Gracelen Care Center
Below-average Medicare ratings — review the inspection history and ask the administrator about recent corrections before visiting.
based on 17 Google reviews

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Quality Concerns Identified
Medicare inspection and quality data reveal areas that families should carefully evaluate before choosing this facility.
- Low overall rating (1/5 stars)
- Above-median deficiencies (11 vs median 9.0)
Bottom 25% in OR · Below recommended RN staffing · Above recommended total nurse staffing · No penalties on record
What this means for your family
We strongly advise against considering this facility based on the consistent and severe reports of neglect, overcrowding, and poor medical oversight. If you are currently evaluating options, please prioritize facilities with transparent staffing ratios and positive recent inspections, as the current feedback for this location indicates a high risk to resident safety.
Google Reviews
Google Reviews
17 reviews on Google“Gracelen Care Center faces severe and consistent criticism regarding patient neglect, lack of privacy, and poor living conditions. Multiple reviewers report that residents are housed four to a room, experience significant delays in assistance, and suffer from inadequate hygiene and medical care. While some older reviews from 2017-2018 praised the memory care staff, the overwhelming majority of recent feedback describes a facility in crisis.”
Quality Themes
Tap a score for detailsStrengths
- Historical praise for memory care staff
- Quiet, pleasant grounds (historical)
Concerns
- Severe overcrowding with 4 residents per room (mentioned by 4 reviewers)
- Neglect of basic hygiene and medical needs (mentioned by 5 reviewers)
- Slow or non-existent staff response to calls for help (mentioned by 3 reviewers)
Rating Trends
Tap a year to see what changed
Distribution · 19 analyzed
How They Respond to Reviews
Questions for Your Tour
- 1Given that some rooms accommodate four residents, how do you ensure each individual receives adequate personal space and privacy?
- 2Could you walk me through your current process for responding to call lights and how you ensure residents receive timely assistance?
- 3With the recent focus on improving cleanliness and hygiene standards, what specific daily protocols are now in place to maintain the living areas?
- 4How does your team coordinate medication management to ensure accuracy and consistency for residents with complex health needs?
- 5What steps are you taking to improve communication with families regarding changes in a resident's health or daily well-being?
- 6Can you describe how your staff is currently trained to support the specific needs of memory care residents to ensure they feel engaged and safe?
Personalized based on this facility's data
Key Review Excerpts
“Most residents will be left to sit in their own urine for the most of the day and only changed a few times, if that.”
“My father was on hospice and its all I can do to flag people down to get him meds to make him feel ok. They cram people in 4 people to a room.”
“They caused my father to have bed sores and then blamed him for the injury. The food is terrible, and they don't give enough portions to feed everyone.”
Staffing
Staffing Hours
per resident/day · Medicare 2026RN hours are below the national benchmark. RNs handle complex medical needs and medication, so ask about coverage during your visit.
Quality Measures
Quality Measures
Resident outcomes compared with national, state, and local averages · 16 measures
7
measures
4
measures
5
measures
Residents on antipsychotic medication
Residents on anti-anxiety or sleep medication
Residents vaccinated for pneumonia
Residents needing more daily help over time
Residents with depression symptoms
Highly dependent on how each facility screens and codes depressive symptoms, so it varies widely between facilities.
Residents whose walking got worse
Short-stay residents vaccinated for pneumonia
Short-stay residents vaccinated for the flu
US average from Medicare published data
Inspection History
Medicare Inspection History
3-year lookback · Medicare 2026
Gracelen Care Center has faced recurring problems with families filing multiple complaints about safety hazards, abuse prevention, and quality of care. The facility shows persistent issues across medication management, infection control, and resident safety that have continued across recent surveys through 2025. While the provider reports correcting deficiencies, the pattern of repeated violations in core care areas suggests ongoing operational challenges families should carefully consider.
Mar 10, 2026Complaint1
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Oct 20, 2025Complaint2
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Aug 28, 2025Complaint1
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Jul 25, 2025Routine10
Nursing and Physician Services Deficiencies
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
Egress Deficiencies
Meet other general requirements.
Services Deficiencies
Meet other general requirements that are deficient.
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Pharmacy Service Deficiencies
Ensure medication error rates are not 5 percent or greater.
Pharmacy Service Deficiencies
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.
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Dec 19, 2024Complaint2
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.
Resident Rights Deficiencies
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.
Apr 8, 2024Routine16
Nutrition and Dietary Deficiencies
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.
Emergency Preparedness Deficiencies
Conduct testing and exercise requirements.
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Gas, Vacuum, and Electrical Systems Deficiencies
Have generator or other power source capable of supplying service within 10 seconds.
Nursing and Physician Services Deficiencies
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.
Nursing and Physician Services Deficiencies
Observe each nurse aide's job performance and give regular training.
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Nursing and Physician Services Deficiencies
Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies
Ensure that residents are fully informed and understand their health status, care and treatments.
Resident Rights Deficiencies
Reasonably accommodate the needs and preferences of each resident.
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
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.
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.
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Pharmacy Service Deficiencies
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Ownership & Operations
Who Operates This Facility
Gracelen Care Center
for profit
Ownership & Management
Owners
Undisclosed
Ownership Data Not Available · Organization
Contact
Get in Touch
Contact this facility directly and verify the details that matter most to your family.
References & Resources
Medicare Care Compare
Official Medicare quality ratings, inspections & staffing data
Google Maps
Photos, directions & neighborhood info
Google Reviews
17 reviews from families & visitors
Official Website
Visit gracelenterrace.com
Medicare data downloads
Original nursing home datasets
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Safer Alternatives Nearby
Based on current clinical data, we identified 6 nearby facilities within 10 miles that may offer a stronger care environment. We encourage families to compare options carefully.
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