All citations for Three Oaks Health Services

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 Three Oaks Health Services

Last standard health inspection on record

March 5, 2026

Showing 1 to 25 of 32 citations

  1. Immediate jeopardy to resident health or safety

    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 J.

    Health citation F-0689, Quality of Life and Care Deficiencies. Inspection of March 11, 2025. Found during a complaint inspection.

    The home gave a date the problem would be corrected (April 2, 2025).

  2. Immediate jeopardy to resident health or safety

    Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

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

    Health citation F-0600, Freedom from Abuse, Neglect, and Exploitation Deficiencies. Inspection of March 4, 2024. Found during a complaint inspection.

    Past non-compliance: already corrected by the time of the inspection (February 19, 2024).

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

    Dispose of garbage and refuse properly.

    Widespread (many residents). CMS level F.

    Health citation F-0814, Nutrition and Dietary Deficiencies. Inspection of March 5, 2026. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 3, 2026).

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

    Provide and implement an infection prevention and control program.

    Widespread (many residents). CMS level F.

    Health citation F-0880, Infection Control Deficiencies. Inspection of March 5, 2026. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 3, 2026).

  5. 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 March 5, 2026. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 3, 2026).

  6. 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 March 5, 2026. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 3, 2026).

  7. 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 March 11, 2025. Found during a complaint inspection.

    The home gave a date the problem would be corrected (April 2, 2025).

  8. 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 December 12, 2024. Found during a standard inspection.

    The home gave a date the problem would be corrected (January 12, 2025).

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

    Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.

    Widespread (many residents). CMS level F.

    Health citation F-0851, Administration Deficiencies. Inspection of December 12, 2024. Found during a standard inspection.

    The home gave a date the problem would be corrected (January 12, 2025).

  10. 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 December 12, 2024. Found during a standard inspection.

    The home gave a date the problem would be corrected (January 12, 2025).

  11. 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.

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

    Fire safety citation K-0321, Smoke Deficiencies. Inspection of March 5, 2026. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 3, 2026).

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

    Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.

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

    Health citation F-0623, Resident Rights Deficiencies. Inspection of December 12, 2024. Found during a standard inspection.

    The home gave a date the problem would be corrected (January 12, 2025).

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

    Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.

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

    Health citation F-0625, Resident Rights Deficiencies. Inspection of December 12, 2024. Found during a standard inspection.

    The home gave a date the problem would be corrected (January 12, 2025).

  14. 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.

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

    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 (November 17, 2023).

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

    Provide safe, appropriate dialysis care/services for a resident who requires such services.

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

    Health citation F-0698, Quality of Life and Care Deficiencies. Inspection of March 5, 2026. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 3, 2026).

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

    Have power receptacles that are properly grounded.

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

    Fire safety citation K-0912, Gas, Vacuum, and Electrical Systems Deficiencies. Inspection of March 5, 2026. Found during a standard inspection.

    The home gave a date the problem would be corrected (April 3, 2026).

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

    Provide appropriate treatment and care according to orders, resident’s preferences and goals.

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

    Health citation F-0684, Quality of Life and Care Deficiencies. Inspection of December 17, 2025. Found during a complaint inspection.

    The home gave a date the problem would be corrected (January 16, 2026).

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

    Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.

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

    Health citation F-0693, Quality of Life and Care Deficiencies. Inspection of December 17, 2025. Found during a complaint inspection.

    The home gave a date the problem would be corrected (January 16, 2026).

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

    Ensure that residents are fully informed and understand their health status, care and treatments.

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

    Health citation F-0552, Resident Rights Deficiencies. Inspection of March 11, 2025. Found during a complaint inspection.

    The home gave a date the problem would be corrected (April 2, 2025).

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

    Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.

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

    Health citation F-0758, Pharmacy Service Deficiencies. Inspection of March 11, 2025. Found during a complaint inspection.

    The home gave a date the problem would be corrected (April 2, 2025).

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

    Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

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

    Health citation F-0580, Resident Rights Deficiencies. Inspection of December 12, 2024. Found during a standard inspection.

    The home gave a date the problem would be corrected (January 12, 2025).

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

    Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

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

    Health citation F-0609, Freedom from Abuse, Neglect, and Exploitation Deficiencies. Inspection of December 12, 2024. Found during a standard inspection and a complaint inspection.

    The home gave a date the problem would be corrected (January 12, 2025).

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

    Ensure medication error rates are not 5 percent or greater.

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

    Health citation F-0759, Pharmacy Service Deficiencies. Inspection of December 12, 2024. Found during a standard inspection.

    The home gave a date the problem would be corrected (January 12, 2025).

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

    Provide and implement an infection prevention and control program.

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

    Health citation F-0880, Infection Control Deficiencies. Inspection of December 12, 2024. Found during a standard inspection.

    The home gave a date the problem would be corrected (January 12, 2025).

  25. 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 December 12, 2024. Found during a standard inspection.

    The home gave a date the problem would be corrected (January 12, 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.