Below 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 July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Harmonee House during CMS and state inspections, most recent first.
The facility did not provide the required 60-day written notice of closure to all residents and their legal representatives. Staff were not informed of the closure in advance, and the ADON was unaware of the notice requirement. All residents were discharged or had passed away before the 60-day period elapsed, and no policy on discharge notices was available when requested.
The facility failed to properly store, label, and date food items in the kitchen, as observed during an inspection. Items in the refrigerator, pantry, and freezer were found without labels or dates, contrary to the facility's policy. Interviews with staff revealed a lack of compliance with labeling and dating procedures, posing a risk of serving expired or spoiled food to residents.
The facility failed to provide a comprehensive activity program that met residents' needs, as many scheduled activities were not conducted, and those that were offered did not align with residents' preferences. Interviews and observations revealed that activities were limited to passive TV watching and occasional volunteer-led events, with insufficient staff involvement. The ADON, who was also responsible for other roles, admitted to being spread thin, resulting in a lack of structured programming.
The facility failed to address grievances from residents about a disruptive peer who sang loudly and spat during meals. Despite complaints, no grievances were documented, and staff acknowledged the behavior but did not implement effective interventions. The facility's grievance process was not followed, leading to residents feeling unheard.
A resident with severe cognitive impairment tested positive for COVID-19 and was moved to an isolation room, but the facility failed to notify the resident's family and physician of these significant changes. Despite the facility's policy requiring such notifications, the family was only informed of a fall incident, not the COVID-19 status or room change. Staff interviews confirmed the lapse in communication and documentation, leading to a deficiency.
A facility failed to involve a resident's family in the care planning process, despite the resident's severe cognitive impairment and preference for family involvement. The DON admitted to not having proof of inviting the family to the meeting, and staff emphasized the importance of family participation. The facility's policies require family involvement, but this was not followed in this case.
The facility failed to properly store and label medications, with three loose medications found in a cart and two residents' insulin vials improperly dated. One insulin vial was used 55 days after opening, exceeding the 30-day guideline. Staff interviews revealed unclear policies and responsibilities for medication cart monitoring and administration.
Failure to Provide 60-Day Written Notice of Facility Closure
Penalty
Summary
The facility failed to provide written notification of impending closure to residents and their legal representatives at least 60 days prior to the closure date, as required. Record review showed that the closure letter was dated September 25, 2025, and residents began being discharged as early as October 1, 2025, with the last resident passing away on October 18, 2025. All 16 residents reviewed for discharge notice did not receive the mandated 60-day written notice. The facility's Nursing Facility Closure Master Resident List confirmed the discharge dates, and no evidence was provided that the required notice was given within the appropriate timeframe. Interviews with the DON and ADON revealed that staff were not informed of the closure until shortly before the letter was sent to families, and the ADON was unaware of the 60-day notice requirement. The facility was unable to provide a policy regarding discharge notices when requested. Observations confirmed the facility was closed as of October 20, 2025, and a sign was posted on the door. The last resident was reported to have been actively dying for about a week prior to passing away in the facility.
Failure to Properly Label and Date Food Items in Kitchen
Penalty
Summary
The facility failed to adhere to professional standards for food service safety, as evidenced by improper storage, labeling, and dating of food items in the kitchen. During an inspection, surveyors observed multiple instances of food items in the refrigerator, pantry, and freezer that were not labeled or dated. Specifically, a bottle of ketchup and trays of cups with various liquids in the refrigerator lacked labels and dates. In the pantry, an open box of potatoes, a package of hot dog buns, individual applesauce cups, and a loaf of bread were found without labels or dates. Similarly, in the freezer, Styrofoam cups with lids containing fruit, bags of frozen vegetables, and a box of breaded meat were also missing labels and dates. Interviews with kitchen staff revealed a lack of compliance with the facility's policy on food labeling and dating. Staff members acknowledged that it was their responsibility to ensure all food items were properly labeled and dated to prevent serving expired or spoiled food, which could lead to food-borne illnesses among residents. The facility's policy clearly stated that all foods stored in the refrigerator or freezer should be covered, labeled, and dated, and dry foods stored in bins should be removed from original packaging, labeled, and dated. Despite training and in-service sessions on these procedures, the facility failed to implement these standards effectively, posing a risk to resident safety.
Inadequate Activity Program for Residents
Penalty
Summary
The facility failed to provide an ongoing program of activities that met the interests and supported the physical, mental, and psychosocial well-being of residents, as required by their comprehensive assessments and care plans. Observations and interviews revealed that scheduled activities were not consistently taking place, and the activities that were offered did not align with the residents' needs and preferences. The activities calendar for September 2024 listed numerous activities, but many were passive, such as watching TV shows, and did not engage residents in meaningful ways. Additionally, several activities were led by volunteers rather than facility staff, indicating a lack of structured programming. Interviews with residents and staff highlighted the inadequacy of the activity program. Residents expressed that activities were limited to Bingo and Bible study on Wednesdays, led by a volunteer, and desired more engaging options like movie nights and crafts. Staff interviews revealed that the Assistant Director of Nursing (ADON) was also responsible for activities, infection prevention, and MDS coordination, leading to a lack of focus on the activity program. The ADON admitted to being spread thin and unable to ensure activities were conducted as scheduled. Observations confirmed that activities like Movie Madness and Sit and Fit were not taking place as planned, and residents were often left without structured engagement. The facility's policy on activity programs emphasized the need for appropriately trained personnel to meet residents' needs, but this was not reflected in practice. The ADON's family member, who was not certified in activities, was previously responsible for leading activities but had transitioned to a night shift. The Director of Nursing (DON) acknowledged the lack of sufficient activities, noting that residents did not receive the socialization needed for their well-being. The failure to follow the activities calendar and provide meaningful engagement could lead to residents experiencing boredom and a decline in their quality of life.
Facility Fails to Address Resident Grievances Regarding Disruptive Behavior
Penalty
Summary
The facility failed to address grievances raised by a resident council concerning a disruptive resident who sang loudly and spat on the floor and occasionally on other residents during meals. This issue was brought up by three anonymous residents during a council meeting, who expressed that the disruptive behavior made it difficult to converse during meals and affected their appetites. Despite these complaints, the facility did not document any grievances related to this issue in the past six months, and the resident council minutes did not reflect these concerns. Interviews with staff members, including an LVN, CNA, ADM, ADON, and DON, revealed that the disruptive behavior of the resident was a known issue. Staff members acknowledged witnessing the resident's loud singing and spitting in the dining room. However, there was no consistent or effective intervention to address the behavior, and the grievances were not formally documented or resolved. The ADON and DON mentioned attempts to redirect the resident or move her to another table, but these actions were not part of a documented grievance process. The facility's policies on resident rights and grievance handling were not followed, as grievances were not recorded or investigated as required. The ADON and DON stated that residents are encouraged, but not required, to eat in the dining room, contradicting what was communicated to the residents. The failure to address the grievances and the lack of documentation indicate a breakdown in the facility's grievance process, leading to residents feeling unheard and unvalued.
Failure to Notify Family of Resident's COVID-19 Status and Room Change
Penalty
Summary
The facility failed to immediately inform a resident's family and physician of a significant change in the resident's condition, specifically a positive COVID-19 test and subsequent room change to isolation. The resident, an elderly male with severe cognitive impairment and multiple health conditions including dementia and chronic obstructive pulmonary disease, was not properly communicated with regarding his health status. The resident's family, who were listed as emergency contacts, were not notified of the positive COVID-19 test or the room change, despite the facility's policy requiring such notifications. Observations and interviews revealed that the resident was moved to an isolation room after testing positive for COVID-19, but his family was only informed of a fall incident, not the COVID-19 status or room change. Interviews with family members confirmed they were unaware of the resident's positive COVID-19 test and room change, although they had been informed of a previous fall. Staff interviews indicated that the charge nurse was responsible for notifying the family and documenting the notification, but this was not done in this case. The facility's policy mandates prompt notification of changes in a resident's condition to the resident, their physician, and their representative. However, the documentation review showed no record of such notifications being made. Staff members, including the LVN, CNA, ADM, and ADON, acknowledged the importance of notifying families about significant changes, but the required actions were not taken, leading to a deficiency in communication and documentation.
Failure to Involve Family in Care Planning
Penalty
Summary
The facility failed to ensure that the care plan for Resident #6 was prepared by an interdisciplinary team with the participation of the resident and their representative. Resident #6, a male with multiple diagnoses including acute bronchitis, type 2 diabetes, dementia, depression, heart disease, cerebral aneurysm, and chronic obstructive pulmonary disease, was admitted to the facility. The resident's significant change MDS indicated severely impaired cognition and a strong preference for family involvement in care discussions. Despite this, the facility did not invite Resident #6's family members to participate in the care plan meeting. Interviews with staff revealed that the Director of Nursing (DON) was responsible for inviting family members to care planning meetings. However, the DON admitted to not having proof of inviting Resident #6's family to the meeting and acknowledged that she "dropped the ball" in this instance. The DON mentioned having a conversation with Resident #6's family member A in August but could not provide evidence of sending an invitation. Other staff members, including the Assistant Director of Nursing (ADON) and a Licensed Vocational Nurse (LVN), emphasized the importance of family involvement in care planning to keep them informed and involved in the resident's care. The facility's policy on care planning and resident rights underscores the importance of involving residents and their families in care planning. The policy states that every effort should be made to schedule care plan meetings at convenient times for the resident and family. Despite these policies, the facility did not adhere to them in the case of Resident #6, as evidenced by the lack of documentation and communication with the family regarding the care plan meeting.
Medication Storage and Labeling Deficiencies
Penalty
Summary
The facility failed to ensure medications were stored and labeled according to accepted professional principles, as observed during a survey. Specifically, three medications were found loose in a medication cart, and two residents' insulin vials and packaging were not marked correctly with the date of opening. One insulin vial was marked with an open date and was still in use 55 days later, exceeding the 30-day usage guideline. Another insulin vial was found open without any date of opening marked on it or its packaging. These observations were confirmed by LVN A, who acknowledged the discrepancies in labeling and storage. Interviews with facility staff, including the Administrator, DON, and ADON, revealed a lack of clear policies and responsibilities regarding medication cart monitoring and medication administration. The night shift nurse was typically responsible for cleaning and stocking the medication cart, but there was no formal policy in place. The DON and ADON confirmed that insulin should be dated upon opening and discarded after 30 days, but this practice was not consistently followed. The facility's policy on medication storage was reviewed, but the Administrator was unable to provide a Medication Administration Policy before the survey exit.
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What surveyors actually found near you
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Amherst
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Arbor Grace Wellness Center | 8.3 mi | ★★★★★ | 15 | 0 |
| Runningwater Draw Care Center Inc | 19.8 mi | ★★★★★ | 6 | 0 |
| Park View Nursing Care Center | 23.7 mi | ★★★★★ | 24 | 2 |
| Levelland Nursing & Rehabilitation Center | 28.8 mi | ★★★★★ | 10 | 1 |
| Castro County Nursing & Rehabilitation | 37.2 mi | ★★★★★ | 2 | 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.