All citations for Royal Oaks Nursing and Rehabilitation Center

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 Royal Oaks Nursing and Rehabilitation Center

Last standard health inspection on record

May 20, 2025

Showing 1 to 25 of 99 citations

  1. Immediate jeopardy to resident health or safety

    Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

    Pattern (more than a few residents). CMS level K.

    Health citation F-0725, Nursing and Physician Services Deficiencies. Inspection of October 22, 2025. Found during a complaint inspection.

    Past non-compliance: already corrected by the time of the inspection (October 9, 2025).

  2. Immediate jeopardy to resident health or safety

    Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.

    Isolated (one or a few residents). CMS level J.

    Health citation F-0755, Pharmacy Service Deficiencies. Inspection of December 13, 2024. Found during a complaint inspection.

    The home gave a date the problem would be corrected (January 17, 2025).

  3. Harm to a resident

    Provide appropriate pressure ulcer care and prevent new ulcers from developing.

    Isolated (one or a few residents). CMS level G.

    Health citation F-0686, Quality of Life and Care Deficiencies. Inspection of June 11, 2026. Found during a complaint inspection.

    The home gave a date the problem would be corrected (July 8, 2026).

  4. Harm to a resident

    Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

    Isolated (one or a few residents). CMS level G.

    Health citation F-0690, Quality of Life and Care Deficiencies. Inspection of February 11, 2026. Found during a complaint inspection.

    The home gave a date the problem would be corrected (July 8, 2026).

  5. Harm to a resident

    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

    Isolated (one or a few residents). CMS level G.

    Health citation F-0689, Quality of Life and Care Deficiencies. Inspection of May 20, 2025. Found during a standard inspection and a complaint inspection.

    The home gave a date the problem would be corrected (June 13, 2025).

  6. Harm to a resident

    Ensure that residents are free from significant medication errors.

    Isolated (one or a few residents). CMS level G.

    Health citation F-0760, Pharmacy Service Deficiencies. Inspection of May 20, 2025. Found during a standard inspection and a complaint inspection.

    The home gave a date the problem would be corrected (June 13, 2025).

  7. Harm to a resident

    Provide appropriate pressure ulcer care and prevent new ulcers from developing.

    Isolated (one or a few residents). CMS level G.

    Health citation F-0686, Quality of Life and Care Deficiencies. Inspection of December 6, 2023. Found during a complaint inspection.

    The home gave a date the problem would be corrected (December 19, 2023).

  8. Harm to a resident

    Provide safe and appropriate respiratory care for a resident when needed.

    Isolated (one or a few residents). CMS level G.

    Health citation F-0695, Quality of Life and Care Deficiencies. Inspection of December 6, 2023. Found during a complaint inspection.

    The home gave a date the problem would be corrected (December 19, 2023).

  9. No harm, with potential for more than minimal harm

    Have a plan that describes the process for conducting QAPI and QAA activities.

    Widespread (many residents). CMS level F.

    Health citation F-0865, Administration Deficiencies. Inspection of June 11, 2026. Found during a complaint inspection.

    The home gave a date the problem would be corrected (July 8, 2026).

  10. No harm, with potential for more than minimal harm

    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

    Widespread (many residents). CMS level F.

    Health citation F-0812, Nutrition and Dietary Deficiencies. Inspection of May 20, 2025. Found during a standard inspection and a complaint inspection.

    The home gave a date the problem would be corrected (June 13, 2025).

  11. 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 May 20, 2025. Found during a standard inspection.

    The home gave a date the problem would be corrected (May 29, 2025).

  12. No harm, with potential for more than minimal harm

    List the names and contact information of those in the facility.

    Widespread (many residents). CMS level F.

    Emergency preparedness citation E-0030, Emergency Preparedness Deficiencies. Inspection of May 20, 2025. Found during a standard inspection.

    The home gave a date the problem would be corrected (May 29, 2025).

  13. No harm, with potential for more than minimal harm

    Have approved installation, maintenance and testing program for fire alarm systems.

    Widespread (many residents). CMS level F.

    Fire safety citation K-0345, Smoke Deficiencies. Inspection of May 20, 2025. Found during a standard inspection.

    The home gave a date the problem would be corrected (May 15, 2025).

  14. No harm, with potential for more than minimal harm

    Inspect, test, and maintain automatic sprinkler systems.

    Widespread (many residents). CMS level F.

    Fire safety citation K-0353, Smoke Deficiencies. Inspection of May 20, 2025. Found during a standard inspection.

    The home gave a date the problem would be corrected (May 19, 2025).

  15. No harm, with potential for more than minimal harm

    Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.

    Widespread (many residents). CMS level F.

    Fire safety citation K-0521, Services Deficiencies. Inspection of May 20, 2025. Found during a standard inspection.

    The home gave a date the problem would be corrected (May 15, 2025).

  16. 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 May 20, 2025. Found during a standard inspection.

    The home gave a date the problem would be corrected (May 15, 2025).

  17. 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 July 1, 2024. Found during a standard inspection.

    The home gave a date the problem would be corrected (August 3, 2024).

  18. 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 April 4, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 14, 2023).

  19. 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 April 4, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 14, 2023).

  20. No harm, with potential for more than minimal harm

    Ensure that testing and maintenance of electrical equipment is performed.

    Widespread (many residents). CMS level F.

    Fire safety citation K-0921, Gas, Vacuum, and Electrical Systems Deficiencies. Inspection of April 4, 2023. Found during a standard inspection.

    The home gave a date the problem would be corrected (May 5, 2023).

  21. No harm, with potential for more than minimal harm

    Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0584, Resident Rights Deficiencies. Inspection of February 11, 2026. Found during a complaint inspection.

    The home gave a date the problem would be corrected (February 23, 2026).

  22. No harm, with potential for more than minimal harm

    Provide and implement an infection prevention and control program.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0880, Infection Control Deficiencies. Inspection of February 11, 2026. Found during a complaint inspection.

    The home gave a date the problem would be corrected (July 8, 2026).

  23. No harm, with potential for more than minimal harm

    Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0804, Nutrition and Dietary Deficiencies. Inspection of May 20, 2025. Found during a standard inspection.

    The home gave a date the problem would be corrected (June 13, 2025).

  24. No harm, with potential for more than minimal harm

    Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0842, Resident Assessment and Care Planning Deficiencies. Inspection of May 20, 2025. Found during a standard inspection.

    The home gave a date the problem would be corrected (June 13, 2025).

  25. No harm, with potential for more than minimal harm

    Provide and implement an infection prevention and control program.

    Pattern (more than a few residents). CMS level E.

    Health citation F-0880, Infection Control Deficiencies. Inspection of May 20, 2025. Found during a standard inspection.

    The home gave a date the problem would be corrected (June 13, 2025).

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.