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Nursing HomeMedicaid Investigative

Oaks of Clearwater, the

Below-average Medicare ratings — review the inspection history and ask the administrator about recent corrections before visiting.

420 Bay Ave, Oak Bluffs · Clearwater, FL 3375660 bedsLicensed & Active
2/5
Medicare
Inspection
Quality
Staffing
Google rating
3.9/5

based on 127 Google reviews

5
4
3
2
1
Oaks of Clearwater, the Nursing Home in Clearwater, FL — Street View
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6/ 10
high Risk

Quality Concerns Identified

Medicare inspection and quality data reveal areas that families should carefully evaluate before choosing this facility.

  • Low overall rating (2/5 stars)
  • Low staffing rating (2/5 stars)
  • Above-median deficiencies (13 vs median 6.0)
  • High staff turnover (61%)
  • High RN turnover (83%)

Bottom 25% in FL · Below recommended RN staffing · Above average staffing · $7,409 in fines

Source: Medicare data

What this means for your family

While the facility offers beautiful views and a vibrant social calendar for independent living, the recurring reports of medication errors and neglect in the skilled nursing and memory care units are critical red flags. If you are considering this facility, we strongly recommend conducting unannounced visits and specifically asking for the facility's recent state inspection reports regarding medication administration and staffing ratios.

Google Reviews

Google Reviews

127 reviews on Google
The Oaks of Clearwater is a large facility that offers a wide range of care levels, from independent living to skilled nursing, and is frequently praised for its stunning waterfront views and active social calendar. However, families should be aware of significant, recurring complaints regarding understaffing, inconsistent medication management, and poor communication from management, particularly within the skilled nursing and memory care units.

Quality Themes

Tap a score for details
Food5.0Staff4.0Clean4.0Activities9.0Meds2.0Memory2.0Comms3.0Value7.0

Strengths

  • Stunning waterfront views
  • Active social and activity calendar
  • Competitive pricing for the area
  • Friendly and compassionate individual staff members

Concerns

  • Chronic understaffing leading to neglect (mentioned by 12 reviewers)
  • Dangerous medication management errors (mentioned by 4 reviewers)
  • Poor communication and responsiveness from management (mentioned by 6 reviewers)
  • Building maintenance issues (leaks, cleanliness, outdated areas) (mentioned by 5 reviewers)

Rating Trends

Tap a year to see what changed

234'14(2)'16(5)'18(7)'20(9)'22(22)'24(20)'26(6)

Distribution · 128 analyzed

5
75
4
17
3
5
2
6
1
25

How They Respond to Reviews

80%response rate

This facility actively engages with reviewer feedback.

Questions for Your Tour

  • 1We've heard wonderful things about the beautiful waterfront views here; how do the residents typically enjoy the outdoor spaces?
  • 2With the active social calendar mentioned by many, what are some of the favorite group activities currently happening for the residents?
  • 3How does the nursing team ensure that medication schedules are followed precisely and double-checked for accuracy?
  • 4What specific protocols are in place to ensure that staff are always available to assist residents with their immediate needs throughout the day?
  • 5How does the management team stay in touch with families to provide regular updates on a resident's well-being and any changes in care?
  • 6Could you tell us about your current plans for any building maintenance or updates to ensure the facility stays clean and comfortable?

Personalized based on this facility's data


Key Review Excerpts

Since moving my mother into The Oaks, I have personally witnessed seven separate occasions where her prescribed medications were left in her apartment and not administered—an alarming violation of proper medication management protocols.

Memory care family member · 2025☆☆☆☆

Between June and December my wheelchair bound family member was sent to the hospital 3 times for mismanaged (overdosed) insulin, fell unconscious in my arms once for low blood sugar... I tried to get the medical staff to fix this 4 times.

Long-term resident's family · 2023☆☆☆☆

The Oaks is just bad all the way around. Just to mention a few things: Apartments are not cleaned, and to make matters worse, they flat out lie by saying that they did clean the apartment.

Independent living family member · 2023☆☆☆☆
Source: 127 Google reviews

Staffing

Staffing Hours

per resident/day · Medicare 2026
RN Hours
0.40hrs
53%
Registered nurses for medical care
Total Nursing
3.92hrs
96%
All nurses + aides combined
Staff Turnover
67%
Lower is better (< 30% = good)
RN Turnover
86%
Lower is better (< 30% = good)

Both RN and total nursing hours are below national benchmarks. This can mean less clinical attention per resident, so ask about their staffing plan.

Quality Measures

Quality Measures

Resident outcomes compared with national, state, and local averages · 17 measures

Medicare Rating
3/ 5
Better Than Avg

10

measures

Worse Than Avg

5

measures

Mixed Results

2

measures

Long-Stay Residents
💊

Residents on anti-anxiety or sleep medication

↓ Lower is better
This Facility39.9%
Worse than Avg
Here
39.9%
US
19.5%
FL
15.0%
Pinellas
18.7%
🚶

Residents whose walking got worse

↓ Lower is better
This Facility23.1%
Worse than Avg
Here
23.1%
US
15.3%
FL
10.6%
Pinellas
10.6%
😔

Residents with depression symptoms

↓ Lower is better
This Facility1.5%
Better than Avg
Here
1.5%
US
12.1%
FL
4.1%
Pinellas
3.4%

Highly dependent on how each facility screens and codes depressive symptoms, so it varies widely between facilities.

💊

Residents on antipsychotic medication

↓ Lower is better
This Facility5.2%
Better than Avg
Here
5.2%
US
15.5%
FL
8.7%
Pinellas
8.0%
🚿

Residents whose bladder or bowel control got worse

↓ Lower is better
This Facility9.4%
Better than Avg
Here
9.4%
US
19.4%
FL
11.5%
Pinellas
11.5%
🛏️

Residents needing more daily help over time

↓ Lower is better
This Facility16.4%
Worse than Avg
Here
16.4%
US
14.4%
FL
9.1%
Pinellas
9.9%
Short-Stay Residents (Rehab / Post-Acute)
💉

Short-stay residents vaccinated for the flu

↑ Higher is better
This Facility93.7%
Mixed vs Avgs
Here
93.7%
US
79.8%
FL
94.7%
Pinellas
93.3%
💉

Short-stay residents vaccinated for pneumonia

↑ Higher is better
This Facility93.7%
Mixed vs Avgs
Here
93.7%
US
81.8%
FL
94.8%
Pinellas
92.6%
💊

Short-stay residents newly given antipsychotics

↓ Lower is better
This Facility0.0%
Better than Avg
Here
0.0%
US
1.6%
FL
1.5%
Pinellas
1.8%
Source: Medicare quality measures

US average from Medicare published data

Inspection History

Medicare Inspection History

3-year lookback · Medicare 2026

12deficiencies
Well above state avg (7.3)
2 complaint-triggered
$7,409 in fines

This facility shows a concerning pattern with 45 deficiencies across five surveys, including two complaint-triggered investigations where families filed reports about grievance handling and abuse response. The most recurring issues involve resident rights violations, fire safety problems, and food safety concerns, with some deficiencies like dietary violations and fire safety appearing repeatedly across multiple surveys, suggesting ongoing challenges with maintaining consistent compliance standards.

Oct 2, 2025Routine
18
0812Potential for harm · WidespreadCorrected

Nutrition and Dietary Deficiencies

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

0880Potential for harm · WidespreadCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

0291Potential for harm · WidespreadCorrected

Egress Deficiencies

Install emergency lighting that can last at least 1 1/2 hours.

0345Potential for harm · WidespreadCorrected

Smoke Deficiencies

Have approved installation, maintenance and testing program for fire alarm systems.

0353Potential for harm · WidespreadCorrected

Smoke Deficiencies

Inspect, test, and maintain automatic sprinkler systems.

0914Potential for harm · WidespreadCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.

0584Potential for harm · PatternCorrected

Resident Rights Deficiencies

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.

0925Potential for harm · PatternCorrected

Environmental Deficiencies

Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.

0582Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.

0644Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

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

0645Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

PASARR screening for Mental disorders or Intellectual Disabilities

0689Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

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

0756Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.

0759Potential for harm · IsolatedCorrected

Pharmacy Service Deficiencies

Ensure medication error rates are not 5 percent or greater.

0842Potential for harm · IsolatedCorrected

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.

0511Potential for harm · IsolatedCorrected

Services Deficiencies

Have properly installed electrical wiring and gas equipment.

0541Potential for harm · IsolatedCorrected

Services Deficiencies

Install properly constructed and protected linen or trash chutes.

0741Potential for harm · IsolatedCorrected

Miscellaneous Deficiencies

Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.

Jul 24, 2025Complaint
1
0585Potential for harm · IsolatedCorrected

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.

Apr 18, 2025Complaint
1
0610Potential for harm · IsolatedCorrected

Freedom from Abuse, Neglect, and Exploitation Deficiencies

Respond appropriately to all alleged violations.

Sep 20, 2023Routine
18
0583Potential for harm · PatternCorrected

Resident Rights Deficiencies

Keep residents' personal and medical records private and confidential.

0584Potential for harm · PatternCorrected

Resident Rights Deficiencies

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.

0812Potential for harm · PatternCorrected

Nutrition and Dietary Deficiencies

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

0550Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

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

0641Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Ensure each resident receives an accurate assessment.

0644Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

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

0657Potential for harm · IsolatedCorrected

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.

0676Potential for harm · IsolatedCorrected

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.

0677Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

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

0695Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

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

0880Potential for harm · IsolatedCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

0919Potential for harm · IsolatedCorrected

Environmental Deficiencies

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

0291Potential for harm · IsolatedCorrected

Egress Deficiencies

Install emergency lighting that can last at least 1 1/2 hours.

0345Potential for harm · IsolatedCorrected

Smoke Deficiencies

Have approved installation, maintenance and testing program for fire alarm systems.

0351Potential for harm · IsolatedCorrected

Smoke Deficiencies

Install an approved automatic sprinkler system.

0712Potential for harm · IsolatedCorrected

Miscellaneous Deficiencies

Have simulated fire drills held at unexpected times.

0761Potential for harm · IsolatedCorrected

Miscellaneous Deficiencies

To conduct inspection, testing and maintenance of fire doors by qualified individuals.

0920Potential for harm · IsolatedCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Ensure proper usage of power strips and extension cords.

Sep 10, 2021Routine
7
0623Potential for harm · PatternCorrected

Resident Rights Deficiencies

Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.

0625Potential for harm · PatternCorrected

Resident Rights Deficiencies

Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.

0732Potential for harm · PatternCorrected

Nursing and Physician Services Deficiencies

Post nurse staffing information every day.

0812Potential for harm · PatternCorrected

Nutrition and Dietary Deficiencies

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

0758Potential for harm · IsolatedCorrected

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.

0355Potential for harm · IsolatedCorrected

Smoke Deficiencies

Properly select, install, inspect, or maintain portable fire extinguishes.

0741Potential for harm · IsolatedCorrected

Miscellaneous Deficiencies

Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.

Ownership & Operations

Who Operates This Facility

Owner / Operator

Oaks of Clearwater, the

Organization Type

for profit

Ownership & Management

Owners

Oaks on the Bay LLC

Owner · Organization

Spring Haven Retirement LLC

Owner · Organization

Jones, David

Owner (parent company)

5%

Mccarthy, Terence

Owner (parent company)

95%

Key personnel

Lyzzaik, ImadW-2 Managing EmployeeDavis, FrancesOfficer / Director
Source: Medicare provider data

Contact

Get in Touch

Contact this facility directly and verify the details that matter most to your family.

References & Resources

EveryPlace is a research directory. Facility information is compiled from public sources — Medicare.gov, state licensing portals, Google Places, and publicly available street-level imagery. Listings do not constitute endorsement, recommendation, or advertisement, and we do not accept payment for placement. Families should verify all details directly with the facility and the original sources linked above before making any care decisions. See our Research Policy for our editorial standards, correction process, and image-removal policy.

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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