01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-01-30 | 4 | 2025-01-30 | 0 |
| Cycle 2 | 2022-12-02 | 16 | 2022-12-02 | 4 |
| Cycle 3 | 2021-05-06 | 1 | 2021-05-06 | 0 |
CMS CCN 1061462026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
The Club At Lake Gibson
855 Carpenters Way · Lakeland, FL 33809 · Polk County
Certified beds120CMS provider file
Recent citation rows25current CMS citation release
Penalty rows0current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
25 rows in the current release
3 rows carry G–L scope/severity codes; 0 carry J–L. 3 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-05-08 · HEALTHF0689Severity G · isolated actual harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2026-06-22 · complaint2026-05-08 · HEALTHF0726Severity G · isolated actual harm
Nursing and Physician Services Deficiencies
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Correction field: Deficient, Provider has date of correction · 2026-06-22 · complaint2025-01-30 · HEALTHF0761Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2025-03-012025-01-30 · HEALTHF0880Severity E · pattern; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2025-03-012024-10-24 · HEALTHF0552Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Ensure that residents are fully informed and understand their health status, care and treatments.
Correction field: Deficient, Provider has date of correction · 2024-11-24 · complaint2024-10-24 · HEALTHF0694Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide for the safe, appropriate administration of IV fluids for a resident when needed.
Correction field: Deficient, Provider has date of correction · 2024-11-24 · complaint2024-10-24 · HEALTHF0880Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2024-11-24 · complaint2024-07-18 · HEALTHF0761Severity F · widespread; potential for more than minimal harm
Pharmacy Service Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2024-08-13 · complaint2022-12-02 · HEALTHF0578Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Correction field: Deficient, Provider has date of correction · 2023-02-222022-12-02 · HEALTHF0637Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Assess the resident when there is a significant change in condition
Correction field: Deficient, Provider has date of correction · 2022-12-312022-12-02 · HEALTHF0656Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Correction field: Deficient, Provider has date of correction · 2022-12-312022-12-02 · HEALTHF0676Severity D · isolated; potential for more than minimal harm
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.
Correction field: Deficient, Provider has date of correction · 2022-12-312022-12-02 · HEALTHF0679Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide activities to meet all resident's needs.
Correction field: Deficient, Provider has date of correction · 2022-12-312022-12-02 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2022-12-312022-12-02 · HEALTHF0689Severity G · isolated actual harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2022-12-312022-12-02 · HEALTHF0697Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe, appropriate pain management for a resident who requires such services.
Correction field: Deficient, Provider has date of correction · 2022-12-312022-12-02 · HEALTHF0725Severity E · pattern; potential for more than minimal harm
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.
Correction field: Deficient, Provider has date of correction · 2022-12-312022-12-02 · HEALTHF0761Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
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.
Correction field: Deficient, Provider has date of correction · 2022-12-312022-12-02 · HEALTHF0791Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide or obtain dental services for each resident.
Correction field: Deficient, Provider has date of correction · 2022-12-312022-12-02 · HEALTHF0867Severity D · isolated; potential for more than minimal harm
Administration Deficiencies
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Correction field: Deficient, Provider has date of correction · 2023-02-222022-12-02 · HEALTHF0880Severity E · pattern; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2022-12-312022-12-02 · FIREK0223Severity D · isolated; potential for more than minimal harm
Egress Deficiencies
Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.
Correction field: Deficient, Provider has date of correction · 2023-01-032022-12-02 · FIREK0345Severity D · isolated; potential for more than minimal harm
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Correction field: Deficient, Provider has date of correction · 2023-01-032022-12-02 · FIREK0761Severity D · isolated; potential for more than minimal harm
Miscellaneous Deficiencies
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Correction field: Deficient, Provider has date of correction · 2023-01-0303 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| No penalty row appeared in the August 2026 penalties file. | |||
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- LAKE GIBSON SNF HOLDCO LLCOrganization · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 10/01/2024
- KATZ, AHARONIndividual · 5% OR GREATER INDIRECT OWNERSHIP INTEREST10% · since 10/01/2024
- BUAH MD TRUSTOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 10/01/2024
- COPPER FL TRUST IIOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 10/01/2024
- GOLD FL TRUST IIOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 10/01/2024
- SILVER FL TRUST IIOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 10/01/2024
- BANK HAPOALIM B.M.Organization · 5% OR GREATER MORTGAGE INTERESTNOT APPLICABLE · since 10/01/2024
- KAMARA, MARIEIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 01/05/2025
- MCDANIEL, CLAYIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 10/01/2024
- WILLIS, ANGELAIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 10/01/2024
- LAKE GIBSON SNF HOLDCO LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/01/2024
- KAMARA, MARIEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/05/2025
- RIOS, JOLIANIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 11/27/2024
- APEX GLOBAL SOLUTIONS LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 10/01/2024
- ASURE WOUND SOLUTIONS LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 06/26/2025
- BANK HAPOALIM B.M.Organization · ADP OF THE SNFNOT APPLICABLE · since 10/01/2024
- CHAIM GITELIS DO PCOrganization · ADP OF THE SNFNOT APPLICABLE · since 10/01/2024
- FORVIS MAZARS LLPOrganization · ADP OF THE SNFNOT APPLICABLE · since 10/01/2024
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours3.54per resident day
RN hours0.53per resident day
Weekend nurse hours3.18per resident day
Staff turnover54.7%CMS reported field
06 / LOCAL RECORDS
Open the Lakeland ledger →Other published facilities nearby
Breezy Hills Rehab And Care Center120 beds · CMS overall 2/552 citation rowsBridgewalk On Harden Health And Rehabilitation, Ll120 beds · CMS overall 1/524 citation rowsCharming Lakes Rehab120 beds · CMS overall 2/545 citation rowsFlorida Presbyterian Homes Inc68 beds · CMS overall 5/523 citation rowsHighlands Lake Center179 beds · CMS overall 2/535 citation rowsLakeland Hills Center120 beds · CMS overall 2/540 citation rowsManor At Carpenters, The72 beds · CMS overall 4/524 citation rowsScott Lake Health And Rehabilitation Center120 beds · CMS overall 2/534 citation rows