had not been seen by a physician for extended periods, ranging from 238 to 287 days, with all subsequent visits being conducted by NPs. Interviews with facility staff, including nurses and unit managers, revealed a lack of awareness regarding the schedule and frequency of physician visits. Nurse #1 and Unit Manager #2 both indicated that residents were typically seen by NPs, and they were unsure of when physicians visited the facility. The Director of Nursing (DON) confirmed that residents should be seen by a physician every 30 days for the first 90 days and then every 60 days thereafter, alternating with NPs, but was unaware that this schedule was not being followed. The deficiency was identified through a review of physician progress notes and interviews with facility staff. The facility's failure to adhere to the required schedule of physician visits resulted in residents not being seen by a physician for significant periods, contrary to the facility's policy and regulatory requirements.
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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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Nursing homes near Falmouth
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Royal Nursing Center, Llc | 1.1 mi | ★★★★★ | 16 | 0 |
| Royal Megansett Nursing & Rehabilitation | 5.8 mi | ★★★★★ | 0 | 0 |
| Royal Of Cotuit | 9.2 mi | ★★★★★ | 11 | 0 |
| Bourne Manor Extended Care Facility | 11.8 mi | ★★★★★ | 15 | 0 |
| Sippican Rehabilitation And Healthcare Center | 12.7 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 August 2026) and official state health department websites.