Royale Gardens Health & Rehabilitation Center
Below-average Medicare ratings — review the inspection history and ask the administrator about recent corrections before visiting.
based on 52 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 (2/5 stars)
- Above-median deficiencies (25 vs median 9.0)
- High staff turnover (62%)
Below average in OR · Below recommended RN staffing · Above recommended total nurse staffing · $200,505 in fines
What this means for your family
While some families report successful short-term rehab outcomes, the facility has a consistent pattern of serious complaints regarding medication management and basic hygiene. If you are considering this facility, we strongly recommend unannounced visits during weekends and evenings to assess staffing levels and response times for yourself.
Google Reviews
Google Reviews
52 reviews on Google“Royale Gardens Health & Rehabilitation Center (formerly Highland House) receives highly polarized feedback, with some families praising the rehab therapy and specific staff members, while others report severe neglect and unprofessionalism. Common complaints include significant delays in medication administration, poor hygiene, and chronic understaffing that impacts basic patient care. Families should be aware of the stark contrast between positive rehab experiences and reports of unsafe conditions for long-term residents.”
Quality Themes
Tap a score for detailsStrengths
- Effective physical therapy programs
- Some compassionate and attentive individual staff members
- Supportive transition and discharge planning
- Veterans wing noted for thoughtful care
Concerns
- Significant delays or errors in medication administration (mentioned by 6 reviewers)
- Chronic understaffing and slow response to call lights (mentioned by 7 reviewers)
- Poor hygiene and failure to assist with basic personal care (mentioned by 6 reviewers)
- Poor food quality and unappealing meals (mentioned by 4 reviewers)
- Communication barriers and lack of transparency from administration (mentioned by 4 reviewers)
Rating Trends
Tap a year to see what changed
Distribution · 105 analyzed
How They Respond to Reviews
This facility responds to some reviews.
Questions for Your Tour
- 1Given that medication management is a top priority for our family, could you walk us through the specific double-check process your nursing team uses to ensure medications are administered accurately and on time?
- 2We noticed that call light response times are a common concern for families; what is your current protocol for monitoring these requests, and how do you ensure staff are alerted when a resident needs immediate assistance?
- 3Could you describe the daily routine for residents, particularly regarding how staff provide support with personal hygiene and grooming to ensure residents feel comfortable and well-cared for throughout the day?
- 4We see that the facility has a dedicated Veterans wing; what specific programs or extra support services are offered there to honor the unique needs of those residents?
- 5How does your administration team handle communication with families regarding changes in a resident's health status, and what is the best way for us to stay updated on our loved one's daily progress?
- 6We understand that nutrition is vital for recovery; could you tell us about the meal planning process and how you accommodate residents who may find the standard menu options unappealing?
Personalized based on this facility's data
Key Review Excerpts
“My mother has just been placed there 2 days ago. She is not given her medications she has been on for years, including life needing insulin. Her blood sugar is at 500 and they refuse to do anything for her.”
“Highland House provided weeks of A+ care for my wife who needed rehab following brain surgery. Every aspect of her care was over the top.”
“The facility is loud for starters and hard for my father to get any rest. When asking questions about my father’s health the staff could not provide a direct answer.”
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 · 17 measures
14
measures
3
measures
Residents on anti-anxiety or sleep medication
Residents on antipsychotic medication
Residents with depression symptoms
Highly dependent on how each facility screens and codes depressive symptoms, so it varies widely between facilities.
Residents vaccinated for pneumonia
Residents who lost too much weight
Residents whose walking got worse
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
Inspection History
Medicare Inspection History
3-year lookback · Medicare 2026
This facility shows concerning patterns with numerous family complaints triggering investigations, though all deficiencies have been corrected. The most recurring problems involve wound care and pressure ulcer prevention, care planning and assessments, and resident protection from abuse or neglect. While the facility addresses issues when cited, the high volume of complaint-driven investigations (37 out of 91 total deficiencies) and repeated problems in critical care areas suggest ongoing quality concerns families should carefully evaluate during visits.
Mar 13, 2026Routine10
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Resident Rights Deficiencies
Allow resident to participate in the development and implementation of his or her person-centered plan of care.
Resident Rights Deficiencies
Allow residents to self-administer drugs if determined clinically appropriate.
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.
Quality of Life and Care Deficiencies
Provide activities to meet all resident's needs.
Quality of Life and Care Deficiencies
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.
Administration Deficiencies
Provide timely, approved x-ray services, or have an agreement with an approved provider to obtain them.
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.
Mar 13, 2026Complaint1
Environmental Deficiencies
Make sure that a working call system is available in each resident's bathroom and bathing area.
Jan 28, 2026Complaint1
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Jul 23, 2025Complaint2
Resident Rights Deficiencies
Ensure that residents are fully informed and understand their health status, care and treatments.
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.
May 1, 2025Complaint1
Nursing and Physician Services Deficiencies
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Feb 28, 2025Complaint1
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Federal Penalties
Fine
Jan 25, 2024
$81,613
Fine
Jul 14, 2023
$71,065
Ownership & Operations
Who Operates This Facility
Royale Gardens Health & Rehabilitation Center
for profit
Chain Affiliation
Volare Health
16 facilities nationwide
Chain avg rating: 1.7/5 · Rank 4 of 15
Ownership & Management
Owners
Pac 12 Opco Holdco LLC
Owner · Organization
Knox Healthcare Pac 12 Holdings LLC
Owner (parent company) · Organization
Pac 12 Holdings LLC
Owner (parent company) · Organization
Pac 12 Pinnacle Holdco LLC
Owner (parent company) · Organization
Hagler, Alexander
Owner (parent company)
Knox, Donald
Owner (parent company)
Key personnel
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
52 reviews from families & visitors
Official Website
Visit highlandhousencc.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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