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Oak Manor Healthcare & Rehabilitation Center

3500 Oak Manor Lane, Largo, FL 33774 · Pinellas County · (727) 581-9427

180 certified beds, about 130 residents a day · For profit - Limited Liability company · Medicare and Medicaid since 1971

Last standard inspection more than 2 years ago Certified for Medicaid Certified for Medicare
Overall
4 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
5 of 5

CMS Care Compare ratings, data as of September 1, 2026 · CCN 105248 · See it on Medicare.gov · Compare with other homes

The record in brief

At its most recent standard inspection, on January 25, 2024, inspectors cited 3 health deficiencies (the Florida average is 7.1, the national average 9.2).

None of its 13 health citations since February 2020 was rated as actual harm or immediate jeopardy.

CMS lists 1 fine totaling $4,017 in the last three years; the largest was $4,017, and the latest is dated January 25, 2024.

Nurses and nurse aides worked 3.56 hours per resident per day, against 3.82 across Florida and 3.86 nationally. Registered nurses accounted for 0.43 of those hours.

37.6% of nursing staff left within the year CMS measured (Florida average 41.4%).

Health inspections

Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.

Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.

Potential for minimal harm Potential for more than minimal harm Actual harm Immediate jeopardy Found on a complaint visit

Where its citations fall on CMS's grid

CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 13 health citations on file.

Severity
Isolated
Pattern
Widespread
Immediate jeopardy
0J
0K
0L
Actual harm
0G
0H
0I
Potential for more than minimal harm
9D
3E
1F
Potential for minimal harm
0A
0B
0C
January 27, 2025Complaint inspection · 1 citation
  1. D
    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.
    F584 · Resident Rights · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) February 13, 2025
    Inspectors wroteBased on observations, interviews, and record review, the facility failed to ensure resident walls and ceiling tiles were maintained in a clean, sanitary, and homelike environment for three resident rooms (224, 225, and 226) out of three rooms observed on the central wing.
June 5, 2024Complaint inspection · 1 citation
  1. D
    Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
    F656 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · found on a complaint visit · Corrected (the home has a date of correction) June 27, 2024
    Inspectors wroteBased on interview and record review, the facility failed to implement a comprehensive person-centered care plan related to wound care orders for one (Resident #1) of three sampled residents.
January 25, 2024Standard inspection · 3 citations
  1. F
    Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
    F925 · Environmental · No actual harm, potential for more than minimal harm, widespread · Corrected (the home has a date of correction) February 25, 2024
    Inspectors wroteBased on observations, staff interviews and facility file review, the facility failed to ensure an effective pest control program to include one of one kitchen space, and during two of four days observed (1/22/2024 and 1/24/2024).
  2. E
    Ensure each resident receives an accurate assessment.
    F641 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) February 25, 2024
    Inspectors wroteBased on interview and record review, the facility failed to ensure the accuracy of the Minimum Data Set (MDS) assessment for three (#126, #127, and #128) of three records reviewed, related to discharge.
  3. D
    Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
    F657 · Resident Assessment and Care Planning · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) February 25, 2024
    Inspectors wroteBased on observation, interviews, and record review, the facility failed to ensure one resident (41) out of thirty-five sampled was care planned for behaviors.
September 18, 2023Complaint inspection · 1 citation
  1. E
    Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
    F755 · Pharmacy Service · No actual harm, potential for more than minimal harm, pattern · found on a complaint visit · Corrected (the home has a date of correction) October 6, 2023
    Inspectors wroteBased on observation, interview, and record review, the facility failed to maintain a system of records to accurately account for all controlled medications in one of three medication carts inspected for six (Resident #2, #5, #6, #7, #8, and #9) of 15 sampled residents.
October 22, 2021Standard inspection · 3 citations
  1. D
    Provide safe and appropriate respiratory care for a resident when needed.
    F695 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) November 22, 2021
    Inspectors wroteBased on observation, interview, record review, the facility failed to store respiratory equipment in a sanitary manner for one (#376), out of thirteen residents receiving respiratory treatments. Findings Included: On 10/20/21 at 11:29 a.m., an interview was conducted with Resident #376. He confirmed that he received medication via a nebulizer. The nebulizer machine was observed in the first, open drawer of the nightstand. The mask was uncovered, sitting on top of the nebulizer machine (photographic evidence obtained). On 10/21/21 at 12:18 p.m., an interview was conducted with Resident #376. He stated that he used the nebulizer every four hours or as needed. He confirmed that he had used the nebulizer that day. The nebulizer machine was observed in the first, open drawer of the nightstand. The mask was uncovered, sitting on top of the nebulizer machine. (photographic evidence obtained). [...]
  2. D
    Post nurse staffing information every day.
    F732 · Nursing and Physician Services · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) November 22, 2021
    Inspectors wroteBased on observation, interview, and record review, the facility failed to have posted staffing information for all shifts readily accessible to residents and visitors at the main entrance.
  3. D
    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.
    F761 · Pharmacy Service · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) November 22, 2021
    Inspectors wroteBased on observation, interviews, and record review, the facility did not ensure that medications were stored according to current accepted professional principles as evidenced by 1. Failure to secure medications in six of six medication carts and 2. Failure to appropriately store respiratory medication for one (Resident #376) of thirteen residents that received respiratory treatments.
February 7, 2020Standard inspection · 4 citations
  1. E
    Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
    F550 · Resident Rights · No actual harm, potential for more than minimal harm, pattern · Corrected (the home has a date of correction) March 6, 2020
    Inspectors wroteBased on observations, resident interview, and staff interviews, the facility failed to ensure residents had a comfortable and dignified dining experience during four of four days observed (2/4/2020, 2/5/2020, 2/6/2020, and 2/7/2020), in one of four dining rooms (the café restorative room). It was observed that residents were 1. Cramped and in the room with staff constantly carrying items over their heads, 2. Residents positioned close to the wall with hand sanitizer stations right at or just above their heads and 3. Residents seated at tables in a manner not able to receive and take bites of food comfortably.
  2. D
    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.
    F688 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) March 6, 2020
    Inspectors wroteBased on interviews, observations, and record review, the facility did not ensure that one of sixty-one sampled residents (#44,) received adequate treatment and care in accordance with recognized practice standards. Specifically, this was related to the facility did not have orders for Resident #44's thumb splint, hand splint and brace during three of four days.
  3. D
    Provide safe and appropriate respiratory care for a resident when needed.
    F695 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) March 6, 2020
    Inspectors wroteBased on observation, clinical record review, and interview, the facility failed to ensure proper storage of respiratory equipment, of a facemask for two (Resident #102 and Resident #309) of two residents sampled.
  4. D
    Provide safe, appropriate dialysis care/services for a resident who requires such services.
    F698 · Quality of Life and Care · No actual harm, potential for more than minimal harm, isolated · Corrected (the home has a date of correction) March 6, 2020
    Inspectors wroteBased on observations, record review, facility policy review and staff interview, the facility failed to ensure one of five residents who receive Dialysis services, and out of sixty-one sampled total residents (#66), was evaluated for pre and post Dialysis visits. It was determined that the facility's Dialysis communication sheets were not documented with all the required information in order to closely evaluate the residents.

Fire safety inspections

11 fire safety citations on file: 2 on January 25, 2024, 3 on October 22, 2021, 6 on February 7, 2020.

Every fire safety citation11 citations
  1. D
    To conduct inspection, testing and maintenance of fire doors by qualified individuals.
    K 761 · January 25, 2024 · Corrected (the home has a date of correction)
  2. D
    Have generator or other power source capable of supplying service within 10 seconds.
    K 918 · January 25, 2024 · Corrected (the home has a date of correction)
  3. D
    Have properly installed hallway dispensers for alcohol-based hand rub.
    K 325 · October 22, 2021 · Corrected (the home has a date of correction)
  4. D
    Ensure proper usage of power strips and extension cords.
    K 920 · October 22, 2021 · Corrected (the home has a date of correction)
  5. D
    Ensure precautions for handling oxygen cylinders and equipment are correctly followed.
    K 929 · October 22, 2021 · Corrected (the home has a date of correction)
  6. D
    Have approved installation, maintenance and testing program for fire alarm systems.
    K 345 · February 7, 2020 · Corrected (the home has a date of correction)
  7. D
    Have simulated fire drills held at unexpected times.
    K 712 · February 7, 2020 · Corrected (the home has a date of correction)
  8. D
    Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
    K 741 · February 7, 2020 · Corrected (the home has a date of correction)
  9. D
    To conduct inspection, testing and maintenance of fire doors by qualified individuals.
    K 761 · February 7, 2020 · Corrected (the home has a date of correction)
  10. D
    Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
    K 914 · February 7, 2020 · Corrected (the home has a date of correction)
  11. D
    Ensure proper usage of power strips and extension cords.
    K 920 · February 7, 2020 · Corrected (the home has a date of correction)

Fines and payment denials

DatePenaltyAmount or length
January 25, 2024Fine $4,017

A payment denial means Medicare and Medicaid stopped paying for new admissions for that period.

Staffing

Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.

MeasureThis homeFloridaUnited States
All nursing staff (RN, LPN and aides)3.563.823.86
Registered nurses0.430.730.69
All nursing staff on weekends3.223.493.42
Nurse aides2.17
Licensed practical nurses0.96
Nursing staff turnover (share who left in a year)37.6%41.4%45.8%
Registered nurse turnover30.0%46.0%42.9%
Administrators who left2

CMS expects 3.48 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.

Staffing by quarter, from daily payroll records

Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 3.71 on weekdays and 3.22 on weekends, 13% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 5.4% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 3.54 in April to June 2025 to 3.56 in January to March 2026.

QuarterAll nursing staffRegistered nursesWeekdaysWeekendsContract staff shareDays with no RN hoursResidents a day
Jan to Mar 20263.560.433.713.22 5.4%0 of 90130
Oct to Dec 20253.550.403.653.28 8.1%0 of 92131
Jul to Sep 20253.580.393.703.27 5.9%0 of 92126
Apr to Jun 20253.540.373.653.27 7.7%0 of 91126
United States, Jan to Mar 20263.750.623.923.335.3%0.5% of days
Florida, Jan to Mar 20263.760.703.903.441.1%0.2% of days

Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.

Quality measures

The measures CMS uses for the quality star. Lower is better for every one of them.

MeasureThis homeFloridaUS
Percentage of long-stay residents whose need for help with daily activities has increased
Long Stay residents, 2025Q2-2026Q1
2.68.713.9
Percentage of long-stay residents with a catheter inserted and left in their bladder
Long Stay residents, 2025Q2-2026Q1
0.00.30.8
Percentage of long-stay residents with a urinary tract infection
Long Stay residents, 2025Q2-2026Q1
0.80.71.6
Percentage of long-stay residents experiencing one or more falls with major injury
Long Stay residents, 2025Q2-2026Q1
2.12.53.2
Percentage of short-stay residents who newly received an antipsychotic medication
Short Stay residents, 2025Q2-2026Q1
0.71.51.6
Percentage of long-stay residents whose ability to walk independently worsened
Long Stay residents, 2025Q2-2026Q1
3.19.514.1
Percentage of long-stay residents with pressure ulcers
Long Stay residents, 2025Q2-2026Q1
3.44.54.6
Percentage of long-stay residents who received an antipsychotic medication
Long Stay residents, 2025Q2-2026Q1
5.78.615.4
Percentage of short-stay residents who were rehospitalized after a nursing home admission
Short Stay residents, 20250101-20251231
21.726.123.8
Percentage of short-stay residents who had an outpatient emergency department visit
Short Stay residents, 20250101-20251231
2.09.112.0
Number of hospitalizations per 1000 long-stay resident days
Long Stay residents, 20250101-20251231
1.62.11.9
Number of outpatient emergency department visits per 1000 long-stay resident days
Long Stay residents, 20250101-20251231
0.41.11.8

Owners and operators

Legal business name: J1513 LLC.

NameRoleTypeShareSince
Graham, Brad5% or greater direct ownership interestIndividual20%09/15/2022
Hollenbeck, Daniel5% or greater direct ownership interestIndividual20%09/25/2022
Rockefeller, Kevin5% or greater direct ownership interestIndividual60%09/15/2022
Graham, BradW-2 managing employeeIndividual09/15/2022

As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.

Questions to ask on a visit

Chosen from this home's own inspection record.

  1. How do you prevent falls and pressure injuries, and how are families told when one happens?Inspectors cited 4 problems in this area, most recently on October 22, 2021: "Provide safe and appropriate respiratory care for a resident when needed."
  2. When is the care plan meeting, and can family attend it?Inspectors cited 3 problems in this area, most recently on June 5, 2024: "Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured."
  3. How do residents and families raise a complaint or grievance, and how fast is it answered?Inspectors cited 2 problems in this area, most recently on January 27, 2025: "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."
  4. How are medications reviewed, and how often are antipsychotic or sedating drugs used?Inspectors cited 2 problems in this area, most recently on September 18, 2023: "Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist."
  5. Who is on the floor on Saturday and Sunday, and how many residents does each aide care for?Weekend nurse staffing here was 3.22 hours per resident per day, below the Florida average of 3.49.
  6. How long has the current administrator been here?CMS counts 2 administrators who left in the period it measured.

Other nursing homes nearby

Florida contacts for a concern about a nursing home

These are the official offices in Florida. NursingHomeClear cannot take or act on complaints.

Common questions

What is Oak Manor Healthcare & Rehabilitation Center's Medicare star rating?
CMS rates Oak Manor Healthcare & Rehabilitation Center 4 out of 5 stars overall, with 3 for health inspections, 3 for staffing and 5 for quality measures (CMS data as of September 1, 2026).
How many deficiencies did Oak Manor Healthcare & Rehabilitation Center get at its last inspection?
3 health deficiencies at the standard inspection on January 25, 2024. The Florida average is 7.1.
Has Oak Manor Healthcare & Rehabilitation Center been fined?
Yes. CMS lists 1 fine totaling $4,017 in the last three years.
Does Oak Manor Healthcare & Rehabilitation Center accept Medicaid?
It is certified to take Medicaid (CMS lists it as "Medicare and Medicaid"). Certification does not mean a Medicaid bed is open: ask the admissions office.
Who owns Oak Manor Healthcare & Rehabilitation Center?
CMS lists 4 owners and managers. Legal business name: J1513 LLC.

Sources

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