Above average — CMS composite of the measures below.
The next survey window likely opens around December 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 Advanced Healthcare Center during CMS and state inspections, most recent first.
An LPN administered narcotic and controlled substances to several residents on the 400 unit but did not sign them out on the controlled substance log at the time of administration. During shift-change inventory, physical counts for multiple medication cards did not match the counts listed on the log, and the DON confirmed that narcotics are to be signed out on the MAR and controlled substance log immediately after removal from the medication cart.
Unsafe food storage and labeling practices were observed in the kitchen and cooler areas. A reach-in refrigerator was left open with serving carts, and prepared beverages inside were undated while the thermometer read 58 degrees F. A resident meal tray that had been eaten from was placed on top of a cooler, and several open food items in the walk-in cooler, including pudding, sour cream, chicken salad, and tortillas, were not labeled with dates opened.
A resident with severe cognitive impairment, multiple comorbidities, and an indwelling urinary catheter had a care plan and physician orders requiring continuous drainage with the catheter bag kept below bladder level and off the floor. On several observations, surveyors found the drainage bag lying on the floor under or next to the bed, and at another time positioned at the level of the bladder rather than below it. A CNA and an RN both confirmed these positions were inconsistent with facility policy, which required the catheter bag to be secured to the bed, kept off the floor, and maintained below bladder level to prevent reflux.
Surveyors found that multiple resident rooms and equipment were not kept clean or properly maintained. In one room, walls near a bed had large gouges, exposed drywall, and visible splatter debris on both the wall and a floor mat, with the ES director unable to state when these areas were last cleaned. In another room, a wall near a bed had gouges and unpainted drywall patches confirmed by maintenance. In a third room, a tube feeding pump pole had fresh and dried tube feeding on its legs and a small puddle of tube feeding on the floor beneath it, verified by the director of risk management.
A resident with impaired cognition and no corrective lenses requested eye care after admission, but the vision provider was in the facility and the resident was not seen. Progress notes contained no documentation that eye care services were provided, and the SSD confirmed the resident had not received vision services since admission. The facility policy stated social services would assist residents with referrals for eye care and other services.
A resident with impaired cognition, transfer dependence, incontinence, and a history of falls was found on the floor next to the bed after attempting to crawl into a wheelchair. Although the care plan included fall precautions such as wheelchair anti-tippers, non-skid footwear, call-light use, keeping the wheelchair close to the bed, and non-skid strips by the bed, the occurrence report did not document what interventions were in place, how long the resident was on the floor, or any witnesses. The DON verified the fall investigation was incomplete and did not include witness statements or review of whether the care-planned interventions were effectively implemented.
The facility did not timely report suspected abuse, neglect, or theft, nor did it report the results of the investigation to the proper authorities as required.
A resident with severe cognitive impairment and multiple chronic conditions did not receive scheduled doses of hydralazine and Insulin Aspart Flexpen within the required timeframe. The assigned LPN delayed administration because the resident was sleeping, failed to notify the physician, and did not document the reason for the late administration, contrary to facility policy. The DON confirmed the medications were given late and lacked proper documentation.
A resident with urinary and bowel incontinence, dependent on staff for toileting, was not provided timely incontinence care as required by facility policy. Observations showed the resident remained in a common area for several hours without being offered care, resulting in soiled clothing and a saturated incontinence brief. Staff confirmed care should be provided every two hours, but lapses in communication and documentation led to the deficiency.
A resident with a history of substance use and no current opioid prescriptions was given medications not ordered for him, including opioids and other drugs, on two separate occasions. In both cases, LPNs administered the wrong medications due to distractions and misidentification, despite facility policy requiring verification of the five rights of medication administration.
Narcotic Medications Not Signed Out at Time of Administration
Penalty
Summary
Narcotic medications were not administered and maintained in a secured manner for four residents receiving controlled substances on the 400 unit. During a shift change inventory, an LPN was observed counting narcotic medication cards in the locked narcotics drawer while another LPN reviewed the controlled substance inventory log. The inventory included medication cards for residents receiving Hydrocodone-acetaminophen 10-325 mg, Clonazepam 0.5 mg, Oxycodone 5 mg, Oxycodone 15 mg, and Pregabalin 150 mg, and the physical counts on several cards did not match the counts listed on the controlled substance log. The LPN stated she had administered narcotic medications to the affected residents during the shift but had not signed them out on the controlled substance log at the time of administration. She also stated she was extremely busy and did not record the medications as administered when they were given. The LPN and another LPN verified that narcotics and controlled substances are to be signed out on the controlled substance log at the time of administration, and the DON confirmed that narcotic medications are to be signed out on the MAR and controlled substance log immediately after removal from the medication cart.
Unsafe food storage and labeling practices in kitchen and cooler areas
Penalty
Summary
The facility failed to maintain a reach-in refrigerator at a safe temperature, failed to date and label food items, and failed to maintain a sanitary environment. During an initial kitchen observation, the reach-in refrigerator located across from the steam table had both doors propped open by serving carts. Inside were multiple cups of prepared beverages, including grape juice, cranberry juice, orange juice, lemonade, milk, and an unidentified liquid; although the cups were labeled, none had dates. The refrigerator thermometer was reading 58 degrees Fahrenheit. Dietary Aide #337 stated the doors were propped open to make it easier to access the prepared cups of juice being placed on resident meal trays and confirmed the cups should have been dated to indicate when they were prepared. Later observation showed a resident meal tray that had been eaten from sitting on top of a smaller reach-in cooler next to the service door after it had been brought into the kitchen from the dining room. In the walk-in cooler, two open containers of pudding, one open container of sour cream, one open container of chicken salad, and an opened package of tortillas were observed without labels indicating the dates opened. [NAME] #339 confirmed the items did not have labels indicating when they were opened. The facility policy required cold foods to be maintained at 41 degrees Fahrenheit or below and stored wrapped or in covered containers, labeled and dated, and arranged to prevent cross contamination, and required food preparation, food service, and dining areas to be maintained in a clean and sanitary condition.
Improper Maintenance of Indwelling Urinary Catheter and Drainage Bag
Penalty
Summary
The deficiency involves the facility’s failure to maintain an indwelling urinary catheter in a sanitary and appropriate manner for one resident with multiple complex medical conditions, including metabolic encephalopathy, severe protein calorie malnutrition, benign prostatic hyperplasia, obstructive and reflux uropathy, hydronephrosis, hypertension, dementia, myocardial infarction, and resistance to Vancomycin. The resident had severely impaired cognition, behavioral symptoms, rejected care on some days, was dependent on staff for ADLs, used an indwelling urinary catheter, was bowel incontinent, and was at risk for pressure ulcer development. The care plan, initiated and later revised, included interventions to keep the catheter bag and tubing below the level of the bladder, provide a privacy bag, and secure the drainage catheter to the resident’s leg. Physician orders directed that the urinary catheter be on continuous drainage, and an antibiotic was ordered for a UTI with bacteremia. Surveyor observations on multiple occasions showed the catheter drainage bag was not maintained according to policy or care plan. On one evening observation, the drainage bag was lying on the floor under the bed, and a later observation that same evening confirmed it remained on the floor. A CNA acknowledged the resident was on contact isolation for a urine infection (MRSA), verified the bag was on the floor, and stated it should have been secured to the bed frame. A subsequent observation found the drainage bag again on the floor next to the bed. On another morning, the drainage bag was observed at the end of the bed at the level of the resident’s bladder rather than below it. The CNA confirmed the bag was not below bladder level and stated it should be to prevent backflow of urine. An RN confirmed that facility policy required the collection bag not be on the floor, to be draining properly, and to be secured below bladder level to prevent reflux, consistent with the written catheter care policy reviewed by surveyors.
Failure to Maintain Clean Resident Rooms and Tube Feeding Equipment
Penalty
Summary
Surveyors identified that resident rooms and equipment were not adequately cleaned or maintained. In one room, a wall behind a resident’s bed had gouges in the drywall with exposed underlayment over an area approximately five feet by five feet. In the same room, another wall to the right of the bed was observed with liquid-appearing splatter debris, and a maroon floor mat next to the bed had the same debris. The Director of Environmental Services confirmed the presence of the debris and stated the resident had a behavior of spitting but could not state when the wall or floor mat were last cleaned. In another room, a wall to the left of a resident’s bed had gouges in the drywall and white unpainted drywall patches over an area approximately five feet by three feet, which the Maintenance Director verified. In a separate room, a tube feeding pump mounted on a pole next to a resident’s bed was observed with a puddle of fresh tube feeding on the legs of the pole, along with older dried tube feeding covering the legs. A small puddle of tube feeding, approximately two inches in diameter, was also present on the floor under the pole. The Director of Risk Management confirmed the presence of tube feeding on the pole and the floor. These observations showed that the facility did not ensure resident rooms were clean and that equipment was adequately maintained for multiple residents.
Failure to Provide Timely Vision Services
Penalty
Summary
The facility failed to ensure timely vision services for one resident who had requested eye care after admission. The resident was admitted with diagnoses including hemiplegia and hemiparesis, COPD, hypertension, anxiety, and depression, and the quarterly MDS indicated impaired cognition and no corrective lenses. A request for services form documented the resident’s request to be seen for eye care, but the vision provider schedule showed the provider was in the facility and the resident was not seen. Progress notes from the resident’s stay contained no documentation that eye care services were provided, and the Social Service Designee confirmed the resident had not received vision services since admission. The facility’s social services policy stated that social services would help residents with referrals for eye care and other services.
Fall prevention interventions not implemented and fall investigation incomplete
Penalty
Summary
The facility failed to ensure fall prevention interventions were implemented and that a fall occurrence was thoroughly investigated for one resident with a history of falls. The resident had atrial fibrillation, bipolar disorder, schizoaffective disorder, major depressive disorder, anxiety disorder, and bilateral knee contractures. The most current MDS identified moderately impaired cognition, lower extremity range of motion impairment on one side, dependence on staff for activities of daily living and transfers, incontinence of bowel and bladder, and use of an anticoagulant, opioids, and anticonvulsant medications. A nursing plan of care addressed the resident’s fall history and included interventions such as ensuring anti-tippers were in place on the wheelchair, non-skid footwear, encouraging the resident to call for help with transfers, keeping the wheelchair close to the bed, and placing non-skid strips on the floor next to the bed. After a prior fall, a follow-up assessment noted the care plan was updated, and a later fall risk assessment again identified the resident as at risk for falling with a history of falls in the prior two to six months. The resident was later found sitting on the floor next to the bed after stating he was crawling on the floor to get into his wheelchair. The occurrence report documented the fall during a transfer but did not include what interventions were in place at the time, how long the resident had been on the floor, or any witnesses or resident-specific interventions related to the incident. The DON verified that the report lacked documentation of the interventions in place and the reason the resident attempted to self-transfer, and also verified the investigation was not thorough because missing information was not requested, no witness statements were obtained, and there was no review of whether the current care-planned interventions had been effectively implemented.
Failure to Timely Report Suspected Abuse, Neglect, or Theft
Penalty
Summary
The facility failed to timely report suspected abuse, neglect, or theft and did not report the results of the investigation to the proper authorities. This deficiency was identified based on a review of facility practices and documentation, which showed that when an incident of suspected abuse, neglect, or theft occurred, the required notifications and reporting to authorities were not completed within the mandated timeframe. The report does not provide specific details about the individuals involved or the nature of the incident, but it clearly states that the reporting and follow-up requirements were not met.
Failure to Administer Critical Medications Within Prescribed Timeframe
Penalty
Summary
A deficiency occurred when a resident with multiple complex medical conditions, including chronic respiratory failure, diabetes mellitus, hypertension, congestive heart failure, and severe cognitive impairment, did not receive prescribed medications within the required timeframe. The resident was ordered to receive hydralazine, a diuretic, three times daily and Insulin Aspart Flexpen on a sliding scale before meals and at bedtime. On the evening in question, both medications scheduled for administration at 9:00 P.M. were not given until 12:28 A.M. the following day, exceeding the facility's policy of administering medications within one hour before or after the scheduled time. The LPN assigned to the resident confirmed that the medications were not administered on time because the resident was sleeping, and there was no documentation in the medical record explaining the delay. Additionally, the physician was not notified about the late administration of these critical medications, and no entry was made to indicate the reason for the delay. The facility's policy requires documentation of medications that are refused, withheld, or not given, and mandates physician contact for critical medications like insulin if not administered as ordered. The Director of Nursing confirmed the lack of documentation and the late administration of the medications.
Failure to Provide Timely Incontinence Care
Penalty
Summary
A deficiency was identified when a resident with a history of osteoporosis, urinary incontinence, hypertension, and dementia did not receive timely incontinence care. The resident, who was always incontinent of bladder and frequently incontinent of bowel, was dependent on staff for toileting. Documentation showed no record of incontinence care being provided from early morning until noon. Multiple observations throughout the morning revealed the resident remained in a common area in a wheelchair without being offered incontinence care, and by late morning, there were noticeable odors of urine and stool. Further investigation found the resident's clothing and wheelchair were wet with urine, and the incontinence brief was heavily saturated with urine and a small amount of stool. Staff interviews confirmed that incontinence care should be provided every two hours, but the assigned CNA was unaware of when the last care had been given due to lack of communication from the previous shift. The facility's policy required routine incontinence care, but this was not followed, resulting in the resident remaining in soiled conditions for an extended period.
Medication Administration Errors Due to Distractions and Misidentification
Penalty
Summary
The facility failed to ensure that medications were administered to the correct resident, resulting in significant medication errors affecting one resident. The resident, who had a history of joint replacement surgery, depression, anxiety, alcohol abuse, and cocaine abuse, was cognitively intact and did not have orders for opioid or several other medications. Despite this, the resident was administered medications including Gabapentin, Doxycycline, Metoprolol, Norco, and Oxycodone, none of which were prescribed to him. The errors were documented in nursing progress notes and confirmed through internal investigations. Interviews with the LPNs involved revealed that both medication errors occurred during periods of distraction and high activity, such as multiple resident requests, similar resident names, and other urgent events on the unit. In both incidents, the LPNs prepared and administered medications intended for other residents to the affected resident, only realizing the mistake after the medications had been ingested. The facility's policy on medication administration emphasizes the importance of verifying the five rights and minimizing distractions, but these procedures were not followed, leading to the errors.
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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 Toledo
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Foundation Park Care Center | 1.8 mi | ★★★★★ | 29 | 0 |
| Concord Care Center Of Toledo | 1.9 mi | ★★★★★ | 6 | 0 |
| Divine Rehabilitation And Nursing At Toledo | 2.5 mi | — | 28 | 0 |
| Continuing Healthcare Of Toledo | 2.7 mi | ★★★★★ | 6 | 0 |
| Park Terrace Rehabilitation Center | 3.3 mi | ★★★★★ | 16 | 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.