All citations for Breakwater Commons

State inspectors check nursing homes that take Medicare or Medicaid against federal rules, usually about once a year, and also look into complaints. Each rule a home did not meet is a citation.

Back to Breakwater Commons

Last standard health inspection on record

April 9, 2026

Showing 1 to 25 of 32 citations

No harm, with potential for more than minimal harm
Develop and maintain an Emergency Preparedness Program (EP).
Widespread (many residents). CMS level F.
Emergency preparedness citation E-0004, Emergency Preparedness Deficiencies. Inspection of April 9, 2026. Found during a standard inspection.
The home gave a date the problem would be corrected (April 15, 2026).
No harm, with potential for more than minimal harm
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Widespread (many residents). CMS level F.
Fire safety citation K-0761, Miscellaneous Deficiencies. Inspection of April 9, 2026. Found during a standard inspection.
The home gave a date the problem would be corrected (April 24, 2026).
No harm, with potential for more than minimal harm
Conduct testing and exercise requirements.
Widespread (many residents). CMS level F.
Emergency preparedness citation E-0039, Emergency Preparedness Deficiencies. Inspection of January 23, 2025. Found during a standard inspection.
The home gave a date the problem would be corrected (February 26, 2025).
No harm, with potential for more than minimal harm
Have simulated fire drills held at unexpected times.
Widespread (many residents). CMS level F.
Fire safety citation K-0712, Miscellaneous Deficiencies. Inspection of January 23, 2025. Found during a standard inspection.
The home gave a date the problem would be corrected (February 14, 2025).
No harm, with potential for more than minimal harm
Conduct risk assessment and an All-Hazards approach.
Widespread (many residents). CMS level F.
Emergency preparedness citation E-0006, Emergency Preparedness Deficiencies. Inspection of November 1, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (December 15, 2023).
No harm, with potential for more than minimal harm
Establish policies and procedures for sheltering.
Widespread (many residents). CMS level F.
Emergency preparedness citation E-0022, Emergency Preparedness Deficiencies. Inspection of November 1, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (December 15, 2023).
No harm, with potential for more than minimal harm
Establish methods for sharing information.
Widespread (many residents). CMS level F.
Emergency preparedness citation E-0033, Emergency Preparedness Deficiencies. Inspection of November 1, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (December 15, 2023).
No harm, with potential for more than minimal harm
Establish emergency prep training and testing.
Widespread (many residents). CMS level F.
Emergency preparedness citation E-0036, Emergency Preparedness Deficiencies. Inspection of November 1, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (December 15, 2023).
No harm, with potential for more than minimal harm
Establish staff and initial training requirements.
Widespread (many residents). CMS level F.
Emergency preparedness citation E-0037, Emergency Preparedness Deficiencies. Inspection of November 1, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (December 15, 2023).
No harm, with potential for more than minimal harm
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Widespread (many residents). CMS level F.
Fire safety citation K-0321, Smoke Deficiencies. Inspection of November 1, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (December 22, 2023).
No harm, with potential for more than minimal harm
Have generator or other power source capable of supplying service within 10 seconds.
Widespread (many residents). CMS level F.
Fire safety citation K-0918, Gas, Vacuum, and Electrical Systems Deficiencies. Inspection of November 1, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (December 15, 2023).
No harm, with potential for more than minimal harm
Have proper medical gas storage and administration areas.
Widespread (many residents). CMS level F.
Fire safety citation K-0923, Gas, Vacuum, and Electrical Systems Deficiencies. Inspection of November 1, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (December 15, 2023).
No harm, with potential for more than minimal harm
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Isolated (one or a few residents). CMS level D.
Fire safety citation K-0211, Egress Deficiencies. Inspection of April 9, 2026. Found during a standard inspection.
The home gave a date the problem would be corrected (April 24, 2026).
No harm, with potential for more than minimal harm
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
Isolated (one or a few residents). CMS level D.
Fire safety citation K-0222, Egress Deficiencies. Inspection of April 9, 2026. Found during a standard inspection.
The home gave a date the problem would be corrected (April 24, 2026).
No harm, with potential for more than minimal harm
Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.
Isolated (one or a few residents). CMS level D.
Fire safety citation K-0223, Egress Deficiencies. Inspection of April 9, 2026. Found during a standard inspection.
The home gave a date the problem would be corrected (April 17, 2026).
No harm, with potential for more than minimal harm
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Isolated (one or a few residents). CMS level D.
Fire safety citation K-0321, Smoke Deficiencies. Inspection of April 9, 2026. Found during a standard inspection.
The home gave a date the problem would be corrected (April 15, 2026).
No harm, with potential for more than minimal harm
Inspect, test, and maintain automatic sprinkler systems.
Isolated (one or a few residents). CMS level D.
Fire safety citation K-0353, Smoke Deficiencies. Inspection of April 9, 2026. Found during a standard inspection.
The home gave a date the problem would be corrected (April 13, 2026).
No harm, with potential for more than minimal harm
Install corridor and hallway doors that block smoke.
Isolated (one or a few residents). CMS level D.
Fire safety citation K-0363, Smoke Deficiencies. Inspection of April 9, 2026. Found during a standard inspection.
The home gave a date the problem would be corrected (April 15, 2026).
No harm, with potential for more than minimal harm
Have properly installed electrical wiring and gas equipment.
Isolated (one or a few residents). CMS level D.
Fire safety citation K-0511, Services Deficiencies. Inspection of April 9, 2026. Found during a standard inspection.
The home gave a date the problem would be corrected (April 17, 2026).
No harm, with potential for more than minimal harm
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
Isolated (one or a few residents). CMS level D.
Fire safety citation K-0222, Egress Deficiencies. Inspection of January 23, 2025. Found during a standard inspection.
The home gave a date the problem would be corrected (January 22, 2025).
No harm, with potential for more than minimal harm
Install an approved automatic sprinkler system.
Isolated (one or a few residents). CMS level D.
Fire safety citation K-0351, Smoke Deficiencies. Inspection of January 23, 2025. Found during a standard inspection.
The home gave a date the problem would be corrected (February 6, 2025).
No harm, with potential for more than minimal harm
Ensure proper usage of power strips and extension cords.
Isolated (one or a few residents). CMS level D.
Fire safety citation K-0920, Gas, Vacuum, and Electrical Systems Deficiencies. Inspection of January 23, 2025. Found during a standard inspection.
The home gave a date the problem would be corrected (January 21, 2025).
No harm, with potential for more than minimal harm
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Isolated (one or a few residents). CMS level D.
Fire safety citation K-0211, Egress Deficiencies. Inspection of November 1, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (December 15, 2023).
No harm, with potential for more than minimal harm
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
Isolated (one or a few residents). CMS level D.
Fire safety citation K-0222, Egress Deficiencies. Inspection of November 1, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (December 22, 2023).
No harm, with potential for more than minimal harm
Install an approved automatic sprinkler system.
Isolated (one or a few residents). CMS level D.
Fire safety citation K-0351, Smoke Deficiencies. Inspection of November 1, 2023. Found during a standard inspection.
The home gave a date the problem would be corrected (December 15, 2023).

Source: CMS Provider Information, Fire Safety Deficiencies, Health Deficiencies, Citation Code Look-up, data as of September 30, 2026. Inspection results describe the home at the time of each inspection.