Overall sentiment is deeply mixed but leans strongly toward negative: the compiled reviews reveal a facility with significant variability in care and operations. A subset of reviews praise clinicians (OT team, some nurse practitioners) and individual caregivers for being attentive, knowledgeable, and personable; families in some cases reported feeling welcome, included in care conversations, and optimistic about recent management reforms. However, a much larger and more persistent set of complaints describe chronic understaffing, poor training, inconsistent competence among staff, frequent communication failures, and serious cleanliness and safety problems. These negative reports are frequent, specific, and severe enough that they dominate the overall impression.
Care quality and clinical concerns: Many reviewers describe missed or delayed care—long waits for call-button responses (with multiple reports of >10 minutes and a few reporting 2+ hour delays), delayed pain medications, missed medication refills, and inadequate pain management. There are alarming accounts of neglect (residents left in urine or feces for hours, not fed or changed, found on the floor after falls), falls during transfers, and reported elder abuse or dehumanizing treatment. Some reviewers allege medication mismanagement, inappropriate handling of legal/financial documents (power of attorney), and even attempts to collect SSI, which, if true, indicate serious procedural and regulatory risks. Conversely, other reviewers describe timely medical attention and improved clinical oversight under new leadership, but these positive clinical reports are less numerous and often tied to specific timeframes (e.g., after a management change).
Staff behavior, morale, and communication: Reviews paint a bifurcated picture of staff. Positive accounts emphasize friendly, caring CNAs and nurses who know residents by name, respond promptly, and go above and beyond (including instances of extended care). Negative reports, which are more numerous and detailed, describe rude or unprofessional staff (including front desk personnel), staff who are disengaged or on personal phones, and caregivers who lack empathy. Low staff morale is a repeated theme and often offered as an explanation for inconsistent care. Communication problems are pervasive: front desk staff transferring calls abruptly, long hold times, phones being dropped, staff admitting they don't know how to use facility phones, poor coordination between shifts, social workers not returning calls or emails, and confusion or poor enforcement of visitation policies (including required 24-hour notices that were not communicated). Specific staff names and incidents were cited in several reviews, indicating recurring personnel-related issues at reception and nursing leadership levels.
Facility, cleanliness, and safety environment: Multiple reviewers describe strong and recurring odors (urine and sometimes feces), visible uncleanliness (dusty shelves, leftover trays, spilled liquids), damaged walls, worn furniture, and an overall old and rundown appearance that contradicts website imagery. Slow or sticky elevators, broken beds or stiff mattresses, unlit rooms, and other maintenance deficits were reported. Safety concerns extend beyond cleaning—reports of unsecured wandering residents, potential neighborhood crime, missing personal items, and allegations of theft or bullying raise questions about physical and procedural security. While some reviewers explicitly state the facility was clean and had no odor during their stay, the prevalence and severity of the negative cleanliness and safety reports are a major pattern.
Dining and nutrition: Reviews on meals are mixed. A few reviewers said the food tasted good and the dining experience could be welcoming, while many others complained about poor nutrition (especially diabetic meals not being low-carb or appropriate), small portions, unpleasant food smells, and dining-room hygiene issues (leftover trays and spills). For residents with specialized diets or diabetes, the reported lapses are significant and recurring.
Management, ownership transition, and recent changes: Several reviews mention ownership or administrative transitions. A new administrator (Crystal, noted December 2024) and reports of management attempting reforms were cited positively by some families who saw improvements in staff attitude and responsiveness. Conversely, many reviews criticize management as unhelpful, rude, or dismissive, refusing grievance forms or failing to follow up. The mixed feedback suggests that outcomes may be shifting over time and that some improvements have been noticed, but that systemic problems persist and are not yet fully resolved.
Notable allegations and patterns of serious concern: Beyond common complaints, multiple reviewers made severe, specific allegations—missing belongings (necklaces, clothing), improper document handling related to POA, claims of attempts to collect SSI, and descriptions of residents being treated as if deceased. A number of reviews called for regulatory shutdown or described the facility as the "worst" or "disgusting." These statements indicate a level of distrust and fear among family members and should prompt external review or investigation if corroborated.
Overall assessment and implications: The reviews collectively describe a facility with highly inconsistent performance. Strengths include pockets of competent clinical staff, dedicated caregivers, visible cleaning at times, and early signs of management-driven improvements. However, the frequency and severity of complaints about understaffing, neglect, poor cleanliness, safety incidents, and communication breakdowns create a substantial pattern of risk for prospective residents. The most consistent themes are staffing shortages and poor responsiveness, hygiene and odor problems, and variable leadership or administrative accountability.
Recommendations for decision-makers and families: Treat reviews as evidence of significant variability. If considering this facility, pursue specific, up-to-date verification: ask for staffing ratios by shift, recent inspection reports, infection-control and cleaning protocols, fall and incident logs, medication management policies, and evidence of remedial actions from management since the ownership/administration changes. Arrange an unannounced visit during different shifts (day, evening, night) to directly observe responsiveness, cleanliness, and staff interactions. For current families, document incidents carefully, escalate through facility leadership, and contact local regulatory agencies if there are unresolved safety or neglect concerns. The presence of positive accounts and reported management efforts offers some hope that problems can be addressed, but the volume and severity of negative reports warrant caution and active oversight.
