ElderGrade

Inspection citations at Royale Gardens Health & Rehabilitation Center

67 citations on record, 7 of which inspectors scored at actual harm or immediate jeopardy. Each one is the state surveyor's own finding, not our summary.

Reading the scope & severity code

A–C

No harm, minimal potential

D–F

No harm, potential for harm

G–I

Actual harm to a resident

J–L

Immediate jeopardy

The letter also encodes how many residents were affected — isolated, a pattern, or widespread. Full explainer.

Citations by survey year

Year Citations Involving harm or jeopardy
2026 11 1
2025 5 0
2024 34 4
2023 17 2
D March 13, 2026 Tag F0842 Corrected Apr 2026

Resident Assessment and Care Planning Deficiencies

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

No actual harm, potential for more than minimal harm

D March 13, 2026 Tag F0776 Corrected Apr 2026

Administration Deficiencies

Provide timely, approved x-ray services, or have an agreement with an approved provider to obtain them.

No actual harm, potential for more than minimal harm

D March 13, 2026 Tag F0688 Corrected Apr 2026

Quality of Life and Care Deficiencies

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.

No actual harm, potential for more than minimal harm

D March 13, 2026 Tag F0679 Corrected Apr 2026

Quality of Life and Care Deficiencies

Provide activities to meet all resident's needs.

No actual harm, potential for more than minimal harm

D March 13, 2026 Tag F0676 Corrected Apr 2026

Quality of Life and Care Deficiencies

Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.

No actual harm, potential for more than minimal harm

D March 13, 2026 Tag F0554 Corrected Apr 2026

Resident Rights Deficiencies

Allow residents to self-administer drugs if determined clinically appropriate.

No actual harm, potential for more than minimal harm

D March 13, 2026 Tag F0553 Corrected Apr 2026

Resident Rights Deficiencies

Allow resident to participate in the development and implementation of his or her person-centered plan of care.

No actual harm, potential for more than minimal harm

E March 13, 2026 Tag F0919 Complaint investigation Corrected Apr 2026

Environmental Deficiencies

Make sure that a working call system is available in each resident's bathroom and bathing area.

No actual harm, potential for more than minimal harm

E March 13, 2026 Tag F0812 Corrected Apr 2026

Nutrition and Dietary Deficiencies

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

No actual harm, potential for more than minimal harm

G March 13, 2026 Tag F0760 Corrected Apr 2026

Pharmacy Service Deficiencies

Ensure that residents are free from significant medication errors.

Actual harm to a resident

E January 28, 2026 Tag F0812 Complaint investigation Corrected Feb 2026

Nutrition and Dietary Deficiencies

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

No actual harm, potential for more than minimal harm

D July 23, 2025 Tag F0600 Complaint investigation Corrected Aug 2025

Freedom from Abuse, Neglect, and Exploitation Deficiencies

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

No actual harm, potential for more than minimal harm

D July 23, 2025 Tag F0552 Complaint investigation Corrected Aug 2025

Resident Rights Deficiencies

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

No actual harm, potential for more than minimal harm

E May 1, 2025 Tag F0725 Complaint investigation Corrected Jun 2025

Nursing and Physician Services Deficiencies

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

No actual harm, potential for more than minimal harm

D February 28, 2025 Tag F0684 Complaint investigation Corrected Mar 2025

Quality of Life and Care Deficiencies

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

No actual harm, potential for more than minimal harm

D January 23, 2025 Tag F0689 Complaint investigation Corrected Feb 2025

Quality of Life and Care Deficiencies

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

No actual harm, potential for more than minimal harm

C October 29, 2024 Tag F0732 Complaint investigation Corrected Dec 2024

Nursing and Physician Services Deficiencies

Post nurse staffing information every day.

No actual harm, minimal potential

D October 29, 2024 Tag F0810 Corrected Dec 2024

Nutrition and Dietary Deficiencies

Provide special eating equipment and utensils for residents who need them and appropriate assistance.

No actual harm, potential for more than minimal harm

D October 29, 2024 Tag F0805 Corrected Dec 2024

Nutrition and Dietary Deficiencies

Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.

No actual harm, potential for more than minimal harm

D October 29, 2024 Tag F0791 Corrected Dec 2024

Quality of Life and Care Deficiencies

Provide or obtain dental services for each resident.

No actual harm, potential for more than minimal harm

D October 29, 2024 Tag F0758 Corrected Dec 2024

Pharmacy Service Deficiencies

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.

No actual harm, potential for more than minimal harm

D October 29, 2024 Tag F0755 Corrected Dec 2024

Pharmacy Service Deficiencies

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

No actual harm, potential for more than minimal harm

D October 29, 2024 Tag F0730 Complaint investigation Corrected Dec 2024

Nursing and Physician Services Deficiencies

Observe each nurse aide's job performance and give regular training.

No actual harm, potential for more than minimal harm

D October 29, 2024 Tag F0699 Complaint investigation Corrected Dec 2024

Quality of Life and Care Deficiencies

Provide care or services that was trauma informed and/or culturally competent.

No actual harm, potential for more than minimal harm

D October 29, 2024 Tag F0686 Complaint investigation Corrected Dec 2024

Quality of Life and Care Deficiencies

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

No actual harm, potential for more than minimal harm

D October 29, 2024 Tag F0677 Complaint investigation Corrected Dec 2024

Quality of Life and Care Deficiencies

Provide care and assistance to perform activities of daily living for any resident who is unable.

No actual harm, potential for more than minimal harm

D October 29, 2024 Tag F0657 Corrected Dec 2024

Resident Assessment and Care Planning Deficiencies

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

No actual harm, potential for more than minimal harm

D October 29, 2024 Tag F0655 Complaint investigation Corrected Dec 2024

Resident Assessment and Care Planning Deficiencies

Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted

No actual harm, potential for more than minimal harm

D October 29, 2024 Tag F0644 Corrected Dec 2024

Resident Assessment and Care Planning Deficiencies

Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.

No actual harm, potential for more than minimal harm

D October 29, 2024 Tag F0609 Corrected Dec 2024

Freedom from Abuse, Neglect, and Exploitation Deficiencies

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

No actual harm, potential for more than minimal harm

D October 29, 2024 Tag F0585 Corrected Dec 2024

Resident Rights Deficiencies

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.

No actual harm, potential for more than minimal harm

D October 29, 2024 Tag F0558 Complaint investigation Corrected Dec 2024

Resident Rights Deficiencies

Reasonably accommodate the needs and preferences of each resident.

No actual harm, potential for more than minimal harm

E October 29, 2024 Tag F0759 Corrected Dec 2024

Pharmacy Service Deficiencies

Ensure medication error rates are not 5 percent or greater.

No actual harm, potential for more than minimal harm

E October 29, 2024 Tag F0712 Corrected Dec 2024

Nursing and Physician Services Deficiencies

Ensure that the resident and his/her doctor meet face-to-face at all required visits.

No actual harm, potential for more than minimal harm

E October 29, 2024 Tag F0711 Corrected Dec 2024

Nursing and Physician Services Deficiencies

Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit.

No actual harm, potential for more than minimal harm

E October 29, 2024 Tag F0684 Complaint investigation Corrected Dec 2024

Quality of Life and Care Deficiencies

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

No actual harm, potential for more than minimal harm

E October 29, 2024 Tag F0679 Corrected Dec 2024

Quality of Life and Care Deficiencies

Provide activities to meet all resident's needs.

No actual harm, potential for more than minimal harm

F October 29, 2024 Tag F0812 Corrected Dec 2024

Nutrition and Dietary Deficiencies

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

No actual harm, potential for more than minimal harm

D January 25, 2024 Tag F0690 Complaint investigation Corrected Mar 2024

Quality of Life and Care Deficiencies

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

No actual harm, potential for more than minimal harm

D January 25, 2024 Tag F0661 Complaint investigation Corrected Mar 2024

Resident Assessment and Care Planning Deficiencies

Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.

No actual harm, potential for more than minimal harm

Citations are published by CMS from state survey agency findings. A citation describes what an inspector observed on a specific date; homes are required to submit a correction plan, and many findings are resolved long before you read them. Ask the administrator what happened and what changed.