Not rated by CMS — ratings are suppressed for new or low-volume facilities.
A standard survey is most likely before 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 Clermont Health And Rehabilitation Center during CMS and state inspections, most recent first.
Several residents did not receive their prescribed long-acting insulin or hypotensive medications as ordered, with LPNs documenting that doses were held or not required without physician parameters or proper documentation. Staff interviews revealed confusion about medication administration protocols, and nursing progress notes lacked explanations for withheld medications. The DON confirmed that staff did not follow physician orders, and medical records did not justify the omissions.
A resident receiving tube feeding was observed lying flat in bed while the feeding pump was running, despite physician orders and the care plan requiring head of bed elevation during feeding. Nursing staff confirmed the need for at least a 30-degree elevation, and the DON reported the facility lacked a formal tube feeding policy.
A physician did not document the rationale for disagreeing with a pharmacist's recommendation to discontinue several PRN medications for a resident, leaving the rationale section blank on the pharmacy review form. The DON and physician confirmed that while rationales are usually provided, time constraints led to the omission in this case.
A resident with diabetes had multiple elevated blood sugar readings requiring PRN glipizide, but the MAR lacked documentation of administration or refusal on numerous occasions. Nursing staff reported confusion about where to document PRN medication, and the DON confirmed this issue. The facility's policy required immediate and accurate documentation, which was not consistently followed.
A resident with MRSA receiving IV antibiotics was not placed on contact precautions, and staff failed to use appropriate PPE or perform hand hygiene during care. Staff entered the room, provided direct care, and performed invasive procedures without donning gowns or gloves, and there was no isolation signage posted, despite facility policy and physician orders requiring these precautions.
The facility failed to ensure the accuracy of the MDS for two residents who were discharged. One resident's discharge was incorrectly documented as to a short-term general hospital instead of the community, and another resident's discharge was incorrectly documented as unplanned instead of planned.
The facility failed to ensure two residents received oxygen as per physician orders. One resident received oxygen at 3 LPM instead of the ordered 2 LPM, and another received oxygen at 4 LPM instead of the ordered 2 LPM. Both residents relied on nurses to manage their oxygen levels, and the DON confirmed the discrepancies.
The facility failed to ensure a safe and homelike environment in two residential units, with issues such as separated baseboard molding, broken floor strips, and a broken windowsill tile. Additionally, a spill in a resident hallway was not immediately addressed by staff, posing safety risks. Interviews confirmed the urgency of these repairs and the expectation for staff to address safety concerns promptly.
The facility failed to provide appropriate urinary catheter care for a resident with a suprapubic catheter. Observations revealed that the catheter tubing was looped and resting on the floor, preventing urine from draining into the catheter bag, which was also found resting in a basin with fluid. Staff members acknowledged improper handling of the catheter tubing and drainage bag, and the facility lacked a specific policy for catheter care.
The facility failed to store foods safely and sanitarily in the main kitchen. Unlabeled and undated food items, including 2.5-gallon buckets of yellowish liquid, a steam pan with a purple jelly-like substance, and an opened bag of plant-based chicken nuggets, were found in the walk-in cooler. The Certified Dietary Manager confirmed these items should have been labeled and dated according to facility policy.
The facility failed to ensure staff performed hand hygiene during medication administration and did not follow infection control standards for administering subcutaneous medications. An RN prepared and administered oral medications to a resident without performing hand hygiene and administered an insulin injection to another resident without cleaning the skin with an alcohol wipe. The DON confirmed that staff should wash their hands before and after every patient interaction.
Failure to Administer Medications as Ordered and Inadequate Documentation
Penalty
Summary
The facility failed to ensure that insulin and hypotensive medications were administered according to physician orders for multiple residents. For several residents with diabetes mellitus, long-acting insulin was not administered as ordered, with staff documenting codes indicating the medication was not required or was held, despite the absence of physician parameters allowing for such actions. Medication Administration Records (MARs) showed repeated instances where insulin doses were omitted, and nursing progress notes lacked documentation explaining the rationale for withholding the medication. Interviews with LPNs revealed a misunderstanding of when to hold long-acting insulin, with some staff stating they used their own judgment or believed parameters existed when they did not. The Director of Nursing confirmed that there were no orders to hold the long-acting insulin, and the expectation was for staff to follow physician orders. In addition to the insulin administration issues, the facility failed to administer midodrine, a medication for hypotension, as ordered for a resident with low systolic blood pressure. Despite multiple documented instances of systolic blood pressure readings below the physician-ordered threshold, the medication was not given. Staff interviews indicated confusion regarding the parameters for administering midodrine, with one LPN stating they focused on diastolic rather than systolic blood pressure and referencing facility in-service training that may have contributed to the misunderstanding. The DON acknowledged that the nurse involved was confused about the correct parameters and that staff are expected to follow provider orders. Across all cases, there was a lack of appropriate documentation in the medical records to justify withholding medications, and staff interviews consistently revealed gaps in knowledge or misinterpretation of physician orders. The deficiencies were identified through review of physician orders, MARs, nursing progress notes, and staff and physician interviews, all of which confirmed that medications were not administered as prescribed and that documentation and communication with providers were insufficient.
Failure to Maintain Proper Positioning During Tube Feeding
Penalty
Summary
A deficiency was identified when a resident receiving enteral nutrition via a PEG tube was observed lying flat in bed with the tube feeding pump running, contrary to physician orders and the resident's care plan, which required the head of bed to be elevated during feeding and medication administration. The resident's physician order specified that the head of bed should be elevated while feeding to prevent complications, and the care plan included the same intervention. During interviews, nursing staff confirmed that the head of bed should be at least at a 30-degree angle during tube feeding. Additionally, when asked, the Director of Nursing stated that the facility did not have a formal policy on tube feeding, only a standard practice.
Physician Failed to Document Rationale for Disagreement with Pharmacist Recommendations
Penalty
Summary
The facility failed to ensure that the physician documented the rationale for disagreeing with the pharmacist's recommendations regarding the discontinuation of several PRN medications for one resident. During a monthly drug regimen review, the pharmacist recommended discontinuing multiple PRN medications due to non-use, but the physician responded with 'Disagree' and left the rationale section blank. The document was signed by the physician without any explanation for the disagreement. Interviews with the Director of Nursing and the physician confirmed that pharmacy reviews are conducted monthly, and while the physician typically writes a rationale for disagreements, in this instance, no rationale was provided due to time constraints.
Incomplete Documentation of PRN Antidiabetic Medication Administration
Penalty
Summary
The facility failed to ensure that medical records for a resident receiving antidiabetic medication were complete and accurate. Physician orders required blood sugar monitoring every 12 hours and administration of glipizide as needed when blood sugar exceeded 180. Review of the resident's Medication Administration Records (MAR) for two consecutive months showed multiple instances where blood sugar readings were above the threshold, but there was no documentation of glipizide administration or refusal. Interviews with nursing staff revealed confusion regarding where to document the administration of PRN glipizide, with some staff indicating they may have documented in the wrong area or could not recall specific events. The Director of Nursing acknowledged this confusion among staff regarding documentation procedures for PRN medications. The resident in question had a history of diabetes mellitus and was described as frequently non-compliant with her antidiabetic medication, often refusing both oral and injectable treatments. Despite this, the facility's policy required immediate and accurate documentation of all medication administrations, including PRN medications, specifying the need to record the date, time, dose, and route. The lack of documentation on the MAR for multiple dates where blood sugar was elevated and glipizide should have been administered or refused constituted a failure to maintain complete and accurate medical records in accordance with professional standards.
Failure to Implement Contact Precautions and PPE Use for Resident with MRSA
Penalty
Summary
The facility failed to implement appropriate infection prevention and control measures for a resident diagnosed with MRSA who was receiving IV antibiotics. Despite physician orders and care plan interventions specifying contact precautions and enhanced barrier precautions, staff did not consistently use required personal protective equipment (PPE) such as gowns and gloves, nor did they perform hand hygiene when entering the resident's room or providing care. Observations revealed that staff entered the resident's room, delivered meals, assisted with positioning, took vital signs, administered medications, and performed dressing changes without donning PPE or performing hand hygiene. There was also no contact isolation signage on the resident's door, and staff were unaware or misinformed about the resident's isolation status. The resident, who had a history of COPD, asthma, respiratory failure, and was on oxygen and fluid restriction, reported to surveyors that staff did not wear gowns or other protective equipment when assisting her. Staff interviews confirmed a lack of understanding regarding the need for contact precautions. Facility policy required gloves and gowns for contact precaution rooms, but this was not followed in practice, as evidenced by multiple staff failing to use PPE and perform hand hygiene during direct care activities, including invasive procedures such as IV site dressing changes and line flushing.
Inaccurate MDS Documentation for Discharged Residents
Penalty
Summary
The facility failed to ensure the accuracy of the Minimum Data Set (MDS) for two residents who were discharged. For Resident #174, the records indicated a discharge to a short-term general hospital, but the MDS Director confirmed that the discharge should have been documented as to the community. Similarly, for Resident #175, the records showed an unplanned discharge, but the MDS Director stated that it should have been documented as a planned discharge. These inaccuracies were identified during interviews with the MDS Director and through a review of the residents' records.
Failure to Administer Oxygen Per Physician Orders
Penalty
Summary
The facility failed to ensure residents received oxygen as per physician orders for two residents. Resident #139 was observed receiving oxygen at 3 liters per minute (LPM) on two separate occasions, despite a physician order specifying oxygen at 2 LPM as needed for shortness of breath. The resident confirmed that the nurse adjusts the oxygen, and the Director of Nursing (DON) verified the discrepancy between the physician order and the administered oxygen level. Similarly, Resident #154 was observed receiving oxygen at 4 LPM on two separate occasions, contrary to a physician order for oxygen at 2 LPM as needed for shortness of breath. The resident was unaware of the correct oxygen level and relied on the nurses to manage it. The DON confirmed the oxygen concentrator was set incorrectly and verified the physician order. The facility's policy on oxygen therapy, which mandates verifying physician orders and applying the correct liter flow, was not followed.
Failure to Maintain Safe and Homelike Environment
Penalty
Summary
The facility failed to ensure a safe and homelike environment for residents in two of the three residential units, specifically the 200 and 300 Units. Observations revealed several maintenance issues, including separated rubber baseboard molding, broken rubber transition floor strips, and a broken stone tile on a windowsill. These issues were noted in the rooms of multiple residents, including one resident whose bed was improperly positioned against a wall with a broken windowsill tile, posing a safety hazard. Interviews with the Maintenance Director and a Registered Nurse confirmed the urgency of these repairs, highlighting the potential risks to residents' safety. Additionally, a puddle of brown liquid was observed on the floor in a resident hallway near the elevator, with two residents in wheelchairs nearby. A Dietary Aide noticed the spill but did not take immediate action to address it, instead planning to report it later. The Assistant Administrator emphasized that staff are expected to address such safety concerns immediately. The facility's Physical Plant Resource Guide outlines procedures for reporting and prioritizing maintenance issues, but the observed deficiencies indicate a failure to adhere to these protocols, compromising resident safety and the homelike environment.
Failure to Provide Appropriate Urinary Catheter Care
Penalty
Summary
The facility failed to ensure appropriate urinary catheter care for Resident #165, who was admitted with diagnoses including urinary tract infection, type 2 diabetes mellitus, hydronephrosis, and neuromuscular dysfunction of the bladder. The resident's care plan specified that the suprapubic catheter should be kept free of kinks and the drainage bag should be kept below the level of the bladder. However, multiple observations revealed that the urinary catheter tubing was looped and resting on the floor, preventing urine from draining into the catheter bag. Additionally, the catheter bag was found resting in a basin with fluid, indicating improper handling and potential contamination risk. During interviews, staff members, including a Registered Nurse (RN) and the Director of Nursing (DON), acknowledged the improper handling of the catheter tubing and drainage bag. The RN admitted to lifting the catheter tubing above the resident's bladder to facilitate drainage, which is against standard practice. The DON also lifted the drainage bag above the resident's bladder to inspect it, further confirming the improper handling. The DON admitted that the facility did not have a specific policy and procedure for catheter care, relying instead on standard practice guidelines. These actions and inactions led to the deficiency in providing appropriate catheter care for Resident #165.
Failure to Store Food Safely and Sanitarily
Penalty
Summary
The facility failed to ensure foods were stored in a safe and sanitary manner in the main kitchen. During a tour of the main kitchen, two unlabeled and undated 2.5-gallon buckets of yellowish liquid were found on the second shelf of the main walk-in cooler. Additionally, a 4-inch steam pan with a purple jelly-like substance, which had no label and an expiration date of 4/23/2024, was observed on the same shelf. An opened and undated bag of plant-based chicken nuggets was also found on the third shelf of the walk-in cooler. The Certified Dietary Manager (CDM) confirmed the presence of these unlabeled and undated food items and acknowledged that all items should have labels and expiration date stickers before storage. The facility's policy, effective January 2023, mandates labeling all leftovers with the recipe name, date of storage, and use-by date, and discarding refrigerated leftovers after 72 hours.
Failure to Perform Hand Hygiene and Follow Infection Control Standards
Penalty
Summary
The facility failed to ensure staff performed hand hygiene during medication administration and did not follow infection control standards for administering subcutaneous medications. During an observation, a Registered Nurse (RN) prepared and administered oral medications to a resident without performing hand hygiene. The RN acknowledged the lapse in hand hygiene during an interview. Additionally, the same RN administered an insulin injection to another resident without performing hand hygiene before donning gloves and without cleaning the skin with an alcohol wipe prior to the injection. The RN admitted to not using an alcohol wipe and not performing hand hygiene before administering the medication. The Director of Nursing (DON) confirmed that staff should wash their hands before and after every patient interaction, either with soap and water or hand sanitizer. The facility's policies on medication administration and hand hygiene, last reviewed on 1/5/2024, emphasize the importance of hand hygiene and the use of antimicrobial agents for both medication products and residents' skin. The policies outline specific steps for hand hygiene and the administration of subcutaneous medications, which were not followed by the RN in the observed instances.
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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 Clermont
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Lakes Of Clermont Health And Rehabilitation Center | 1.9 mi | — | 5 | 0 |
| Skytop View Rehabilitation Center | 2.4 mi | — | 1 | 0 |
| Aviata At Colonial Lakes | 8.4 mi | — | 5 | 0 |
| Health Central Park | 10.5 mi | — | 0 | 0 |
| Winter Garden Rehabilitation And Nursing Center | 11.2 mi | — | 4 | 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.