Medicare shows an abuse citation on record. Review the linked inspection sources and ask the facility about corrective action before deciding.
based on 53 Google reviews

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These current public-data fields deserve follow-up with the facility and the official Medicare record. They are not a clinical risk score or a substitute for an in-person assessment.
Medicare shows an abuse citation on record. Read the linked source details, ask the administrator what corrective action was taken, and independently verify the facility’s current status before deciding.
Oakwood Care and Rehabilitation is frequently praised for its friendly, welcoming staff and clean, well-appointed interior spaces. While many families express high satisfaction with the care provided to their loved ones, there are recurring reports of a persistent, strong odor of urine in the hallways. Families considering this facility should weigh the positive, compassionate staff culture against these specific environmental concerns.
Quality Themes
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Concerns
Rating Trends
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Distribution · 48 analyzed
This facility rarely responds to reviews.
Personalized based on this facility's data
Key Review Excerpts
“The building is clean and the staff is friendly. It is an environment that feels inviting, the staff stop to welcome you and offer assistance and the residents are engaged in fun activities.”
“Mom has dementia, good and bad days, but the staff love her. I'm glad she's there for now.”
“The people at Oakwood were very, very nice, no complaints there. But the stench of urine was really bad, I have a good walk to get to my brother’s room and I smelled it really strong all the way down the halls.”
Both RN and total nursing hours are below the EveryPlace reference benchmarks. Ask the facility how it staffs each shift for current resident needs.
Reference benchmarks (0.75 RN and 4.1 total nursing hours per resident/day) are comparison targets, not current federal minimum requirements.
Resident outcomes compared with national, state, and local averages · 17 measures
5
measures
10
measures
2
measures
Residents with depression symptoms
Highly dependent on how each facility screens and codes depressive symptoms, so it varies widely between facilities.
Residents on anti-anxiety or sleep medication
Residents whose bladder or bowel control got worse
Residents needing more daily help over time
Residents on antipsychotic medication
Residents vaccinated for pneumonia
Short-stay residents vaccinated for pneumonia
Short-stay residents vaccinated for the flu
Short-stay residents newly given antipsychotics
US average from Medicare published data
Detailed Medicare record · up to 3-year lookback
Families have repeatedly filed complaints triggering 41 out of 115 deficiencies, with serious concerns about resident protection from abuse and neglect appearing across multiple surveys. Issues consistently involve neglect protection, infection control, and medication management, along with recurring problems with food safety and resident rights. While the facility corrects violations when cited, the pattern of repeated complaints about fundamental safety protections suggests ongoing challenges in maintaining consistent care standards.
Administration Deficiencies
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
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.
Quality of Life and Care Deficiencies
Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
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.
Resident Rights Deficiencies
Allow resident to participate in the development and implementation of his or her person-centered plan of care.
Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Construction Deficiencies
Use approved construction type or materials.
Egress Deficiencies
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
Egress Deficiencies
Install emergency lighting that can last at least 1 1/2 hours.
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Smoke Deficiencies
Properly select, install, inspect, or maintain portable fire extinguishes.
Services Deficiencies
Install properly constructed and protected linen or trash chutes.
Miscellaneous Deficiencies
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Gas, Vacuum, and Electrical Systems Deficiencies
Have generator or other power source capable of supplying service within 10 seconds.
Egress Deficiencies
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Egress Deficiencies
Provide at least two remote exits on each floor or fire section of the building.
Smoke Deficiencies
Provide properly protected cooking facilities.
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Smoke Deficiencies
Install corridor and hallway doors that block smoke.
Gas, Vacuum, and Electrical Systems Deficiencies
Have proper fire barriers, ventilation and signs for the transfilling of oxygen.
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Quality of Life and Care Deficiencies
Provide activities to meet all resident's needs.
Nursing and Physician Services Deficiencies
Observe each nurse aide's job performance and give regular training.
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
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
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.
Nutrition and Dietary Deficiencies
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Quality of Life and Care Deficiencies
Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Federal Penalties
Fine
Jan 29, 2025
$53,151
Payment Denial
Jan 29, 2025
8-day denial
Fine
Apr 10, 2024
$52,416
Fine
Oct 9, 2023
$111,704
Payment Denial
Oct 9, 2023
21-day denial
Oakwood Care and Rehabilitation
for profit
The Ensign Group
342 facilities nationwide
Chain avg rating: 3.2/5 · Rank 314 of 328 (Lowest rating)
Owners
Port, Barry
Individual is an Owner, Partner or Trustee of Any Adp of the Snf
Key personnel
Contact this facility directly and verify the details that matter most to your family.
Medicare Care Compare
Official Medicare quality ratings, inspections & staffing data
Google Maps
Photos, directions & neighborhood info
Google Reviews
53 reviews from families & visitors
Official Website
Visit oakwoodcareandrehab.com
Medicare data downloads
Original nursing home datasets
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. Some summaries, interpretations, suggested questions, and pricing research are AI-generated or AI-assisted and may contain errors or omit important context. 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.
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