Royal Care of Avon Park

1213 W Stratford Rd · Avon Park, FL · 33825 · 8634536674

90 certified beds For profit - Limited Liability company

Why this verdict

  • Inspection record is far worse than the national median (deficiency count and severity).
  • Inspection results are getting worse cycle over cycle, not better.

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Red flags

Cited under the freedom-from-abuse rule

Cited 1 time under F600 (freedom from abuse/neglect) below the actual-harm level — worth asking about on a tour.

No standard inspection in over 2 years

The inspection record here is older than usual — conditions may have changed since.

Score breakdown

Inspection record 30% of score 33
Serious harm & abuse 20% 94
Staffing 20% 77
Federal penalties 15% 61
Trend 10% 18
Context 5% 85

Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.

CMS ratings & staffing

Overall: 2 of 5 Inspections: 1 of 5 Staffing: 4 of 5 Quality measures: 5 of 5

Total nurse hours / resident-day4.003.48 min · 4.1 strong
RN hours / resident-day0.820.55–0.75
Weekend hours / resident-day3.39≈ weekday level
Nursing turnover / year48%median 45%
Fines (3-yr window)2 · $17,342

Inspection citations (26 in the current record)

  • Potential for harm · D February 19, 2026 · found via complaint

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

    Corrected March 19, 2026 · Freedom from Abuse, Neglect, and Exploitation

  • Actual harm · G May 9, 2024

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

    Corrected May 31, 2024 · Quality of Life and Care

  • Potential for harm · D May 9, 2024

    Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

    Corrected May 31, 2024 · Resident Rights

  • Potential for harm · E May 9, 2024

    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.

    Corrected May 31, 2024 · Resident Rights

  • Potential for harm · D May 9, 2024

    Ensure each resident receives an accurate assessment.

    Corrected May 31, 2024 · Resident Assessment and Care Planning

  • Potential for harm · E May 9, 2024

    PASARR screening for Mental disorders or Intellectual Disabilities

    Corrected May 31, 2024 · Resident Assessment and Care Planning

  • Potential for harm · E May 9, 2024

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

    Corrected May 31, 2024 · Quality of Life and Care

  • Potential for harm · D May 9, 2024

    Provide for the safe, appropriate administration of IV fluids for a resident when needed.

    Corrected May 31, 2024 · Quality of Life and Care

  • Potential for harm · D May 9, 2024

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

    Corrected May 31, 2024 · Quality of Life and Care

  • Potential for harm · D May 9, 2024

    Ensure each resident’s drug regimen must be free from unnecessary drugs.

    Corrected May 31, 2024 · Pharmacy Service

  • Potential for harm · D May 9, 2024

    Ensure medication error rates are not 5 percent or greater.

    Corrected July 18, 2024 · Pharmacy Service

  • Potential for harm · D May 9, 2024

    Ensure that residents are free from significant medication errors.

    Corrected May 31, 2024 · Pharmacy Service

  • Potential for harm · E May 9, 2024

    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.

    Corrected May 31, 2024 · Pharmacy Service

  • Potential for harm · D May 9, 2024

    Provide or obtain dental services for each resident.

    Corrected May 31, 2024 · Quality of Life and Care

  • Potential for harm · E May 9, 2024

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

    Corrected May 31, 2024 · Nutrition and Dietary

  • Potential for harm · F May 9, 2024

    Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.

    Corrected July 18, 2024 · Administration

  • Potential for harm · E May 9, 2024

    Provide and implement an infection prevention and control program.

    Corrected May 31, 2024 · Infection Control

  • Potential for harm · E May 9, 2024

    Put firmly secured handrails on each side of hallways.

    Corrected May 31, 2024 · Environmental

  • Potential for harm · D December 22, 2021

    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.

    Corrected January 14, 2022 · Quality of Life and Care

  • Potential for harm · D December 22, 2021

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

    Corrected January 14, 2022 · Quality of Life and Care

  • Potential for harm · D March 13, 2020

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

    Corrected April 6, 2020 · Quality of Life and Care

  • Potential for harm · D March 13, 2020

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

    Corrected April 6, 2020 · Quality of Life and Care

  • Potential for harm · D March 13, 2020

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

    Corrected April 6, 2020 · Quality of Life and Care

  • Potential for harm · E March 13, 2020

    Ensure that residents are free from significant medication errors.

    Corrected April 6, 2020 · Pharmacy Service

  • Potential for harm · D March 13, 2020

    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.

    Corrected April 6, 2020 · Pharmacy Service

Showing the 25 most recent. The Safety Report includes every citation with full findings.

Federal penalties

DateTypeAmount / length
May 9, 2024Fine$4,017
May 9, 2024Fine$13,325

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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 105812 · certified since July 1, 1993. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.