Not rated by CMS — ratings are suppressed for new or low-volume facilities.
The next survey window likely opens around November 2026
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 Apple Rehab Cromwell during CMS and state inspections, most recent first.
A resident with significant mobility deficits and a physician's order for two-person assistance during bed-level care was left vulnerable when a nurse aide provided care alone, as the care card did not specify the required assistance. This led to the resident falling from the bed and sustaining a head laceration requiring hospital treatment. The deficiency was due to the facility's failure to update documentation and ensure staff compliance with the prescribed level of assistance.
A resident with a history of stroke, Barrett's esophagus, and dysphagia, requiring pureed food with thickened liquids and 1 to 1 supervision for feeding, consumed fluid unsupervised. This led to aspiration and subsequent health complications, including hospitalization for aspiration pneumonia. Despite the facility's dysphagia policy, lapses in supervision and positioning allowed the resident access to liquids. Multiple staff members, including RNs, an SLP, and a COTA, were involved in the incident, highlighting the need for consistent adherence to supervision protocols.
The facility failed to follow proper infection control practices, including improper storage of bedpans for two residents, inadequate cleanliness in the laundry area, and an LPN not using appropriate hand hygiene and PPE during wound care for a resident with a deep tissue injury.
The facility failed to obtain and honor Advance Directives for three residents upon admission, leading to discrepancies between the residents' preferences and the physician orders. One resident had a DNR form without a physician's signature, another had an incomplete form due to a nurse's delay, and a third had an inconsistency between the admission note and the lack of a completed consent form.
A resident with cognitive impairments reported that a Nurse Aide (NA) yelled at and pointed her finger in the resident's face. Another staff member witnessed the incident, and the Director of Nursing Services (DNS) confirmed it could be classified as abuse. The facility's investigation supported the allegation of verbal harassment, and the NA received a written disciplinary action.
The facility failed to prevent a Nurse Aide from working during an investigation of mistreatment involving a resident with dementia and anxiety disorder. Despite the incident being reported to the Administrator, the Director of Nursing Services was not informed until several days later, allowing the Nurse Aide to continue working. This action was against the facility's policy, which mandates immediate suspension of the accused individual pending investigation.
The facility failed to report allegations of mistreatment and neglect involving two residents to the State Agency in a timely manner. One resident reported being yelled at and pointed at by a Nurse Aide, while another resident was left in a wet incontinent brief for several hours on two occasions. The incidents were not reported as required by facility policy.
A facility failed to promptly investigate an allegation of mistreatment involving a resident with cognitive impairments. The incident, where a nurse aide yelled at and pointed her finger at the resident, was reported to the Administrator but the investigation was delayed. The Director of Nursing Services acknowledged the delay and the facility's policy requiring immediate investigation was not followed.
The facility failed to properly transcribe and follow physician orders for two residents, leading to deficiencies in their care. One resident did not receive the correct wound treatment, and another did not receive required Braden Scale assessments and weekly body audits. Additionally, a third resident did not have their vital signs monitored as directed following the administration of the Influenza vaccine and a subsequent change in condition.
The facility failed to ensure proper pressure ulcer care and prevention for two residents. One resident did not receive required Braden scales and skin assessments, and another had a low air loss mattress set incorrectly due to lack of staff training. These deficiencies were confirmed through clinical record reviews and staff interviews.
The facility failed to ensure that a resident's monthly weight and reweight were obtained after a significant weight loss. Despite the Dietician's request for a reweight, it was not completed promptly, showing a lapse in adherence to the facility's weight monitoring policy.
A resident with acute respiratory failure and Covid-19 had their oxygen incorrectly set at 3 liters instead of the prescribed 2 liters. A Nurse Aide, unaware of her scope of practice, set the oxygen level, while the responsible LPN was occupied with other tasks. The Director of Nursing confirmed that only licensed staff should set oxygen levels.
The facility failed to ensure an LPN was trained on the proper setting of a low air loss mattress for a resident with pressure ulcers. The mattress was set incorrectly, potentially affecting the healing process, and the LPN admitted to not receiving the necessary training.
The facility failed to secure a controlled substance and a medication storage room. An unlocked controlled drug box containing Lorazepam was found, and the medication storage room door was propped open, leaving it unsecured. The facility's policy requiring double locking of controlled substances and secure storage of medications was not followed.
The facility failed to include and have available consultations from outside vendors in the paper or electronic chart for a resident with a right tibia fracture and other conditions. Staff interviews revealed that consults were kept in locked filing cabinets in the Rehabilitation room, inaccessible after hours, and the facility lacked a policy for outside vendor consultations.
The facility failed to post required information on how to file a complaint with the State Agency. A resident reported being unaware of the grievance process, and observations confirmed the absence of such postings. The Administrator could not provide a relevant policy and acknowledged the oversight.
The facility failed to maintain a safe, clean, and homelike environment, with issues such as a duct-taped call bell, a hole in the tile flooring, and a cluttered shower room. The Director of Maintenance was unaware of these problems, and environmental rounds had not been conducted since the Infection Control Nurse resigned.
Failure to Follow Two-Person Assist Order Results in Resident Fall and Injury
Penalty
Summary
A deficiency occurred when staff failed to follow a physician's order requiring two staff members to assist a resident with bed-level activities, including turning and incontinent care. The resident, who had a history of stroke with right-sided hemiplegia and hemiparesis, morbid obesity, aphasia, and was on anticoagulant therapy, was dependent on staff for all activities of daily living and was at risk for falls. Despite these needs, the resident's care card did not specify the required two-person assist for turning and repositioning, and a nurse aide provided care alone during the incident. During the event, the nurse aide turned the resident without assistance, resulting in the resident falling off the bed and sustaining a scalp laceration that required hospital treatment and staples. Documentation and interviews confirmed that the resident had consistently required two-person assistance due to body size and right-sided weakness, and that this requirement was supported by physician orders and assessments. However, the care card was not updated to reflect this, leading to the nurse aide's decision to provide care alone unless the resident exhibited increased behaviors. Facility policies required that the care card be updated to reflect changes in the resident's plan of care, including assistance needs for positioning. The failure to update the care card and ensure staff followed the physician's order for two-person assistance directly contributed to the resident's fall and injury during routine care.
Aspiration Risk Management and Supervision Lapse
Penalty
Summary
The report details a deficiency in a nursing home related to the failure to ensure that liquids were not accessible to a resident on aspiration precautions. Resident #71, who had a history of cerebrovascular accident (stroke) with left-sided paralysis, Barrett's esophagus, and dysphagia, was identified as being at risk for aspiration. Despite being on a diet of pureed food with thickened liquids and requiring 1 to 1 supervision for feeding, Resident #71 was found to have consumed fluid unsupervised, leading to aspiration and subsequent health complications. Multiple staff members, including RNs, a Speech Language Pathologist (SLP), and an Occupational Therapy Assistant (COTA), were involved in the incident on 12/6/23. The SLP noted that Resident #71 attempted to self-feed and had difficulty following instructions, leading to the need for continued 1 to 1 supervision with meals. Interviews with staff members revealed that Resident #71 was found holding a cup of liquid unsupervised, resulting in coughing, aspiration, and ultimately hospitalization for aspiration pneumonia and other related complications. Observations and interviews indicated that despite the resident's known risk for aspiration and the facility's dysphagia policy in place, lapses in supervision and positioning led to the accessibility of liquids to Resident #71.
Infection Control Deficiencies
Penalty
Summary
The facility failed to follow proper infection control practices in several instances. For Residents #22 and #65, disposable medical equipment such as bedpans were improperly stored uncovered in the shared bathroom, despite facility policy requiring them to be covered and stored in individual bags. This was observed both before and after the room was cleaned by housekeeping staff. Interviews with the residents and the Director of Nursing Services (DNS) confirmed the improper storage practices, which were not in line with the facility's policy on bedpan storage. In the laundry area, the facility did not maintain a clean environment. Observations identified a moderate to significant coating of white/gray debris on various surfaces, including a wall-mounted fan, ceiling fan paddles, pre-dispensing chemical boxes and tubing, and dryer tops. Interviews with the laundry and maintenance supervisors revealed that they were unaware of the debris buildup, despite cleaning schedules indicating that these areas were regularly cleaned. This discrepancy suggests a failure in the facility's cleaning protocols and oversight. For Resident #44, who had a deep tissue injury to the coccyx, the facility failed to use appropriate hand hygiene and personal protective equipment (PPE) during wound care. An LPN was observed removing a soiled dressing and cleansing the wound without changing gloves or performing hand hygiene before applying a clean dressing. The DNS confirmed that the LPN did not follow the facility's policy, which requires changing gloves and sanitizing hands between handling soiled and clean dressings.
Failure to Obtain and Honor Advance Directives
Penalty
Summary
The facility failed to obtain and honor Advance Directives for three residents upon admission, leading to discrepancies between the residents' preferences and the physician orders. Resident #69 had a written Advance Directive Form indicating Do Not Resuscitate (DNR) status, but the form lacked a physician's signature, and a physician's order directed staff to perform Cardiopulmonary Resuscitation (CPR). The Director of Nursing (DNS) could not explain the discrepancy between the resident's preference and the physician's order, despite the resident's care plan indicating adherence to the resident's and physician's directives. Resident #474, who was cognitively intact and required assistance for transfers and personal hygiene, had an incomplete medical intervention consent form. The admitting nurse, RN #2, did not complete the form within the required 24 hours, believing the resident should sign it in the presence of a family member. The DNS and RN #5 were aware of the incomplete form but could not explain why it was backdated when it was eventually completed. The facility's policy required the form to be completed and signed within 24 hours of admission. Resident #572, admitted with diagnoses including atrial fibrillation and congestive heart failure, had an inconsistency between the admission nurse's note indicating DNR status and the lack of a completed Medical Interventions Consent Form. RN #4 did not complete the admission paperwork during her shift and passed the responsibility to the next shift. The form was eventually completed after surveyor inquiry, but the initial failure to complete it led to the resident being considered a full code. The facility's policy required the advance directives to be reviewed and completed upon admission, with a physician's order obtained regarding the code status.
Failure to Protect Resident from Verbal Harassment
Penalty
Summary
The facility failed to ensure that Resident #13 was not treated in a scolding manner. Resident #13, who has diagnoses including adjustment disorder with mixed anxiety and depressed mood, unspecified dementia, and anxiety disorder, reported an incident where Nurse Aide (NA) #3 yelled at and pointed her finger in the resident's face. This incident was corroborated by another staff member, NA #2, who witnessed NA #3 standing over Resident #13, bending at her waist, pointing in the resident's face, and yelling. The Director of Nursing Services (DNS) confirmed that the incident could be classified as abuse due to the willful action and confrontation by NA #3. The Administrator, who was also a witness, intervened to get assistance for Resident #13 on the day of the incident. Further interviews and record reviews revealed that NA #3 confronted Resident #13 about allegedly telling others that she was not providing care. NA #3 admitted to questioning Resident #13 but denied shaking her hand at the resident. The DNS provided documentation indicating that NA #3 received a written disciplinary action, and the facility's investigation supported the allegation of verbal harassment. The facility's policy on residents' rights mandates that residents be treated with consideration, respect, and full recognition of their dignity and individuality, which was not upheld in this case.
Failure to Suspend Staff During Abuse Investigation
Penalty
Summary
The facility failed to prevent a Nurse Aide (NA #3) from working during an investigation of mistreatment involving a resident with adjustment disorder, unspecified dementia, and anxiety disorder. The incident occurred when NA #3 was reported to have yelled at the resident and pointed her finger in the resident's face. Despite the report being made to the Administrator on 2/22/24, the Director of Nursing Services (DNS) was not informed until 2/28/24, and NA #3 continued to work at the facility during this period. The facility's policy mandates immediate suspension of the accused individual pending investigation, which was not followed in this case. The investigation summary and staff interviews confirmed that NA #3 worked on 2/27/24 and 2/28/24, even though the incident was under investigation. The DNS acknowledged that the staffing schedule should have been adjusted to prevent NA #3 from working during the investigation. The Administrator, who witnessed the incident, failed to notify the DNS promptly, leading to a delay in the investigation and non-compliance with the facility's abuse policy.
Failure to Report Allegations of Mistreatment and Neglect
Penalty
Summary
The facility failed to report an allegation of mistreatment involving two residents to the State Agency in a timely manner. Resident #13, who has diagnoses including adjustment disorder with mixed anxiety and depressed mood, unspecified dementia, and anxiety disorder, reported an incident where a Nurse Aide (NA) yelled at and pointed a finger in their face. This incident was witnessed by another NA and reported to the Administrator, but the Director of Nursing Services (DNS) was not informed until several days later. The DNS acknowledged that the incident should have been reported to the State Agency within two hours of notification, but it was not reported until prompted by the surveyor's inquiry. Resident #40, who has diagnoses including polyneuropathy, epilepsy, and adjustment disorder, experienced neglect in their care. The resident was left in a wet incontinent brief for several hours on two separate occasions and voiced concerns about developing a urinary tract infection. The DNS was unaware of these complaints until informed by the State Agency surveyor. The facility's policy requires immediate investigation and reporting of such incidents, but no Reportable Event document had been completed for these complaints. The VP of Clinical Services indicated they were still gathering data before submitting the report to the State Agency.
Failure to Investigate Allegation of Mistreatment Timely
Penalty
Summary
The facility failed to complete a thorough investigation after an allegation of mistreatment involving a resident with diagnoses including adjustment disorder, dementia, and anxiety disorder. The resident, who was moderately cognitively impaired and required extensive assistance, reported during a Resident Council meeting that a nurse aide had yelled at and pointed her finger in the resident's face over a month ago. The facility's investigation summary confirmed that the incident was reported to the Administrator on the day it occurred, but the investigation was not initiated or conducted in a timely manner. The Director of Nursing Services (DNS) acknowledged that the investigation should have been started immediately but was only formally initiated several days later when the incident was brought to her attention. The facility's policy mandates that all allegations of abuse or mistreatment be thoroughly investigated and acted upon immediately. However, the investigation into the incident involving the resident and the nurse aide was delayed, with witness statements only being obtained several days after the incident. The DNS was unsure when the investigation was fully completed, indicating a lack of timely and thorough investigation as required by the facility's policy. The Administrator, who was a witness to the incident, did not notify the DNS or initiate an investigation promptly, further contributing to the deficiency.
Failure to Follow Physician Orders and Conduct Required Assessments
Penalty
Summary
The facility failed to properly transcribe and follow physician orders for two residents, leading to deficiencies in their care. Resident #30, who was admitted with cellulitis, MRSA, and other conditions, did not receive the correct wound treatment as per the physician's updated orders. The orders to cleanse the wounds with Normal Saline and apply Calcium Alginate were not transcribed, resulting in the resident continuing to receive an outdated treatment. Additionally, the clinical record did not reflect any wound measurements upon admission until ten days later, when the wound physician measured them. The Director of Nursing Services (DNS) acknowledged that the updated treatment orders were not distributed to the floor nurses, leading to the incorrect treatment being administered. Resident #65, who had a right tibia fracture and was at risk for skin breakdown, did not receive the required Braden Scale assessments and weekly body audits as per physician orders. The clinical record showed that only the initial assessments were completed, and no further assessments were documented. The responsible nurse confirmed that these assessments should have been completed weekly but were not. The facility's policies on Braden Scale and body audits were not followed, resulting in a lack of ongoing monitoring for skin integrity. Resident #71, who had a cerebrovascular accident and dysphagia, did not have their vital signs monitored as directed by the physician following the administration of the Influenza vaccine and a subsequent change in condition. The clinical record lacked documentation of temperature monitoring after the vaccine and hourly vital signs following a hypoxic event. The Regional Nurse confirmed the omission and stated that staff should follow the APRN's orders as directed. These failures in following physician orders and facility policies led to deficiencies in the care provided to the residents.
Deficiencies in Pressure Ulcer Care and Prevention
Penalty
Summary
The facility failed to ensure proper pressure ulcer care and prevention for two residents. Resident #31 was admitted with multiple diagnoses and was identified as being at mild risk for developing pressure ulcers. Despite physician orders and facility policy requiring weekly Braden scales and skin assessments, the clinical record lacked documentation for several scheduled assessments. Additionally, after the discovery of pressure ulcers on Resident #31's heels, a required Braden scale was not completed. Interviews with staff confirmed the absence of documentation and the failure to follow protocol after the onset of pressure ulcers. Resident #53, who had a history of cerebral vascular accident, dementia, and mitral valve insufficiency, was identified as being at moderate risk for pressure ulcers. A low air loss mattress was ordered for Resident #53 after the development of pressure ulcers. However, the mattress was not set according to the resident's weight, which could affect wound healing. The LPN responsible for setting the mattress was not trained on how to do so, and the incorrect setting was only discovered during an interview and observation with the Wound Physician. The Director of Nursing Services (DNS) confirmed that the low air loss mattress should be set according to the resident's weight and that the Charge Nurse is responsible for checking its function each shift. Despite the facility's policy and procedures, the lack of proper training and documentation led to deficiencies in pressure ulcer care for both residents.
Failure to Monitor Resident's Weight
Penalty
Summary
The facility failed to ensure that a monthly weight and reweight was obtained for Resident #53 after a significant weight loss. Resident #53, who had diagnoses including cerebral vascular accident, dementia, and mitral valve insufficiency, was weighed on 9/15/23 and not reweighed until 1/4/24. The resident was not weighed in February 2024. On 3/18/24, Resident #53 weighed 155 pounds, indicating a 21.5-pound loss since the previous weight on 1/4/24. Despite the Dietician's request for a reweight on 3/18/24, it was not completed promptly, and the resident had not been reweighed since then, showing a significant weight loss of 23.5 pounds over 87 days by 4/1/24. Interviews with the Dietician, Director of Nurses (DNS), and LPN #2 revealed that the facility's policy required reweights within 24 hours if there was a 5-pound discrepancy and monthly weights for residents. However, the policy was not followed, as Resident #53's weight from February was not completed, and the reweight requested on 3/18/24 was delayed. The Dietician expected a reweight the same day or the next day, but it was not done, indicating a lapse in the facility's adherence to its weight monitoring policy.
Failure to Administer Oxygen at Correct Setting
Penalty
Summary
The facility failed to administer oxygen at the correct setting for a resident with acute respiratory failure, Covid-19, and hypertension. The physician's order directed oxygen at 2 liters continuously to maintain oxygen saturation greater than 90%. However, observations on two separate occasions identified that the resident's oxygen was set at 3 liters instead of the prescribed 2 liters. The Treatment Administration Record indicated that the oxygen level had been checked and recorded as 2 liters, but this was not accurate according to the observations made by the surveyor. Interviews revealed that a Nurse Aide (NA) had set the oxygen level at 3 liters, unaware that this task was outside her scope of practice. The Licensed Practical Nurse (LPN) responsible for the resident's care admitted that she had not set the oxygen level that morning as she was busy with medication pass. The Director of Nursing confirmed that only licensed staff should set the oxygen levels for residents. The deficiency was identified when the surveyor observed the incorrect oxygen setting and confirmed it through interviews and record reviews.
Lack of Training on Low Air Loss Mattress Settings
Penalty
Summary
The facility failed to ensure that an LPN was trained on the proper setting of a low air loss mattress for a resident with pressure ulcers. The resident, who had a history of cerebral vascular accident, dementia, and mitral valve insufficiency, was identified as being at risk for developing pressure ulcers. Despite the care plan and treatment administration record specifying the use of a low air loss mattress and the need to check its function every shift, the LPN was observed to be unsure of how to set the mattress correctly. The mattress was set at 325, which was inappropriate for the resident's weight of 155 pounds, potentially affecting the healing of the pressure ulcers. The LPN admitted to not receiving training on setting the air mattress and had to rely on maintenance for assistance. The Wound Physician confirmed that the incorrect setting of the mattress could influence the healing process. The Director of Nursing stated that the training for setting the air mattress should have been part of the orientation process, but there was no documentation to confirm that the LPN had received this training. The deficiency was identified during an observation and interview with the Wound Physician and the LPN, highlighting a gap in the training and competency of the nursing staff in managing specialized equipment for residents at risk of pressure ulcers.
Failure to Secure Controlled Substances and Medication Storage Room
Penalty
Summary
The facility failed to properly secure a controlled substance and a medication storage room. During an observation of the East medication storage room, it was found that the controlled drug box inside the refrigerator was unlocked and contained an unopened bottle of Lorazepam, a schedule 4 controlled substance. Additionally, the padlock outside the refrigerator door was also found to be unlocked. The LPN present acknowledged the broken lock and stated that the Maintenance Department and the DNS had been notified, but no repairs had been made. The Director of Maintenance and the DNS both confirmed that they were unaware of the broken lock and that no maintenance request had been submitted. A review of the Facility Work Request Log did not show any documentation of the broken lock for maintenance to address. The facility's policy requires controlled substances stored in the refrigerator to be double locked, which was not adhered to in this case. Further observations revealed that the East medication storage room door was propped open with a garbage can, leaving it unsecured. This occurred while three visitors and four residents were in close proximity to the medication room, with no facility staff present in the area at that time. An LPN later admitted to propping the door open to quickly access supplies for a resident who had removed a dressing. The DNS confirmed that the medication storage room should have been secured and not left open. The facility's policy mandates that all medications and biologicals be securely stored in a locked cabinet, cart, or medication room, which was not followed in this instance.
Failure to Include and Access Orthopedic Consultations
Penalty
Summary
The facility failed to include and have available consultations from outside vendors in the paper or electronic chart for Resident #65, who had a right tibia fracture, history of falls, type 2 diabetes mellitus, and chronic kidney disease. The admission Minimum Data Set (MDS) assessment identified that Resident #65 was cognitively intact and required substantial assistance for bed mobility, was dependent for transfers, and required moderate assistance for personal hygiene. The Resident Care Plan indicated the need for follow-up with the orthopedic physician and other interventions. However, the clinical record did not contain any documentation or notes from the orthopedic provider that Resident #65 had seen. Interviews with staff revealed that orthopedic consults were not filed in the resident's chart and were instead kept in the Rehabilitation room's filing cabinets, which were locked and inaccessible after hours. The facility did not have a policy for outside vendor consultations, and staff could not access the consult sheets after therapy staff had left for the day. This lack of access to critical medical information could hinder the continuity of care for residents like Resident #65, who had multiple outside orthopedic appointments that were not documented in the clinical record.
Failure to Post Complaint Filing Information
Penalty
Summary
The facility failed to ensure the required information related to contact information and how to file a complaint to the State Agency was posted in the facility. During a Resident Council meeting, a resident stated they were not aware of how to file a grievance or make a complaint and had not observed any information within the facility to guide them. Subsequent observations on all units confirmed the absence of the required postings. The Administrator was unable to provide a policy for making residents aware of how to contact the State Agency and acknowledged the failure to post the necessary information.
Facility Fails to Maintain Safe and Homelike Environment
Penalty
Summary
The facility failed to ensure a safe, clean, comfortable, and homelike environment for its residents. During an initial tour, it was observed that a resident's call bell was duct-taped to the wall, a room had a significant hole in the tile flooring, and the shower room used by 24 residents was cluttered with wooden pallets and boxes of supplies. The Director of Maintenance was unaware of these issues, indicating a lack of communication and oversight in maintaining the facility's environment. Additionally, environmental rounds had not been conducted since the Infection Control Nurse resigned over a month ago, further contributing to the oversight. Upon re-inspection, it was found that the North Unit shower room was leaking into an adjacent conference room, with missing grout and caulking in the tile joints. The Director of Maintenance acknowledged these issues and stated that they would be addressed promptly. The facility failed to provide an environmental condition and/or repair policy when requested, highlighting a gap in their procedural documentation and maintenance practices.
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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 Cromwell
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Pilgrim Manor | 2.8 mi | — | 0 | 0 |
| Ledgecrest Health Care Center | 3.4 mi | — | 4 | 0 |
| Autumn Lake Healthcare At Cromwell | 3.4 mi | — | 0 | 0 |
| Wadsworth Glen Health Care And Rehabilitation Cent | 4.1 mi | — | 0 | 0 |
| Civita Care Center At Newington | 4.3 mi | — | 39 | 1 |
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