Above average — CMS composite of the measures below.
A standard survey is most likely before around August 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 Hawthorne House during CMS and state inspections, most recent first.
Surveyors found a soiled utility closet with a malfunctioning keypad lock left unsecured on a unit where residents with cognitive impairment reside. Inside the closet, staff stored multiple hazardous chemical products, including disinfectants and moisture absorbers, whose SDS instructions call for immediate and specific first aid in cases of skin or eye contact or ingestion. CNAs on the unit acknowledged the door should have been locked due to the hazardous nature of the chemicals and the cognitive status of residents, but they were unsure how long the lock had been inoperable.
Surveyors found that the facility did not provide or document required information about advanced directives for the majority of sampled residents. Both electronic and paper records lacked evidence that residents or their representatives were offered or reviewed information on their right to formulate an advanced directive, as confirmed by facility leadership.
Surveyors identified widespread deficiencies in housekeeping and maintenance, including dirty and stained bathroom floors, disrepair of privacy curtains, untreated wooden laundry carts, chipped paint, broken heater parts, and uncleanable surfaces in several resident rooms and common areas. These issues were confirmed by staff interviews and affected the overall cleanliness and comfort of the facility.
Surveyors found unsecured cleaning chemicals, medical and wound care supplies, and a sharp object accessible to residents in multiple units. Environmental hazards included a loose toilet and a headphone cord taped across a walkway with lifting tape, creating a tripping risk. These deficiencies were confirmed through staff interviews and direct observation, indicating a failure to ensure a safe environment and adequate supervision to prevent accidents.
The facility did not have a functioning Antibiotic Stewardship Program, as infection tracking logs were incomplete and lacked essential information such as organism identification, culture results, and antibiotic appropriateness. Key data fields were left blank, and there was no evidence of monitoring infection trends or antibiotic use. Leadership confirmed that infection tracking was not fully implemented, and a recent staff change in the Infection Preventionist role contributed to the deficiency.
A resident with a possible serious mental disorder did not receive a required PASRR Level II face-to-face evaluation after the initial screening indicated it was necessary. Review of records and staff interview confirmed that the assessment was not completed as instructed to determine the need for specialized services.
A resident with suicidal ideation had physician orders for 15-minute checks, but staff failed to consistently document these checks, resulting in numerous missed entries over several days. This deficiency was confirmed by the DON.
The facility did not complete required annual performance evaluations for three CNAs, as there was no evidence of evaluations for the current year for staff hired in various years. This was confirmed through review and interviews with facility leadership.
A medication cart was found to contain an expired punch card of Codeine Sulfate 30mg, which remained available for use. The expired medication was discovered during a medication pass and confirmed by the DON.
Surveyors found unsanitary kitchen conditions, improper food labeling and dating, expired food items in use, and significant gaps in required temperature monitoring and documentation for dish machines and refrigerators/freezers. Staff and administrator interviews confirmed these deficiencies, which were observed across multiple areas and units.
A CNA was observed carrying unbagged soiled linen with bare hands from a resident's room to the soiled linen room, in violation of facility policy requiring contaminated laundry to be bagged and handled with standard precautions. The CNA confirmed the improper handling during the survey.
A resident who had indicated a desire to receive the pneumococcal vaccine did not have documentation in their clinical or immunization records showing that the vaccine was reviewed or administered, as confirmed by the Administrator during a surveyor interview.
A resident who had indicated a desire to receive the COVID-19 vaccine did not have documentation in their immunization records showing that the vaccine was reviewed or administered. This was confirmed by the Administrator during a surveyor interview.
A CNA did not complete the required annual dementia training, as confirmed by a review of employee education records and verification with the Facility Administrator.
A resident with schizophrenia, bipolar disorder, and PTSD did not receive effective treatment and services. The facility failed to complete a comprehensive trauma assessment and did not document trauma triggers. Despite the resident expressing suicidal ideations and experiencing hallucinations, safety measures were inconsistently documented, and the care plan lacked specific interventions for PTSD. Multiple self-harm attempts occurred, yet the care plan was not updated, and the resident's safety plan was missing, leading to repeated hospitalizations.
The facility failed to provide adequate housekeeping and maintenance services in three units. Issues included cracked floor tiles, black substances around toilets, torn adhesive coverings, stained floor tiles, peeling laminate, dirty equipment, and damaged wheelchairs. These deficiencies were confirmed during an environmental tour with the Director of Maintenance and the Maintenance Assistant.
The facility failed to maintain a sanitary environment for respiratory care equipment, including unlabeled and improperly stored oxygen nasal cannulas and nebulizer equipment for six residents. Additionally, one resident's oxygen concentrator was set incorrectly, contrary to the physician's order.
The facility failed to monitor vaccine storage temperatures consistently and did not remove expired medications. The immunization refrigerator on the Kennebec unit had inconsistent temperature logs, and an expired bottle of Milk of Magnesium was found on a medication cart in the [NAME] Short Hall. These issues were confirmed by staff and discussed with the Acting Director of Nursing.
The facility failed to maintain sanitary conditions in food storage and preparation areas. Undated and unlabeled hard-boiled eggs were found in the walk-in refrigerator, and dust and debris were observed on ceiling vents and a rarely used stand mixer.
The facility failed to issue written transfer/discharge notices to two residents or their legal representatives for facility-initiated transfers/discharges to an acute care facility. This deficiency was confirmed by a surveyor during an interview with the Licensed Clinical Social Worker.
The facility failed to issue written transfer/discharge notices to two residents or their legal representatives for facility-initiated transfers/discharges to an acute care facility. The clinical records for both residents lacked evidence of such notices, which was confirmed by the surveyor during an interview with the Licensed Clinical Social Worker.
The facility failed to review and revise the care plan by an IDT that included, to the extent possible, participation of a resident and/or their representative after each assessment. The resident stated they had only participated in one care plan meeting in the past year, and records showed no evidence of their invitation or participation in other meetings. This was confirmed by the Licensed Social Worker.
Unsecured Soiled Utility Closet Containing Hazardous Chemicals
Penalty
Summary
Surveyors identified a deficiency related to accident hazards and inadequate supervision when, during an environmental tour, a soiled utility closet on the Somerset unit was found unlocked despite being equipped with a keypad locking mechanism. Inside the unlocked closet, surveyors observed multiple chemical products stored on a shelf, including Tropiclean, Virex TB Ready-To-Use Disinfectant Cleaner, Hang [NAME] Plus Clinging Disinfectant Bowl Cleaner, and Damp Rid Moisture Absorbers. Staff present at the time, including two CNAs, reported that the keypad lock had not been functioning properly and were unable to state how long it had been inoperable. They acknowledged that the door should have been secured because of the hazardous chemicals stored inside and the presence of residents with cognitive impairment on the unit. The Safety Data Sheets (SDS) for each of the chemicals in the unlocked closet described the need for immediate and specific first aid measures in the event of skin contact, eye contact, or ingestion, including flushing skin or eyes with water for extended periods, removing contaminated clothing, not inducing vomiting unless directed, and seeking medical or poison control advice. These documented properties of the chemicals, combined with the unsecured storage area and the known presence of cognitively impaired residents on the unit, formed the basis of the cited deficiency for failing to ensure hazardous chemicals were properly secured and the environment was free from accident hazards.
Failure to Document and Provide Advanced Directive Information
Penalty
Summary
The facility failed to ensure that documentation regarding residents' advanced directives was accurate and present in the clinical records for 20 out of 24 sampled residents. Record reviews revealed that both electronic and paper medical records for these residents lacked evidence that the facility had offered, reviewed, or provided written information about the right to formulate an advanced directive to the residents or their representatives. This deficiency was identified through a comprehensive review of multiple residents' records, which consistently showed missing documentation related to advanced directives. The absence of such documentation was noted across a significant number of residents, indicating a widespread issue rather than isolated incidents. The findings were confirmed during interviews with facility leadership, including the Director of Nursing and the Administrator, who acknowledged the lack of proper documentation. No information was provided in the report regarding the specific medical histories or conditions of the affected residents at the time of the deficiency. The focus of the findings was solely on the facility's failure to provide and document the required information about advanced directives as mandated by policy and regulation.
Failure to Maintain Sanitary and Comfortable Environment Across Multiple Units
Penalty
Summary
Surveyors observed multiple deficiencies in the facility's housekeeping and maintenance services across three of four units and the laundry room during two separate facility tours. Specific findings included dirty and stained floors around the base of toilets in several resident rooms, a pink wash bucket left on the bathroom floor, and privacy curtains in disrepair. Additional issues were noted such as untreated wooden bases on laundry carts, peeling laminate and missing finish on bathroom doors, chipped and missing paint on baseboard heaters, broken heater parts on the floor, rusty sinks, stained transition strips, and dusty wall fans. The walls behind residents' beds were also marred with black marks and chipped paint exposing sheetrock. These conditions were confirmed by interviews with facility staff, including a Registered Nurse, the Administrator, and the Director of Nursing. The observations indicated that the facility failed to maintain a sanitary, orderly, and comfortable environment as required, impacting the safety and comfort of residents in multiple areas of the building.
Unsecured Chemicals, Medical Supplies, and Environmental Hazards Create Accident Risks
Penalty
Summary
Surveyors identified multiple deficiencies related to accident hazards and inadequate supervision across several units in the facility. Unsecured cleaning chemicals, including a container of Sani-Cloth Plus Germicidal Disposable Cloth and a spray bottle of Virex TB Ready-To-Use Disinfectant Cleaner, were found accessible to residents in their rooms and common areas. Additionally, wound care and medication supplies, as well as a sharp object (scissors), were left unattended and accessible to residents on the Geriatric Psychiatric Kennebec Unit. A toilet in one resident's room was observed to be loose and not secured to the floor, and a resident was found with a headphone cord taped across the walkway, with the tape lifting and creating a tripping hazard. Oxygen tanks were also not stored securely on one of the days observed. These deficiencies were confirmed through direct observation and interviews with facility staff, including the Unit Manager, Housekeeping Team Lead, Quality Improvement Manager, Registered Nurse, and Administrator. The presence of unsecured chemicals, medical supplies, sharp objects, and environmental hazards such as a loose toilet and tripping hazards demonstrated a failure to maintain a safe environment free from accident hazards and to provide adequate supervision to prevent accidents.
Failure to Implement and Monitor Antibiotic Stewardship Program
Penalty
Summary
The facility failed to implement an effective Antibiotic Stewardship Program (ASP) as required. Record reviews showed that the Infection Preventionist's monthly antibiotic log for the period from 1/1/25 through 3/11/25 listed 13 resident infections, but the documentation was incomplete. Several columns intended to capture critical information such as bacteria type, infection site, and other relevant data were left blank. The log also lacked evidence of follow-through on antibiotic use, analysis of infection trends, identification of organisms, detection of infection clusters, and tracking of antibiotic types used. During an interview, the Administrator and DON acknowledged that infection tracking was incomplete, missing information on whether cultures were performed, culture results, organism identification, and appropriateness of antibiotic selection. The facility had a recent change in Infection Preventionist staff, with the previous person leaving abruptly and a new employee starting on the day of the interview, further contributing to the lack of an implemented ASP.
Failure to Complete Required PASRR Level II Evaluation
Penalty
Summary
The facility failed to coordinate and complete the required Pre-Admission Screening and Resident Review (PASRR) Level II evaluation for a resident with a possible serious mental disorder. Record review showed that a PASRR Level I screening, conducted by Maximus, indicated the need for a face-to-face Level II evaluation to determine the necessity for specialized services. However, there was no evidence in the clinical record that the Level II evaluation was completed as instructed. This was confirmed during an interview with the Administrator, who acknowledged the absence of documentation showing that the required assessment had been performed.
Failure to Complete Physician-Ordered 15-Minute Checks for Resident with Suicidal Ideation
Penalty
Summary
The facility failed to follow physician orders for 15-minute checks for a resident who had been placed on this monitoring protocol due to suicidal ideation. The clinical record indicated that the 15-minute checks were to be documented on a paper sheet from 3/27/25 to 4/16/25. However, review of the documentation revealed multiple missing checks on several dates within this period, with the number of missed checks ranging from 7 to 75 on specific days. This information was confirmed with the Director of Nursing.
Failure to Complete Annual Performance Evaluations for CNAs
Penalty
Summary
The facility failed to complete annual performance evaluations for three out of five sampled certified nursing assistants (CNAs), as required. Specifically, there was no evidence of completed annual performance evaluations for the year 2024 for CNAs who were hired in July 2001, July 2023, and March 1990. This deficiency was identified through performance evaluation reviews and staff interviews, and the absence of documentation was confirmed with the Facility Administrator.
Expired Medication Found in Medication Cart
Penalty
Summary
Surveyors observed that a medication cart on the [NAME] Unit contained a medication punch card of Codeine Sulfate 30mg that had expired in January 2025. This expired medication was still available for use in the cart at the time of observation. The issue was identified during a morning medication pass and brought to the attention of the Certified Nursing Assistant responsible for administering medications from the cart, as well as the Registered Nurse present. The Director of Nursing confirmed the presence of the expired medication in the cart later that morning. The deficiency was related to the facility's failure to ensure that expired medications were removed from the supply available for use, as required by regulations for the storage and labeling of drugs and biologicals.
Deficiencies in Kitchen Sanitation, Food Storage, and Temperature Monitoring
Penalty
Summary
Surveyors identified multiple deficiencies in the facility's food service operations, including unsanitary conditions and improper food handling practices. During an initial kitchen tour, observations included a broken ceiling light lens, rusty and dirty dish machine table legs, missing floor tiles exposing untreated cement, and food debris and dirt on the kitchen and dry storage floors. Additionally, a chemical hose was found hanging into a sink, a bus bucket was collecting drain water under a vegetable sink, and a standing floor mixer had dried residue. Dishes and cups were found wet stacked and stained, and several food items in dry storage, the walk-in refrigerator, and the walk-in freezer were not properly labeled or dated. Further deficiencies were noted with expired food items, as a container of thickened orange juice was found on a unit service cart ten days past its best use by date. Staff interviews confirmed the presence and use of these expired and improperly stored items. The facility's policies require proper dating, labeling, and storage of food, as well as regular monitoring and documentation of dish machine and refrigerator/freezer temperatures to ensure food safety, but these procedures were not consistently followed. A review of temperature monitoring logs revealed significant gaps in documentation for both dish machine and refrigerator/freezer temperatures across multiple units and months. No documentation was provided for certain months, and numerous dates were missing for others. The administrator confirmed the lack of monitoring and documentation, as well as the other observed deficiencies in food storage, cleanliness, and equipment maintenance.
Improper Handling of Soiled Linen by CNA
Penalty
Summary
The facility failed to maintain proper infection prevention and control practices regarding the handling of soiled linen. On one unit, a Certified Nursing Assistant (CNA) was observed exiting a resident's room while carrying unbagged soiled linen with bare hands, contrary to the facility's policy which requires all used laundry to be handled as potentially contaminated and bagged or contained at the point of collection. The CNA confirmed handling the soiled linen without gloves or a bag and transporting it to the soiled linen room, where it was placed in a hamper. This incident was observed and discussed with a Registered Nurse/Unit Manager during the survey.
Failure to Administer Pneumococcal Vaccine as Requested
Penalty
Summary
A deficiency was identified when a resident's clinical and immunization records were reviewed and found to lack evidence that a pneumococcal vaccine had been reviewed or administered. The resident had previously indicated on a vaccine consent form a desire to receive the pneumonia vaccine. During an interview, the Administrator confirmed that there was no documentation of the vaccine being reviewed or given to the resident.
Failure to Review and Administer COVID-19 Vaccine
Penalty
Summary
The facility failed to review and/or offer the COVID-19 vaccine to one of five residents reviewed for immunizations. Specifically, the clinical record for this resident included a form indicating that the resident understood the information provided and wished to receive the COVID-19 vaccine. However, the resident's immunization records did not contain evidence that the COVID-19 vaccine was reviewed or administered. This deficiency was confirmed during an interview with the Administrator, who acknowledged that the COVID-19 vaccine had not been reviewed or given to the resident.
Failure to Ensure Mandatory Dementia Training for CNA
Penalty
Summary
The facility failed to ensure that a Certified Nursing Assistant (CNA) attended the mandatory yearly dementia training. Review of the CNA's employee in-service and attendance record showed no evidence that the required dementia training was completed for the year 2024. This deficiency was identified during a review of employee files and was confirmed by the Facility Administrator.
Deficiency in Mental Health Care and Safety Measures
Penalty
Summary
The facility failed to provide effective treatment and services for a resident diagnosed with schizophrenia, bipolar disorder, and PTSD. The resident's medical record was incomplete, lacking a comprehensive trauma assessment and documentation of trauma triggers. Despite the resident expressing suicidal ideations and experiencing hallucinations, there was no consistent documentation of safety measures or notifications to the provider. The care plan did not include specific focus, goals, or interventions for PTSD, and safety checks were inadequately documented or not performed. The resident experienced multiple incidents of self-harm attempts, including being found with a pillowcase and sheet around their neck. Despite these serious events, the care plan was not updated with additional safety measures, and the facility failed to locate the resident's safety plan. The lack of documentation and appropriate interventions contributed to the resident's repeated hospitalizations due to safety concerns. Interviews with nursing staff revealed awareness of the resident's triggers, yet this information was not documented in the medical record, further indicating a deficiency in the facility's care and treatment of the resident's mental health needs.
Inadequate Housekeeping and Maintenance Services
Penalty
Summary
The facility failed to provide adequate housekeeping and maintenance services necessary to maintain a sanitary, orderly, and comfortable environment in three of its units: Long Hall, Kennebec, and Somerset. On the Long Hall unit, room [ROOM NUMBER] had seven cracked floor tiles and a black substance around the base of the toilet. The common area had a torn and lifting nonslip adhesive covering on the wheelchair scale. On the Somerset unit, the shared bathroom for rooms [ROOM NUMBERS] had a stained floor tile, peeling laminate on the sink vanity, and an area of patched drywall requiring paint. The base and frame of the sit-to-stand lift were dirty, and a wheelchair had a ripped armrest and torn seat cushion. On the Kennebec unit, the shared bathroom for rooms [ROOM NUMBERS] had a black substance at the base of the toilet. These findings were confirmed during an environmental tour with the Director of Maintenance and the Maintenance Assistant.
Failure to Maintain Sanitary Respiratory Care Equipment
Penalty
Summary
The facility failed to provide a sanitary environment to prevent the development and transmission of disease and infection related to oxygen and nebulizer mask/tubing for six residents. Observations revealed that oxygen nasal cannulas and nebulizer equipment were not labeled, dated, or stored properly. Specifically, Resident #2's nasal cannula was found lying across the bed without evidence of weekly changes, Resident #3's nasal cannula was dated 4/14/24 and stored improperly, and Resident #16's nebulizer equipment was not stored in a bag. Additionally, Resident #37's oxygen tank had an unlabeled nasal cannula, and Resident #69's nasal cannula was also unlabeled and improperly stored. Resident #172 was observed wearing an unlabeled nasal cannula with the concentrator set at 1 LPM, contrary to the physician's order of 2 LPM for dyspnea and oxygen saturation below 90%. The Acting DON confirmed these observations and adjusted Resident #172's oxygen to the correct setting as per the physician's order. The facility's Respiratory Therapy policy and procedure, revised in February 2022, mandates that oxygen cannulas and tubing be changed every seven days or as needed, and stored in a plastic bag when not in use. Nebulizer equipment should be rinsed, dried, and stored in a plastic bag marked with the date and resident's name between uses, and discarded every seven days. The facility failed to adhere to these guidelines, as evidenced by the improper storage and lack of documentation for the respiratory equipment of the six residents reviewed. This non-compliance with the facility's own infection control policies contributed to the deficiencies observed during the survey.
Inadequate Monitoring of Vaccine Storage and Expired Medication Found
Penalty
Summary
The facility failed to adequately monitor vaccine storage temperatures and ensure the removal of expired medications. Specifically, the immunization refrigerator on the Kennebec unit was found to contain various vaccines, including Influenza, COVID-19, and Pneumonia vaccines. However, the temperature log attached to the refrigerator showed inconsistent monitoring. For several months, temperatures were either recorded only once a day or not at all, contrary to the facility's policy and CDC guidelines, which require temperature checks twice daily. This lack of consistent monitoring was confirmed by an LPN during the surveyor's observation. Additionally, an expired medication was found on one of the medication carts in the [NAME] Short Hall. An opened bottle of Milk of Magnesium with an expiration date was discovered and subsequently discarded by a CNA-M. This issue was confirmed during an observation and later discussed with the Acting Director of Nursing. These deficiencies highlight lapses in the facility's medication management and vaccine storage protocols.
Failure to Maintain Sanitary Food Storage and Preparation
Penalty
Summary
The facility failed to serve and store food in a sanitary manner on two of three survey days. On 5/6/24 at 9:05 a.m., during an initial kitchen tour with the Director of Food Service, a surveyor observed a bag of hard-boiled eggs in the walk-in refrigerator that were not dated and not labeled. This was confirmed with the Director of Food Service at that time. On 5/8/24 at 10:30 a.m., during a return observation of the kitchen with the Food Service Director, a surveyor observed a light to moderate amount of dust and debris on all ceiling vents. Additionally, a large stand mixer that had not been used in over a month was found with a small amount of dark liquid at the bottom of the bowl and was covered with a light amount of dust and scattered food particles. This was confirmed with the Food Service Manager at that time.
Failure to Issue Written Transfer/Discharge Notices
Penalty
Summary
The facility failed to issue a written transfer/discharge notice to two residents or their legal representatives for facility-initiated transfers/discharges to an acute care facility. Resident 13 was transferred to an acute hospital on two occasions, and the clinical record lacked evidence of a written notice for both instances. Similarly, Resident 31 was transferred to an acute hospital on two occasions, and the clinical record also lacked evidence of a written notice for both instances. These findings were confirmed by a surveyor during an interview with the Licensed Clinical Social Worker.
Failure to Issue Written Transfer/Discharge Notices
Penalty
Summary
The facility failed to issue a written transfer/discharge notice to two residents or their legal representatives for facility-initiated transfers/discharges to an acute care facility. Resident 13 was transferred to an acute hospital on two occasions, 3/24/24 and 7/2/23, and subsequently readmitted, but the clinical record lacked evidence of a written notice. Similarly, Resident 31 was transferred to an acute hospital on 5/25/23 and 9/21/23, and subsequently readmitted, with no written notice documented in the clinical record. These findings were confirmed by the surveyor during an interview with the Licensed Clinical Social Worker on 5/7/24 at 3:26 p.m.
Failure to Include Resident in Care Plan Meetings
Penalty
Summary
The facility failed to review and revise the care plan by an interdisciplinary team (IDT) that included, to the extent possible, participation of the resident and/or his/her representative after each assessment for Resident #37. During an interview, Resident #37 stated he/she had only participated in one care plan meeting in the past year. Review of the IDT care plan meeting notes indicated that meetings occurred on 7/26/23 and 11/1/23, but there was no evidence that Resident #37 was invited or participated. Additionally, the IDT meeting on 2/7/24 noted that Resident #37 did not attend because the resident was in the middle of a dressing change. This was confirmed by the Licensed Social Worker during an interview.
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Illustrative
What surveyors actually found near you
We read the 211 citations issued within 25 miles in the last 12 months — including the 2 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
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Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Freeport
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Coastal Manor | 3.3 mi | ★★★★★ | 36 | 0 |
| Brentwood Center For Health & Rehabilitation, Llc | 4 mi | ★★★★★ | 23 | 0 |
| Sedgewood Commons | 7.7 mi | ★★★★★ | 0 | 0 |
| Horizons Living And Rehab Center | 9.2 mi | ★★★★★ | 0 | 0 |
| Mid Coast Senior Health Center | 9.2 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.