Medicare flags this nursing home for abuse. Medicare adds this flag when a home was cited for abuse that harmed a resident, or for potential abuse more than once. Ask the home what changed.
Inspection citations
13’22
4’23
67’24
56’25
18’26
158 shown
| Date | Severity | What inspectors found | Visit |
|---|---|---|---|
| Aug 25, 2026 | D · potential | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Complaint |
| Jul 9, 2026 | G · harm | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Complaint |
| Jul 1, 2026 | D · potential | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Complaint |
| Jul 1, 2026 | E · potential | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | Complaint |
| Jul 1, 2026 | D · potential | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Complaint |
| May 4, 2026 | D · potential | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | Complaint |
| Apr 15, 2026 | D · potential | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | Complaint |
| Apr 15, 2026 | D · potential | Provide enough food/fluids to maintain a resident's health. | Complaint |
| Apr 2, 2026 | D · potential | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Complaint |
| Apr 2, 2026 | E · potential | Provide for the safe, appropriate administration of IV fluids for a resident when needed. | Complaint |
| Apr 2, 2026 | E · potential | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Complaint |
| Mar 23, 2026 | D · potential | Provide and implement an infection prevention and control program. | Complaint |
| Mar 13, 2026 | D · potential | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Complaint |
| Mar 13, 2026 | D · potential | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | Complaint |
| Mar 13, 2026 | D · potential | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Complaint |
| Feb 2, 2026 | D · potential | Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge. | Complaint |
| Jan 22, 2026 | D · potential | Provide safe, appropriate pain management for a resident who requires such services. | Complaint |
| Jan 22, 2026 | E · potential | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Complaint |
| Dec 16, 2025 | D · potential | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Complaint |
| Dec 16, 2025 | D · potential | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Complaint |
| Nov 24, 2025 | E · potential | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | Complaint |
| Nov 24, 2025 | D · potential | Provide safe and appropriate respiratory care for a resident when needed. | Complaint |
| Sep 17, 2025 | D · potential | Provide and implement an infection prevention and control program. | Complaint |
| Aug 29, 2025 | D · potential | Allow residents to self-administer drugs if determined clinically appropriate. | Routine |
| Aug 29, 2025 | D · potential | Reasonably accommodate the needs and preferences of each resident. | Routine |
| Aug 29, 2025 | D · potential | 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. | Routine |
| Aug 29, 2025 | D · potential | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Routine |
| Aug 29, 2025 | D · potential | 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. | Routine |
| Aug 29, 2025 | E · potential | Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. | Routine |
| Aug 29, 2025 | D · potential | Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted | Routine |
| Aug 29, 2025 | E · potential | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Complaint |
| Aug 29, 2025 | D · potential | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | Routine |
| Aug 29, 2025 | E · potential | Ensure services provided by the nursing facility meet professional standards of quality. | Routine |
| Aug 29, 2025 | D · potential | Provide care and assistance to perform activities of daily living for any resident who is unable. | Routine |
| Aug 29, 2025 | E · potential | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | Routine |
| Aug 29, 2025 | E · potential | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Routine |
| Aug 29, 2025 | E · potential | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Complaint |
| Aug 29, 2025 | D · potential | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | Routine |
| Aug 29, 2025 | E · potential | Provide enough food/fluids to maintain a resident's health. | Routine |
| Aug 29, 2025 | D · potential | 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. | Routine |
| Aug 29, 2025 | D · potential | Provide for the safe, appropriate administration of IV fluids for a resident when needed. | Routine |
| Aug 29, 2025 | D · potential | Provide safe and appropriate respiratory care for a resident when needed. | Routine |
| Aug 29, 2025 | E · potential | Provide safe, appropriate pain management for a resident who requires such services. | Routine |
| Aug 29, 2025 | D · potential | Provide safe, appropriate dialysis care/services for a resident who requires such services. | Routine |
| Aug 29, 2025 | D · potential | Provide care or services that was trauma informed and/or culturally competent. | Routine |
| Aug 29, 2025 | D · potential | Ensure each resident must receive and the facility must provide necessary behavioral health care and services. | Routine |
| Aug 29, 2025 | D · potential | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Routine |
| Aug 29, 2025 | E · potential | Ensure medication error rates are not 5 percent or greater. | Routine |
| Aug 29, 2025 | E · potential | Ensure that residents are free from significant medication errors. | Routine |
| Aug 29, 2025 | D · potential | 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. | Routine |
| Aug 29, 2025 | E · potential | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Routine |
| Aug 29, 2025 | E · potential | Have a policy regarding use and storage of foods brought to residents by family and other visitors. | Routine |
| Aug 29, 2025 | E · potential | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Routine |
| Aug 29, 2025 | E · potential | Provide and implement an infection prevention and control program. | Routine |
| Aug 29, 2025 | E · potential | Implement a program that monitors antibiotic use. | Routine |
| Aug 29, 2025 | E · potential | Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home. | Routine |
| Aug 29, 2025 | D · potential | Develop and implement policies and procedures for flu and pneumonia vaccinations. | Routine |
| Aug 29, 2025 | D · potential | Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status. | Routine |
| Aug 5, 2025 | D · potential | Ensure that residents are free from significant medication errors. | Complaint |
| Jul 15, 2025 | D · potential | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Complaint |
| Jul 15, 2025 | D · potential | Make sure that a working call system is available in each resident's bathroom and bathing area. | Complaint |
| Jun 18, 2025 | E · potential | Provide safe, appropriate pain management for a resident who requires such services. | Complaint |
| May 28, 2025 | D · potential | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Complaint |
| May 28, 2025 | D · potential | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Complaint |
| Apr 22, 2025 | D · potential | 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. | Complaint |
| Apr 22, 2025 | D · potential | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Complaint |
| Apr 1, 2025 | D · potential | Provide safe and appropriate respiratory care for a resident when needed. | Complaint |
| Mar 27, 2025 | D · potential | Provide and implement an infection prevention and control program. | Complaint |
| Mar 20, 2025 | D · potential | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Complaint |
| Mar 20, 2025 | D · potential | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | Complaint |
| Mar 13, 2025 | D · potential | Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility. | Complaint |
| Jan 14, 2025 | E · potential | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Complaint |
| Jan 14, 2025 | G · harm | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Complaint |
| Jan 14, 2025 | E · potential | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | Complaint |
| Dec 3, 2024 | D · potential | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Complaint |
| Oct 28, 2024 | D · potential | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | Complaint |
| Oct 22, 2024 | D · potential | Assist a resident in gaining access to vision and hearing services. | Complaint |
| Oct 22, 2024 | D · potential | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Complaint |
| Oct 22, 2024 | E · potential | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Complaint |
| Oct 22, 2024 | E · potential | Ensure that residents are free from significant medication errors. | Complaint |
| Sep 27, 2024 | D · potential | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Complaint |
| Sep 27, 2024 | D · potential | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | Complaint |
| Sep 17, 2024 | D · potential | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Routine |
| Sep 17, 2024 | D · potential | Allow residents to self-administer drugs if determined clinically appropriate. | Routine |
| Sep 17, 2024 | D · potential | Reasonably accommodate the needs and preferences of each resident. | Routine |
| Sep 17, 2024 | D · potential | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Routine |
| Sep 17, 2024 | B · minimal | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | Routine |
| Sep 17, 2024 | E · potential | Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment. | Routine |
| Sep 17, 2024 | D · potential | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | Routine |
| Sep 17, 2024 | D · potential | PASARR screening for Mental disorders or Intellectual Disabilities | Routine |
| Sep 17, 2024 | E · potential | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Routine |
| Sep 17, 2024 | E · potential | Ensure services provided by the nursing facility meet professional standards of quality. | Routine |
| Sep 17, 2024 | E · potential | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Routine |
| Sep 17, 2024 | D · potential | 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. | Routine |
| Sep 17, 2024 | E · potential | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Routine |
| Sep 17, 2024 | D · potential | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | Routine |
| Sep 17, 2024 | D · potential | 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. | Routine |
| Sep 17, 2024 | E · potential | Provide safe and appropriate respiratory care for a resident when needed. | Complaint |
| Sep 17, 2024 | D · potential | Provide safe, appropriate dialysis care/services for a resident who requires such services. | Routine |
| Sep 17, 2024 | B · minimal | Post nurse staffing information every day. | Routine |
| Sep 17, 2024 | E · potential | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Routine |
| Sep 17, 2024 | E · potential | 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. | Routine |
| Sep 17, 2024 | E · potential | Ensure that residents are free from significant medication errors. | Routine |
| Sep 17, 2024 | E · potential | 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. | Routine |
| Sep 17, 2024 | E · potential | Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician. | Routine |
| Sep 17, 2024 | E · potential | Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. | Routine |
| Sep 17, 2024 | E · potential | Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. | Routine |
| Sep 17, 2024 | E · potential | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | Routine |
| Sep 17, 2024 | E · potential | Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs. | Routine |
| Sep 17, 2024 | D · potential | Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | Routine |
| Sep 17, 2024 | E · potential | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | Routine |
| Sep 17, 2024 | E · potential | Provide and implement an infection prevention and control program. | Routine |
| Sep 17, 2024 | D · potential | Implement a program that monitors antibiotic use. | Routine |
| Sep 17, 2024 | E · potential | Keep all essential equipment working safely. | Routine |
| Sep 4, 2024 | D · potential | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Complaint |
| Sep 4, 2024 | D · potential | Provide and implement an infection prevention and control program. | Complaint |
| Sep 4, 2024 | E · potential | Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status. | Complaint |
| Aug 29, 2024 | D · potential | 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. | Complaint |
| Aug 29, 2024 | D · potential | 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. | Complaint |
| Aug 29, 2024 | D · potential | Assist a resident in gaining access to vision and hearing services. | Complaint |
| Aug 29, 2024 | D · potential | Provide safe and appropriate respiratory care for a resident when needed. | Complaint |
| Aug 29, 2024 | E · potential | Establish a governing body that is legally responsible for establishing and implementing policies for managing and operating the facility and appoints a properly licensed administrator responsible for managing the facility. | Complaint |
| Aug 20, 2024 | D · potential | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | Complaint |
| Aug 14, 2024 | D · potential | Provide and implement an infection prevention and control program. | Complaint |
| Aug 1, 2024 | G · harm | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Complaint |
| Jul 9, 2024 | D · potential | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Complaint |
| Jul 9, 2024 | D · potential | Respond appropriately to all alleged violations. | Complaint |
| Jul 9, 2024 | E · potential | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Complaint |
| Jul 9, 2024 | E · potential | Provide and implement an infection prevention and control program. | Complaint |
| Jun 28, 2024 | D · potential | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Complaint |
| Jun 28, 2024 | E · potential | Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged. | Complaint |
| Jun 28, 2024 | D · potential | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Complaint |
| Jun 28, 2024 | D · potential | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Complaint |
| Jun 6, 2024 | G · harm | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | Complaint |
| Jun 6, 2024 | D · potential | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | Complaint |
| May 30, 2024 | G · harm | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | Complaint |
| Apr 5, 2024 | D · potential | Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. | Complaint |
| Apr 5, 2024 | D · potential | Provide and implement an infection prevention and control program. | Complaint |
| Feb 16, 2024 | E · potential | Provide safe, appropriate dialysis care/services for a resident who requires such services. | Complaint |
| Feb 7, 2024 | D · potential | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Complaint |
| Feb 7, 2024 | E · potential | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | Complaint |
| Oct 30, 2023 | E · potential | 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. | Complaint |
| Oct 30, 2023 | D · potential | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Complaint |
| Oct 30, 2023 | D · potential | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | Complaint |
| Oct 10, 2023 | D · potential | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | Complaint |
| Mar 11, 2022 | D · potential | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | Routine |
| Mar 11, 2022 | D · potential | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | Routine |
| Mar 11, 2022 | D · potential | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | Routine |
| Mar 11, 2022 | D · potential | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | Routine |
| Mar 11, 2022 | D · potential | 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. | Routine |
| Mar 11, 2022 | D · potential | Provide safe and appropriate respiratory care for a resident when needed. | Routine |
| Mar 11, 2022 | E · potential | Provide safe, appropriate pain management for a resident who requires such services. | Routine |
| Mar 11, 2022 | E · potential | Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist. | Routine |
| Mar 11, 2022 | D · potential | Ensure each resident’s drug regimen must be free from unnecessary drugs. | Routine |
| Mar 11, 2022 | E · potential | 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. | Routine |
| Mar 11, 2022 | D · potential | Ensure that residents are free from significant medication errors. | Routine |
| Mar 11, 2022 | D · potential | 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. | Routine |
| Mar 11, 2022 | E · potential | Provide and implement an infection prevention and control program. | Routine |
Medicare's severity letters: A–C minimal harm, D–F potential for more than minimal harm, G–L actual harm or immediate danger. Source: CMS health deficiencies file, processed October 1, 2026.
Questions to ask on a visit
Antelope Valley Care Center
44567 North 15th St. West, Lancaster, CA 93534 · (661) 949-5524
Visit date: ____________ Spoke with: ______________________
Record on file
- Certification
- Medicare and Medi-Cal certified skilled nursing facility
- Medicare number (CCN)
- 555456
- Certified beds
- 199
- Legal owner
- Antelope Valley SNF Healthcare LLC
- Part of
- Pacs Group
Full profile on Medicare's Care Compare. Source: CMS, processed October 1, 2026.
Is this your business, or is something wrong? Request a correction. It's free, and we never charge to be listed.
Other nursing homes in Lancaster
- Desert Canyon Post Acute, LLC2 of 5 stars overall
- Mirage Post Acute1 of 5 stars overall
- The Ellison John Transitional Care Center2 of 5 stars overall
Nursing homes near Lancaster
- Nursing homes in Lancaster
- Nursing homes in Los Angeles 78
- Nursing homes in Long Beach 25
- Nursing homes in Glendale 13
- Nursing homes in Pasadena 13
- Nursing homes in Santa Monica 12
- Nursing homes in Torrance 12
- Nursing homes in El Monte 11
- Nursing homes in Pomona 9
- Nursing homes in Gardena 8
- Nursing homes in North Hollywood 7
- Nursing homes in Norwalk 7
- Nursing homes in San Gabriel 7
- Search near Lancaster on a map
- All senior living and care in Lancaster