Not rated by CMS — ratings are suppressed for new or low-volume facilities.
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 Estrella Health And Rehabilitation Center during CMS and state inspections, most recent first.
Two residents received medications outside physician-ordered parameters, resulting in drug regimens that were not free from unnecessary drugs. One resident with multiple comorbidities and intact cognition had PRN oxycodone ordered with specific tablet counts tied to pain-scale ranges, yet MARs showed repeated administrations of 2- and 3-tablet doses when documented pain scores fell outside the ordered ranges. Another resident with encephalopathy, respiratory failure, pneumonia, diabetes, and hypertension had midodrine ordered every 8 hours for hypotension with instructions to hold the dose if SBP exceeded 110, but MARs over several months showed the drug was given multiple times when SBP readings were above that threshold. In interviews, RNs, LPNs, and the DON confirmed that these administrations did not follow the written physician parameters, despite facility policies requiring medications to be given only as ordered and in clinically indicated doses and durations.
The facility failed to maintain comfortable water and food temperatures, impacting residents' well-being. Several residents reported no hot water, affecting their ability to shower, while others noted cold food and coffee. A dietary manager confirmed food temperatures were below expected levels. The facility experienced a water backup, and ongoing kitchen remodeling was noted. Despite these issues, the director of nursing and executive director were unaware of plumbing problems.
The facility failed to ensure proper food storage, labeling, and handling practices. Observations revealed expired and improperly sealed food items in the refrigerator, freezer, and dry storage. Additionally, the cook used improper sanitizing methods and handled food without gloves, leading to potential foodborne illness risks.
Failure to Follow Physician-Ordered Medication Parameters for Pain and Hypotension
Penalty
Summary
The deficiency involves the facility’s failure to ensure medications were administered in accordance with physician‑ordered parameters, resulting in drug regimens that were not free from unnecessary drugs for two residents. For one resident with diagnoses including atherosclerotic heart disease, shoulder pain, type II diabetes, depression, muscle weakness, and a complete rotator cuff tear, the physician ordered oxycodone 5 mg with specific PRN dosing tied to a pain scale: 1 tablet every 4 hours as needed for mild pain (1–3), 2 tablets every 4 hours as needed for moderate pain (4–7), and 3 tablets every 4 hours as needed for severe pain (8–10). The resident’s care plan directed staff to administer the opioid as prescribed, and the resident’s MDS showed intact cognition with a BIMS score of 14. Despite these clear parameters, MAR reviews for November and December showed repeated administrations of oxycodone that did not match the ordered pain‑score ranges. For this resident, the November MAR documented that the 2‑tablet oxycodone dose for moderate pain (4–7) was given when the recorded pain level was 8 on one occasion and 3 on another, both outside the ordered range. The 3‑tablet oxycodone dose for severe pain (8–10) was administered multiple times when the documented pain level was below 8, including pain scores of 7, 6, and even 1. These out‑of‑parameter administrations occurred on numerous dates throughout November, and continued into December, when the 3‑tablet dose was again given for pain scores of 6 and 7 instead of the ordered 8–10 range. In interviews, an LPN who administered medications reviewed the record and confirmed that the oxycodone doses had been given outside the ordered parameters on multiple occasions, and stated that pain levels documented on the MAR reflected the resident’s pain before medication administration. The DON also reviewed the MARs, confirmed that the oxycodone orders were not followed on multiple dates in November and December, and acknowledged that physician orders were not followed, characterizing the issue as a documentation error. The second resident involved had diagnoses including encephalopathy, respiratory failure with hypoxia, pneumonia, type 2 diabetes, essential hypertension, cognitive communication deficit, and a need for assistance with personal care, and had a BIMS score of 13 indicating intact cognition. A physician order dated in December directed that midodrine 10 mg be given by mouth every 8 hours for hypotension, with a specific parameter to hold the medication if the systolic blood pressure (SBP) was greater than 110. Review of the MARs for January through April showed that midodrine was administered multiple times when the recorded SBP exceeded 110, including readings such as 112/73, 120/69, 132/68, 142/69, and other values above the ordered hold parameter. These administrations were carried out by multiple RNs and LPNs across morning, midday, and evening medication passes. In interviews, nursing staff described the facility policy as requiring adherence to physician‑ordered parameters and contacting the provider when parameters were outside the administration window, and acknowledged that giving medications outside those parameters constituted a medication error. The DON reviewed the March MAR and confirmed that the midodrine order parameters were not followed and that the physician’s orders were not adhered to. Facility policies titled "Physicians Orders," "Administration of Drugs," and "Unnecessary Drugs" stated that drugs are to be administered only upon the order of a licensed prescriber, that medications must be administered in accordance with written physician orders, and that residents are to receive only those medications, in doses and for durations clinically indicated to treat assessed conditions. The documented practice for both residents, as evidenced by MAR reviews and staff and DON interviews, showed that medications were repeatedly administered outside the specific parameters set by the prescribing physicians, contrary to these policies.
Deficiencies in Water and Food Temperature Management
Penalty
Summary
The facility failed to maintain comfortable water temperatures and safe food temperatures, which could negatively impact residents' psychosocial well-being. Multiple residents reported the absence of hot water in their bathrooms, affecting their ability to shower. One resident mentioned not having a shower since September 30 due to the lack of hot water. Another resident's family member confirmed the absence of hot water, and a CNA acknowledged the ongoing water issues, particularly during the evening. Additionally, the facility experienced a water backup, and a plumber was working on the issue. The director of nursing and executive director were unaware of any plumbing issues, despite ongoing kitchen remodeling and pipe replacement. Residents also reported that their food, including soup and coffee, was served cold. A dietary manager confirmed that the food temperatures were below the expected level when reaching residents. The facility's policy on resident rights emphasizes the importance of treating residents with dignity and respect, which was compromised by these deficiencies. Observations included bathroom flooding and missing shower sheets for a resident, further indicating systemic issues with facility maintenance and resident care.
Improper Food Storage and Handling Practices
Penalty
Summary
The facility failed to ensure that food items were stored, labeled, and dated in accordance with professional standards for food service safety. During an initial kitchen observation, several food items in the refrigerator were found to be beyond their use-by dates, including grape jelly, mustard, and a package of impossible burgers that was also not sealed. Additionally, the refrigerator contained an open container of potato salad and a metal serving pan with caked grease containing cooked hotdogs in water, partially covered with plastic wrap. The freezer had open and unsealed bags of frozen green beans, impossible patties, and ground beef patties. The dry storage area had an open and unsealed package of Jet Puff Marshmallows. These deficiencies could result in food-borne related illnesses due to improper storage and handling of food items. Further observations revealed improper food handling practices by the cook. The cook was seen cleaning the meat preparation station with a cloth from a sanitizing bucket that contained pieces of raw ground beef and then using the same cloth to clean the station again. During the preparation of pureed macaroni and cheese, the cook used his ungloved hand to scoop cheese sauce and touched the cooked macaroni, then wiped his hands on his apron. The dietary supervisor had to repeatedly instruct the cook to blend the macaroni and cheese to the correct consistency and to use milk instead of chicken stock. After the preparation, the cook used the same contaminated cloth to clean the puree preparation surface until the dietary supervisor intervened. The dietary supervisor acknowledged the risks associated with improper sanitizing concentration and improper food storage, labeling, and dating practices, which could lead to foodborne illnesses such as E-Coli.
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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 Avondale
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Palm Valley Post Acute | 1.3 mi | — | 4 | 0 |
| Sun Health La Loma Care Center | 4.5 mi | — | 1 | 0 |
| Northpark Health And Rehabilitation Of Cascadia | 5.4 mi | — | 3 | 0 |
| Diamondback Healthcare Center | 5.7 mi | — | 6 | 0 |
| Az - Rio Vista Post Acute And Rehabilitation | 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 August 2026) and official state health department websites.