Tag 0689 · Severity G
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · Deficient, Provider has date of correction 2024-09-20At a glance
CMS data snapshot: 2026-08-01 · Sources and limitations
| Ownership | For profit - Corporation | Certified beds | 120 |
|---|---|---|---|
| Estimated occupancy | 92.6% | Latest inspection | 2024-08-21 |
County and Florida comparison
Navy: facility · Teal: county · Gray: Florida
Overall rating
Facility: 1 of 5
Health-inspection score
Facility: 103.0 points
Total nurse staffing
Facility: 3.31 hours/day
RN staffing
Facility: 0.27 hours/day
Staff turnover
Facility: 42.9%
Latest health deficiencies
Facility: 15 deficiencies
View data table
| Metric | Facility | County | Florida |
|---|---|---|---|
| Overall rating | 1 of 5 | 3 of 5 | 3 of 5 |
| Health-inspection score | 103.0 points | 65.5 points | 38.5 points |
| Total nurse staffing | 3.31 hours/day | 4.11 hours/day | 3.63 hours/day |
| RN staffing | 0.27 hours/day | 0.80 hours/day | 0.62 hours/day |
| Staff turnover | 42.9% | 34.3% | 41.8% |
| Latest health deficiencies | 15 deficiencies | 6 deficiencies | 6 deficiencies |
Comparisons describe CMS data; they are not recommendations.
Inspection history
2024-08-21
15 deficiencies
Highest severity: G
Immediate-jeopardy citations: 0
Tag 0812 · Severity F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction 2024-09-20Tag 0679 · Severity E
Provide activities to meet all resident's needs.
Quality of Life and Care Deficiencies · Deficient, Provider has date of correction 2024-09-20Tag 0680 · Severity E
Ensure the activities program is directed by a qualified professional.
Quality of Life and Care Deficiencies · Deficient, Provider has date of correction 2024-09-20Tag 0947 · Severity E
Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
Nursing and Physician Services Deficiencies · Deficient, Provider has date of correction 2024-09-20Tag 0550 · Severity D
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies · Deficient, Provider has date of correction 2024-09-20Tag 0584 · Severity D
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.
Resident Rights Deficiencies · Deficient, Provider has date of correction 2024-09-20Tag 0655 · Severity D
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction 2024-09-20Tag 0684 · Severity D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies · Deficient, Provider has date of correction 2024-09-20Tag 0791 · Severity D
Provide or obtain dental services for each resident.
Quality of Life and Care Deficiencies · Deficient, Provider has date of correction 2024-09-20Tag 0880 · Severity D
Provide and implement an infection prevention and control program.
Infection Control Deficiencies · Deficient, Provider has date of correction 2024-09-202022-10-24
9 deficiencies
Highest severity: E
Immediate-jeopardy citations: 0
Tag 0679 · Severity E
Provide activities to meet all resident's needs.
Quality of Life and Care Deficiencies · Deficient, Provider has date of correction 2022-11-17Tag 0680 · Severity E
Ensure the activities program is directed by a qualified professional.
Quality of Life and Care Deficiencies · Deficient, Provider has date of correction 2022-11-17Tag 0761 · Severity D
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Pharmacy Service Deficiencies · Deficient, Provider has date of correction 2022-11-172021-03-10
11 deficiencies
Highest severity: E
Immediate-jeopardy citations: 0
Tag 0679 · Severity E
Provide activities to meet all resident's needs.
Quality of Life and Care Deficiencies · Deficient, Provider has date of correction 2021-04-10Tag 0563 · Severity D
Honor the resident's right to receive visitors of his or her choosing, at the time of his or her choosing.
Resident Rights Deficiencies · Deficient, Provider has date of correction 2021-04-10Tag 0578 · Severity D
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Resident Rights Deficiencies · Deficient, Provider has date of correction 2021-04-10Tag 0582 · Severity D
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Resident Rights Deficiencies · Deficient, Provider has date of correction 2021-04-10Tag 0585 · Severity D
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
Resident Rights Deficiencies · Deficient, Provider has date of correction 2021-04-10Tag 0656 · Severity D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction 2021-04-10Tag 0688 · Severity D
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
Quality of Life and Care Deficiencies · Deficient, Provider has date of correction 2021-04-10Tag 0700 · Severity D
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
Quality of Life and Care Deficiencies · Deficient, Provider has date of correction 2021-04-10Tag 0760 · Severity D
Ensure that residents are free from significant medication errors.
Pharmacy Service Deficiencies · Deficient, Provider has date of correction 2021-04-10Tag 0812 · Severity D
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction 2021-04-10Staffing composition
2.07 hours/dayNurse aide
0.97 hours/dayLPN
0.27 hours/dayRN
- Total staffing
- 3.31 hours/day
- County median
- 4.11 hours/day
- Florida median
- 3.63 hours/day
- Weekend total
- 3.17 hours/day
- Staff turnover
- 42.9%
- RN turnover
- 85.0%
Reported averages, not a real-time staffing schedule.
Resident outcomes
Lower is generally better
Hospitalizations
2.7 per 1,000 daysworseFlorida: 2.1 per 1,000 days · County: 1.7 per 1,000 days20250101-20251231
Emergency-department visits
1.1 per 1,000 daysworseFlorida: 1.0 per 1,000 days · County: 1.1 per 1,000 days20250101-20251231
Falls with major injury
3.6%worseFlorida: 2.2% · County: 3.6%2025Q2-2026Q1
Pressure ulcers
2.2%betterFlorida: 4.2% · County: 3.2%2025Q2-2026Q1
Urinary tract infections
0.3%unavailableFlorida: 0.0% · County: 0.3%2025Q2-2026Q1
Antipsychotic medication use
11.2%worseFlorida: 7.0% · County: 7.0%2025Q2-2026Q1
These group measures do not predict an individual resident’s experience.
Questions to ask
Use these prompts during a tour or phone call
How many RNs are typically on site during days, nights, and weekends?
Suggested because of: rn staffingWhat fall-prevention program is used, and how are families notified after a fall?
Suggested because of: falls major injuryHow are antipsychotic medications reviewed, reduced when appropriate, and discussed with families?
Suggested because of: antipsychotic useWhat operational changes followed the facility's most recent penalty?
Suggested because of: penaltiesHow will the care plan be developed, reviewed, and shared with our family?
Suggested because of: general care planning
Facility Details
- County
- Lee County
- Certified beds
- 120
- Average daily residents
- 111.1
- Ownership
- For profit - Corporation
- Provider type
- Medicare and Medicaid
- In hospital
- No
- Date certified
- 1998-12-14
- CCN
- 106000
Staffing Data
| Reported measure | Value |
|---|---|
| Nurse aide hours | 2.06744 |
| Lpn hours | 0.96932 |
| Rn hours | 0.26876 |
| Reported total hours | 3.30552 |
| Weekend total hours | 3.16999 |
| Weekend rn hours | 0.27607 |
| Adjusted total hours | 3.9136 |
| Total turnover percent | 42.9 |
| Rn turnover percent | 85 |
| Administrators left | 1 |
Hours are per resident per day; turnover values are percentages. Missing values are not zero.
Penalties & Enforcement
$50,028.00Total fines
3Number of fines
1Payment denials
| Date | Type | Amount |
|---|---|---|
| 2025-06-12 | Fine | $29,819.00 |
| 2024-08-21 | Fine | $10,033.00 |
| 2024-08-21 | Fine | $10,176.00 |
| 2024-08-21 | Payment Denial | Not reported |
Totals reflect the supplied CMS records, not a lifetime total.
Citations
15Health citations
15Fire safety citations
Health counts describe the latest rating cycle. Fire counts cover supplied fire-safety records.
Serious Deficiencies
FL counts scope/severity G–L as serious deficiencies. Immediate jeopardy is J–L; these are not interchangeable.
3
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Ownership & Operators
| Name | Role | Share |
|---|---|---|
| EVANS PARENT LLC | DIRECT OWNERSHIP INTEREST | NOT APPLICABLE |
| LEE EVANS HOLDCO LLC | INDIRECT OWNERSHIP INTEREST | NOT APPLICABLE |
| FREUND, NOCHUM | CORPORATE OFFICER | NOT APPLICABLE |
| FREUND, NOCHUM | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| SHOMAN, EDWIN | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| SIPRA, SAJID | OPERATIONAL/MANAGERIAL CONTROL | NOT APPLICABLE |
| DAGAN, AMITAI | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | NOT APPLICABLE |
| GOLDBERGER, ABRAHAM | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | NOT APPLICABLE |
| GOLDBERGER, FAIGY | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | NOT APPLICABLE |
| HERSKOWITZ, ELIEZER | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | NOT APPLICABLE |
| HERSKOWITZ, YAAKOV | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | NOT APPLICABLE |
| TRAVITSKY, AARON | INDIVIDUAL IS AN OWNER, PARTNER OR TRUSTEE OF ANY ADP OF THE SNF | NOT APPLICABLE |
| ASPIRE MGT LLC | ADP OF THE SNF | NOT APPLICABLE |
| SHOMAN, EDWIN | ADP OF THE SNF | NOT APPLICABLE |
| SIPRA, SAJID | ADP OF THE SNF | NOT APPLICABLE |
Helpful resources
Educational information, not medical or legal advice. Data & methodology