Above average — CMS composite of the measures below.
Past the typical resurvey interval — a standard survey could occur at any time
Estimate from public CMS data, current as of June 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Country Lawn Ctr For Rehab during CMS and state inspections, most recent first.
A facility failed to implement a care plan for a resident's PEG tube site care. The resident, with respiratory failure and throat cancer, had orders for daily dressing changes. However, during an observation, the dressing was found unchanged since several days prior, confirmed by an LPN and the DON.
A facility failed to manage tracheostomy secretions and maintain hygiene for a resident dependent on personal care. The resident was found with dried debris on a washcloth beneath the tracheostomy tube and soiled linens, confirmed by an LPN and CNAs. The CNAs noted that the resident's gown and bedding should be changed daily and as needed, indicating a lapse in care practices.
A resident with a PEG tube had inaccurate documentation in their medical record. The care plan required daily dressing changes, but an observation revealed the dressing was not changed as documented. The TAR inaccurately showed that the site was cleansed and a T-sponge was applied twice daily. Interviews with an LPN and the DON confirmed the discrepancy between documented and actual care.
A facility failed to follow infection control protocols during tracheostomy care for a resident with respiratory failure and throat cancer. An LPN did not wear a mask or face shield and used a soiled washcloth to clean the resident's oxygen mask and tracheostomy site, contrary to facility policy and CDC guidance. The LPN also neglected to change gloves or perform hand hygiene, increasing the risk of cross-contamination. The DON confirmed the LPN's actions were inappropriate.
The facility failed to develop comprehensive care plans for residents, leading to unaddressed medical needs. A resident with cognitive impairment and behavioral issues lacked interventions in her care plan, resulting in hospitalization. Another resident's dialysis treatment was not reflected in her care plan, despite physician orders. Additionally, residents with conditions like atrial fibrillation, severe rash, and indwelling catheter lacked appropriate care plans, as confirmed by interviews and record reviews.
A facility failed to maintain privacy for a resident during medication administration. An RN entered a resident's room to administer medications via a PEG tube without closing the door or pulling the privacy curtain, exposing the resident's bare abdomen and incontinence brief. The RN acknowledged the lack of privacy provided. The resident had a complex medical history, including conditions like respiratory failure and hydrocephalus.
The facility failed to assist two residents with shaving, despite their need for substantial assistance with personal hygiene. Both residents, with various medical conditions, were observed with long beard hairs and expressed a desire to be shaved. Interviews with staff confirmed the need for shaving, but the facility's practice of shaving on shower days or as needed was not adequately followed.
A facility failed to monitor a resident for side effects of an anticoagulant medication prescribed for chronic atrial fibrillation. Despite the resident's diagnoses of vascular dementia, atrial fibrillation, and diastolic heart failure, there were no orders or evidence of monitoring for side effects. This deficiency was confirmed by a Regional Nurse Consultant.
Failure to Implement PEG Tube Care Plan
Penalty
Summary
The facility failed to implement the care plan for Resident #3 concerning the care of their percutaneous endoscopic gastrostomy (PEG) tube insertion site. Resident #3, who was admitted with diagnoses including respiratory failure, throat cancer, and a PEG tube, had a care plan dated 02/18/25 that included interventions for tube feeding due to their nothing by mouth (NPO) status. The care plan specified administering skin treatments to the PEG tube site as ordered. Physician orders from February 2025 through March 2025 required cleansing the PEG tube site with normal saline and applying a T-sponge twice daily. However, during an observation on 03/06/25, it was noted that the PEG tube insertion site had a split gauze dressing dated 02/28/25, indicating it had not been changed as required. This was confirmed by both the LPN present and the Director of Nursing, who acknowledged the dressing was overdue for a change.
Failure to Manage Tracheostomy Secretions and Maintain Hygiene
Penalty
Summary
The facility failed to provide necessary care and services for a resident who was dependent on assistance for personal hygiene, specifically in managing secretions from a tracheostomy. The resident, who had diagnoses including respiratory failure and muscle weakness, was observed with brownish/red dried debris on a washcloth placed beneath the tracheostomy tube, as well as on their gown, pillowcase, and sheets. This observation was confirmed by an LPN, who acknowledged the need for aides to provide the resident with activities of daily living (ADL) care. Further inspection by CNAs revealed that the resident was dependent on assistance for all ADLs and confirmed that the resident's gown and bed linens were soiled and emitted a foul odor. The CNAs stated that the resident's gown and bedding should be changed daily and as needed, indicating a lapse in the facility's adherence to the care plan and the resident's hygiene needs. This deficiency was investigated under a specific complaint number, highlighting noncompliance in the facility's care practices.
Inaccurate Documentation of PEG Tube Care
Penalty
Summary
The facility failed to ensure accurate documentation in the medical record for a resident with a percutaneous endoscopic gastrostomy (PEG) tube. The resident, who was admitted with diagnoses including respiratory failure and throat cancer, was on a nothing by mouth (NPO) status and received tube feeding. The care plan required skin treatments to the PEG tube site, and physician orders specified cleansing the site with normal saline and applying a T-sponge twice daily. However, during an observation, it was found that the dressing on the PEG tube site was dated several days prior, indicating it had not been changed as required. Despite this, the Treatment Administration Record (TAR) inaccurately documented that the site was cleansed and the dressing was applied twice daily. Interviews with the LPN and the Director of Nursing confirmed the discrepancy between the documented care and the actual care provided, highlighting a failure in maintaining accurate medical records.
Inadequate Infection Control During Tracheostomy Care
Penalty
Summary
The facility failed to ensure appropriate infection prevention and control measures during tracheostomy care for a resident with respiratory failure, throat cancer, and dysphagia. The resident, who had a tracheostomy and PEG tube, was under enhanced barrier precautions (EBP) due to the presence of indwelling medical devices. During an observation, an LPN entered the resident's room without wearing a mask or face shield, which was required due to the risk of splash or spray during tracheostomy care. The LPN used a soiled washcloth to clean the resident's oxygen mask and around the tracheostomy site, which is against the facility's policy that mandates the use of sterile gauze pads for cleaning. The LPN also failed to change gloves or perform hand hygiene before filling the resident's water canister, further increasing the risk of cross-contamination. The facility's policies, as well as CDC guidance, require the use of personal protective equipment (PPE) such as gowns, masks, and face shields during high-contact care activities, especially when there is a risk of exposure to body fluids. The Director of Nursing acknowledged that the LPN should have worn a mask and should not have used a soiled washcloth for cleaning. The facility's infection control protocol emphasizes the importance of standard precautions, including hand hygiene and appropriate PPE use, to prevent exposure to body fluids and potential cross-contamination. This deficiency was identified during a complaint investigation, highlighting non-compliance with established infection control practices.
Deficiencies in Comprehensive Care Planning
Penalty
Summary
The facility failed to develop comprehensive care plans for several residents, leading to deficiencies in addressing their specific medical needs. Resident #23, who was cognitively impaired and exhibited physical and verbal behaviors, did not have a care plan that included interventions for these behaviors, despite documented incidents of combative actions. The care plan only addressed wandering, and interviews confirmed the lack of updates to include physical behaviors, which resulted in hospitalization. Resident #15, diagnosed with end-stage renal disease and heart failure, attended dialysis three times a week. However, her care plan did not reflect her dialysis treatment, despite physician orders indicating the schedule. This oversight was confirmed by a Regional Nurse Consultant, highlighting a gap in the care planning process for her critical treatment needs. Resident #42, with vascular dementia and atrial fibrillation, was on anticoagulant medication but lacked a care plan addressing these conditions and the need for monitoring side effects. Similarly, Resident #68, who had a severe rash and was on multiple medications for itching, did not have a care plan addressing her skin condition. Resident #31, with an indwelling catheter for prostate neoplasm, also lacked a corresponding care plan. These omissions were confirmed through interviews and record reviews, indicating a systemic issue in care plan development.
Failure to Maintain Resident Privacy During Medication Administration
Penalty
Summary
The facility failed to maintain privacy for a resident during medication administration. An observation was conducted where a registered nurse entered the room of a resident to administer medications via a percutaneous endoscopic gastrostomy (PEG) tube. The nurse did not close the door or pull the privacy curtain, and proceeded to pull up the resident's hospital gown, exposing the resident's bare abdomen and incontinence brief. The nurse then administered the medications without providing the necessary privacy. The nurse acknowledged at the time of the observation that privacy should have been provided by closing the door and/or pulling the privacy curtain before exposing the resident. The resident involved had a complex medical history, including nontraumatic subarachnoid hemorrhage, respiratory failure, hydrocephalus, and several other conditions requiring personal care. The facility census at the time was 79, and this incident affected one resident out of seven observed for medication administration.
Failure to Assist Residents with Shaving
Penalty
Summary
The facility failed to provide necessary assistance with shaving for two residents, Resident #31 and Resident #77, who were unable to perform this activity of daily living themselves. Resident #31, who was admitted with multiple diagnoses including urinary tract infection, pancreatitis, and major depressive disorder, was observed on June 24, 2024, with long beard hairs. Despite being cognitively intact and requiring substantial assistance with personal hygiene, there was no evidence in the progress notes from May 2, 2024, to June 26, 2024, that Resident #31 refused shaving. Interviews with the resident and Registered Nurses #118 and #170 confirmed the need for shaving. Similarly, Resident #77, admitted with conditions such as severe sepsis, dysphagia, and anxiety disorder, was also observed with long beard hairs on June 25 and June 26, 2024. The resident expressed a desire to be shaved, and the progress notes indicated no refusal of shaving assistance. Interviews with the resident and Registered Nurses #118 and #170 confirmed the need for shaving. The facility's practice was to shave male residents on shower days or as needed, which was not adequately implemented for these residents.
Failure to Monitor Anticoagulant Side Effects
Penalty
Summary
The facility failed to adequately monitor the use of an anticoagulant medication for side effects in a resident diagnosed with vascular dementia, atrial fibrillation, and diastolic heart failure. The resident was admitted with a physician's order for Eliquis, an anticoagulant, to be administered twice daily for chronic atrial fibrillation. However, the facility did not have any orders or evidence in place to monitor the resident for side effects associated with this high-risk medication. This deficiency was confirmed during an interview with the Regional Nurse Consultant, who acknowledged the lack of monitoring for side effects related to the resident's anticoagulant medication.
What surveyors are citing around you — mapped
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Repeat citations, what's rising near you, and quality measures — ranked so department heads know exactly where to look first.
Illustrative
What surveyors actually found near you
We read the 367 citations issued within 25 miles in the last 12 months — including the 3 immediate-jeopardy cases — and tell you exactly what happened, in plain English, matched to your record.
Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
Illustrative
A prioritized, do-first checklist
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Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Navarre
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Altercare Of Navarre Ctr For Rehab & Nrsg Care | 1.9 mi | ★★★★★ | 13 | 0 |
| Brewster Convalescent Center | 1.9 mi | ★★★★★ | 0 | 0 |
| Legends Care Rehabilitation And Nursing Center | 4.6 mi | ★★★★★ | 10 | 0 |
| Hennis Care Centre Of Bolivar | 6.7 mi | ★★★★★ | 1 | 0 |
| Meadow Wind Health Care Center | 7 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 June 2026) and official state health department websites.