Below 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 Oasis Center For Rehabilitation And Healing during CMS and state inspections, most recent first.
A resident with a history of hip fracture, muscle weakness, COPD, osteoporosis, and moderate cognitive impairment experienced an unwitnessed fall and was found on the floor next to an unlocked wheelchair, reporting elbow pain with bruising and swelling. Later the same day, an Interact evaluation documented pain and marked bruising and swelling in the right elbow, trochanter, and thigh, and the physician ordered immediate X‑rays of the right elbow, femur, and hip. Due to inclement weather, the X‑ray company did not come, and despite the resident’s ongoing pain and the documented injuries, the resident was not sent to the ER for imaging that day. X‑rays obtained the following morning showed acute fractures of the right hip and right elbow, and subsequent hospital evaluation identified additional pelvic and humeral fractures, confirming that there was a significant delay between the fall and the identification of these injuries.
Surveyors found multiple rooms and common areas with stained and damaged floor tiles, visible dirt and debris behind entrance doors, dirty bathroom sinks with apparent beard shavings, broken bathroom fixtures, holes in bathroom doors, overflowing trash, and unattended food trays on tables. A mechanical lift was also observed with visible dirt on its base. These conditions, verified by a CNA, the ADON, and the Maintenance Director, did not meet the facility’s own policy requiring a safe, clean, sanitary, and homelike environment for all residents.
Two residents on the smokers list were found with unsafe smoking practices and smoking materials in their rooms. One resident with COPD and other chronic conditions was observed vaping in bed and had vaporizers on her bedside table while oxygen was in the room. Another resident with CHF, COPD, nicotine dependency, and moderate cognitive impairment had cigarettes and a lighter in her room and on her person, despite care plan directions about staff holding the lighter and removing oxygen before smoking.
Unsafe bedside storage of medications: A resident with CHF, DM2, HTN, and moderate cognitive impairment had multiple oral meds ordered and was not care planned or assessed for self-administration. Although the MAR showed the meds were signed off as given, surveyors observed a clear cup with eight pills on the bedside table, and an ADON confirmed no residents were on a self-administration program.
Call lights were found on the floor and not within reach for two residents during observation. One resident had severe cognitive impairment, dementia, and needed assistance with all ADLs, while the other had moderate cognitive impairment, severe vision impairment, dementia, and required partial to moderate assistance with all ADLs. Both care plans included keeping the call light within reach and encouraging use of the call bell system, and facility staff verified the findings.
The facility failed to maintain sanitary conditions in food storage and preparation, with several items found unsealed and undated in the kitchen. Additionally, the exhaust hood had not been cleaned professionally as required, leading to an accumulation of dust and debris. The facility's policies for food storage and hood cleaning were not followed, resulting in non-compliance.
The facility failed to maintain an adequate emergency supply of food and water, affecting all 92 residents. Observations showed insufficient emergency food items, and interviews revealed the absence of an emergency water supply. The Maintenance Directors and Administrator were aware of the issue but did not take action to replenish supplies, leading to noncompliance during a complaint investigation.
The facility failed to follow the posted menu and dietary requirements for two residents, resulting in missing fruit cups on their breakfast trays. Despite the residents' diet orders and willingness to consume the fruit, it was not provided. The dietary staff did not adhere to the facility's policy on tray line service accuracy, leading to noncompliance identified during a complaint investigation.
The facility failed to serve palatable food, affecting several residents. Observations revealed that noodles lacked cream sauce, and the recipe was unavailable until requested by a surveyor. Residents reported bland food, and a test tray confirmed the lack of flavor in noodles and green beans. The Ombudsman noted dietary concerns, including meals not matching the menu.
The facility failed to maintain a clean, comfortable, and homelike environment in the memory care unit, as a strong, pervasive odor of foul-smelling urine was detected throughout the unit. An LPN confirmed that housekeeping did not spend much time on the unit and failed to remove the odor, and observations showed that air freshener was used ineffectively. The facility's policy requires a clean environment with pleasant scents, which was not upheld.
The facility failed to maintain a sanitary kitchen environment, with observations of grease and dirt buildup on the puree prep station, dirty tiles, and a microwave with dried food splatter. Expired Hydrion test strips were also being used to test sanitization levels, as verified by the Dietary Manager.
The facility failed to provide a clean and sanitary environment, affecting all 92 residents. Observations revealed broken tiles, dirty sinks, and buildup of dirt in various areas, including the shower room, activity lounge, and resident rooms. The Environmental Safety and Services Director confirmed that rooms were to be cleaned daily, but the facility did not adhere to its cleaning policy.
The facility failed to provide palatable food when gelatine was served in a liquid form, affecting all residents receiving food from the kitchen. Residents reported poor food quality and lack of menus. A test tray confirmed the issue, and the Dietary Manager verified the gelatine was not served correctly.
Delay in Diagnostic Evaluation and Treatment After Resident Fall
Penalty
Summary
The deficiency involves the facility’s failure to provide timely care and services following a resident’s unwitnessed fall. The resident had been admitted with a nondisplaced intertrochanteric fracture of the right femur, muscle weakness, COPD, osteoporosis, and avascular necrosis, and had moderate cognitive impairment. On the date of the incident, staff heard the resident yelling and found her sitting on the floor, leaning on the wheel of an unlocked wheelchair beside the bed. She reported right elbow pain, and staff noted bruising, swelling, and normal range of motion. She was assisted back to bed. An Interact Change in Condition Evaluation later that evening documented marked localized bruising, swelling, or pain not only in the right elbow but also in the right trochanter and right thigh, and indicated the resident had pain. Following the fall, the resident complained of right hip and upper leg pain and requested that staff call her brother. The physician was notified and immediate X‑rays of the right elbow, right femur, and right hip were ordered. However, the X‑rays were not obtained that day because the contracted X‑ray company could not come to the facility due to inclement weather. The DON confirmed that, despite the inability of the X‑ray company to respond, the resident was not sent to the ER that day to obtain imaging as an emergency measure. The Medical Director acknowledged awareness that the X‑rays were delayed until the following day and attributed the delay to the X‑ray company’s availability. The X‑rays were finally completed the next morning and revealed an acute intertrochanteric fracture of the proximal right femur and an acute comminuted fracture of the olecranon process of the proximal ulna, with associated osteopenia, joint effusion, and soft tissue swelling. Subsequent hospital evaluation identified additional fractures involving the right superior and inferior pubic rami and redemonstration of an impacted proximal humeral fracture with evidence of healing. The resident’s brother confirmed that nearly 24 hours elapsed between the fall and the discovery of the fractures, and he expressed concern about the delay in treatment. The facility’s Managing Falls and Fall Risk policy stated that staff would try to minimize complications from falling, but in this case, the resident did not receive timely diagnostic evaluation and related care after the fall when the ordered X‑rays could not be obtained as planned.
Failure to Maintain Clean and Homelike Environment in Resident Rooms and Common Areas
Penalty
Summary
The facility failed to maintain a clean, sanitary, and homelike environment in multiple resident rooms and common areas, as identified during an initial building tour conducted between 9:45 A.M. and 11:00 A.M. on 01/12/26. In one room, surveyors observed stained tiles, a buildup of visible dirt and debris behind the entrance door, bathroom tiles coming up, visible dirt within the heating unit, and visible dirt and food on the floor beneath a locked closet; these findings were verified by a CNA. Another room had a buildup of visible dirt and debris behind the entrance door, stained floor tiles, chipped bathroom floor tile, a bathroom door with a hole, a broken toilet paper holder, and a bathroom sink with visible dirt and apparent beard shavings, also verified by the same CNA. Additional rooms were noted to have a buildup of visible dirt and debris behind entrance doors and damaged tile next to a resident bed, with these findings verified by the ADON. The common area was observed with a dirty floor, an unattended breakfast tray of food on an end table, and overflowing garbage, verified by the ADON. During a subsequent tour at 4:20 P.M. the same day with the Maintenance Director, multiple rooms on different units were again noted to have a buildup of visible dirt and debris behind entrance doors. One previously cited room still had a dirty bathroom sink with apparent beard shavings, a broken toilet paper holder, bathroom floor tiles coming up, and a bathroom door with a hole. The common room on the 400 unit continued to have a floor with visible dirt and a food tray remaining on the end table. Additional rooms were noted with dirt and debris behind entrance doors, and a mechanical lift on the 100 unit was observed with visible dirt on its base. All of these findings were verified by the Maintenance Director. Review of the facility’s "Homelike Environment" policy dated 02/2021 showed that the facility policy required a safe, clean, comfortable, and homelike environment, including a clean, sanitary, and orderly environment, which was not met in these observations.
Unsafe Smoking Practices and Poor Control of Smoking Materials
Penalty
Summary
The facility did not ensure safe smoking practices for two residents who were identified as smokers. Resident #67, who had diagnoses including COPD, chronic kidney disease, rheumatoid arthritis, anxiety, depression, tobacco use, and was cognitively intact with a BIMS score of 15, was listed as an independent smoker. Although the smoking assessment indicated she could light her own cigarette and had no cognitive, visual, or dexterity problems, survey observations found three Prime vaporizers on her bedside table and later an empty box of Geek vaporizers on the same table. The record also noted that she had oxygen in her room, and a psych note documented her lying in bed vaping. Resident #34, who had diagnoses including CHF, COPD, nicotine dependency, bipolar disorder, anxiety, depression, and tobacco use, was also listed as an independent smoker. Her smoking assessment stated that oxygen needed to be removed before smoking, and her care plan noted prior education about not smoking with oxygen on her wheelchair and that cigarettes and a lighter would be held by staff after she attempted to smoke in her room. However, the MDS showed a BIMS score of 10, indicating moderate cognitive impairment, and survey observations found cigarettes on her bedside table, her lighter in her jacket pocket, and a disposable lighter in a hard box on her bedside table. Staff interviews confirmed the lighter and cigarettes were in her possession, despite the care plan direction that the lighter should be given to the nurse.
Unsafe bedside storage of medications
Penalty
Summary
Medications were not stored in a safe fashion for Resident #43, who was admitted on 10/08/25 with diagnoses including chronic congestive heart failure, acute respiratory failure with hypoxia, diabetes mellitus type II with hyperglycemia, acute pulmonary edema, gastroesophageal reflux disease, hypertension, and shortness of breath. The resident had multiple medication orders, including isosorbide, atorvastatin, nifedipine, hydrochlorothiazide, magnesium, spironolactone, Lasix, Klor-Con, lisinopril, Jardiance, and hydralazine. The care plan did not include self-administration of medication, the quarterly MDS showed a BIMS score of 10 indicating moderate cognitive impairment, and the resident was not assessed for medication self-administration. The MAR showed all oral medications were signed off as given from 01/01/26 through 01/12/26. However, during observation on 01/12/26 at 10:00 A.M., a clear medication cup containing eight medications was found on the resident’s bedside table, and Housekeeper #376 verified the pills in the cup at the time of the observation. On 01/13/26, the ADON stated there were no current residents in the facility on a medication self-administration program. Facility policy stated medications are to be administered in a safe and timely manner and stored in a safe, secure, and orderly manner.
Call Lights Not Within Reach
Penalty
Summary
A deficiency was identified for failure to ensure a working call system was available and within reach in residents’ rooms. During observation on 01/12/26, Resident #24 was found in bed with the call light on the floor at the foot of the bed, and CNA #316 verified the finding. Resident #24 was admitted on 12/13/24 and had diagnoses including unspecified dementia, adult failure to thrive, anxiety, unspecified amnesia, age-related cognitive decline, and unspecified non traumatic intracerebral hemorrhage. The resident’s care plan identified a fall risk related to cognitive impairment and gait/balance problems and included interventions to keep the call light within reach. The annual MDS showed a BIMS score of 4/15, indicating severe cognitive impairment, and that the resident needed supervision or touching assistance with all ADLs. Resident #41 was also observed in bed with the call light on the floor, and ADON #429 verified the finding during the observation on 01/12/26. Resident #41 was admitted on 10/22/15 and had diagnoses including major depressive disorder, diabetes mellitus type II, suicidal ideations, mild cognitive impairment, Alzheimer's disease, unspecified dementia, legal blindness, chronic viral hepatitis B, and psychosis not due to a substance or known physiological condition. The care plan stated the resident required assistance with ADLs and was at risk for falls related to legal blindness and anoxic brain damage, with interventions to keep the call light within reach and encourage use of the call bell system. The annual MDS showed a BIMS score of 9/15, indicating moderate cognitive impairment, with partial to moderate assistance needed for all ADLs and severely impaired vision.
Sanitation and Maintenance Deficiencies in Kitchen Operations
Penalty
Summary
The facility failed to ensure that food was stored, prepared, and served under sanitary conditions, which had the potential to affect all residents receiving meals from the kitchen. During an observation of the kitchen, several items in the walk-in cooler were found opened and resealed with plastic wrap without being labeled or dated, including shredded mozzarella cheese, waffles, and hardboiled eggs. Additionally, an unidentified product resembling brown sugar was found in an opened bag without a label or date. In the dry storage area, a half bag of dried penne pasta was left open to the air. The Assistant Dietary Director confirmed that all opened items should be resealed, labeled, and dated, as per the facility's undated food storage policy. The facility also failed to maintain the exhaust hood in the kitchen according to professional standards. The exhaust hood had not been cleaned professionally since January 2024, and there was a visible accumulation of dust and debris in the vents. The facility's policy required professional cleaning of the hood every six months, but the July cleaning was missed due to a lack of confirmation from the previous maintenance person, who no longer worked at the facility. The Administrator confirmed that the facility was supposed to be on a schedule for cleaning every January and July, but the commercial company did not receive confirmation for the July cleaning, resulting in non-compliance with the facility's policy.
Inadequate Emergency Food and Water Supply
Penalty
Summary
The facility administration failed to maintain an adequate supply of emergency food and water, potentially affecting all 92 residents. Observations and interviews revealed that the facility's emergency food supply was insufficient, with bare spots noted on storage shelves and a lack of necessary items to support the emergency menu. The Dietary Director confirmed the absence of the required emergency food supply. Additionally, the facility lacked an emergency water supply, as confirmed by the Maintenance Director, who expressed concern over the issue. The facility had previously disposed of its emergency water supply due to expired and leaking containers, and no replenishment had been made. Interviews with the Maintenance Directors and the Administrator highlighted a lack of action to address the deficiency. Maintenance Director #401 had raised concerns about the absence of emergency water, which had been ignored, leading to uncertainty about the facility's preparedness for a water-related disaster. Maintenance Director #402 also acknowledged the issue but assumed that the requirement for emergency water might have changed. The Administrator was aware of the problem but admitted that no steps had been taken to reorder the necessary supplies. The facility's policy required a minimum three to seven-day supply of emergency food and water, which was not met, resulting in noncompliance during the investigation of a complaint.
Failure to Follow Dietary Menu and Serve Required Items
Penalty
Summary
The facility failed to adhere to the posted menu and dietary requirements for two residents, which was observed during a facility tour. Resident #5, who was cognitively intact and had a diet order for a consistent carbohydrate/no added salt diet with mechanically altered chopped texture and thin liquids, was served a breakfast tray missing the fruit cup that was listed on the menu. Despite the resident's willingness to consume the fruit, it was not provided, and the dietary staff member stated she did not see it on the menu. This discrepancy was confirmed by an Occupational Therapy Assistant and highlighted as a concern by the Ombudsman. Similarly, Resident #89, who was moderately cognitively impaired and had a diet order for a regular diet with mechanically altered ground texture and thin liquids, was also not served the fruit cup as per the menu. The dietary staff member again stated she did not see the fruit on the menu, and this was confirmed by a State tested Nursing Assistant. The facility's policy on the accuracy of tray line service was not followed, as meals were not checked against the therapeutic diet spreadsheet to ensure compliance with the menu. This deficiency was part of a complaint investigation.
Deficiency in Palatable Food Service
Penalty
Summary
The facility failed to ensure that palatable food was served to all residents, affecting three residents directly and potentially impacting all residents receiving meals from the kitchen. During a lunch service, it was observed that the noodles served did not have the cream sauce as per the menu, and the dietary staff confirmed the absence of a recipe for the parmesan creamed noodles. The Dietary Director acknowledged that the recipe book was being updated and that the recipe for the noodles was not available until requested by the state surveyor. A test tray revealed that while some food items were at appropriate temperatures and tasted good, the noodles and green beans were bland and lacked flavor. Resident #39, who was on a CCHO/NAS diet with a mechanically altered chopped texture, reported that the food was often bland, specifically mentioning the noodles served during lunch. Resident #45, on a similar diet, also expressed that the facility did not use seasoning, resulting in bland food. Resident #36, with a CCHO/NAS diet, described the food as terrible and bland. These residents were cognitively intact and independent in eating, indicating that their feedback was reliable and reflective of their dining experience. The Ombudsman also noted dietary concerns, particularly meals not matching the posted menu. This deficiency was investigated under a specific complaint number, highlighting the facility's non-compliance with dietary standards. The lack of adherence to recipes and the absence of proper seasoning contributed to the deficiency, affecting the quality of meals provided to the residents.
Failure to Maintain a Clean and Homelike Environment in Memory Care Unit
Penalty
Summary
The facility did not ensure the memory care unit environment was maintained in a clean, comfortable, and homelike manner. Upon observation, a strong, pervasive odor of foul-smelling urine was detected throughout the entire memory care unit. This issue was confirmed by an LPN who stated that housekeeping did clean the unit but did not spend much time there and failed to remove the foul-smelling urine odor. Further observation revealed that the housekeeper was only spraying air freshener, which did not eliminate the odor. The facility's policy titled 'Homelike Environment,' last revised in February 2021, mandates that the facility staff and management maximize characteristics that reflect a personalized, homelike setting, including maintaining a clean, sanitary, and orderly environment with pleasant, neutral scents. The policy also requires minimizing characteristics that reflect a depersonalized, institutional setting, including institutional odors. The deficiency was identified during the investigation of Master Complaint Number OH00153659 and Complaint Numbers OH00153284 and OH00153155.
Sanitary Deficiencies in Kitchen Environment
Penalty
Summary
The facility failed to maintain a sanitary kitchen environment, which could potentially affect all residents receiving nothing by mouth. During a tour of the kitchen, it was observed that the puree prep station had a buildup of grease and dirt on the bottom shelf and dirt on the top shelf. The white tiles around the kitchen walls had a buildup of black dirt, and the microwave contained dried food splatter. Additionally, the three-sink sanitation station had expired Hydrion test strips, which were being used to test sanitization levels. These findings were verified by the Dietary Manager, who confirmed that food preparation stations were supposed to be cleaned after each use and acknowledged the use of expired test strips.
Facility Failed to Maintain Clean and Sanitary Environment
Penalty
Summary
The facility failed to provide a clean and sanitary environment, which had the potential to affect all 92 residents. During a tour of the facility, several areas were found to be in poor condition. The shower room on the 300-hall had broken tiles around the shower drain, a visibly dirty handwashing sink, and a supply cart with visible dirt. The paper towel dispenser, baseboard heating unit, and tub also had visible dirt and buildup. Additionally, the toilet was full of a bowel movement, and there were broken tiles at the bottom of the doorway. The activity lounge on the 400-hall had visible dirt on the walls, chair rail, baseboard heating unit, and windowsill. These observations were verified by Concierge #808 during the tour. Further observations revealed that room [ROOM NUMBER] had a broken screen in the window, a buildup of dirt on the baseboard heating units, and various debris inside the heating unit. The windowsill, blinds, paper towel holder, and overbed light fixture also had visible dirt and dust buildup. An interview with the Environmental Safety and Services Director (ESSD) #759 confirmed that resident rooms were supposed to be cleaned daily and terminally cleaned upon discharge. The facility's policy on cleaning and disinfection, dated August 2020, stated that environmental surfaces should be disinfected or cleaned regularly and when visibly soiled. These findings were verified by ESSD #759 and represent non-compliance investigated under Master Complaint Number OH00152468.
Facility Failed to Provide Palatable Food
Penalty
Summary
The facility failed to provide palatable food when gelatine was served in a liquid form, which had the potential to affect all residents receiving food from the kitchen. During an interview, a resident revealed that no menus were provided and the food quality was poor. An observation of the tray line in the kitchen showed a meal that included gelatine with diced pears, which was served in a liquid form. A test tray confirmed this issue, and the Dietary Manager verified that the gelatine was not served as it should have been. Another resident also reported that the food was terrible. This deficiency was investigated under Master Complaint Number OH00152468.
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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 Youngstown
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Beeghly Oaks Center For Rehabilitation & Healing | 2 mi | ★★★★★ | 0 | 0 |
| Park Center Healthcare And Rehabilitation | 2 mi | ★★★★★ | 18 | 0 |
| Canfield Healthcare Center | 2 mi | ★★★★★ | 29 | 3 |
| Shepherd Of The Valley-boardman | 2.7 mi | ★★★★★ | 21 | 0 |
| Vista Center Of Boardman | 2.8 mi | ★★★★★ | 14 | 0 |
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