Cycle 1
Health 2025-12-04 · Fire 2025-12-04
11 health deficiencies
Top issue: Quality of Life and Care (4 deficiencies)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Mount Dora, FL
Avante At Mt Dora, Inc
3-star overall rating with 3-star inspections with 11 recent health deficiencies
3050 Brown Ave, Mount Dora, FL
(352) 383-4161
Overall
3 / 5
CMS overall stars
Health inspections
3 / 5
Survey and complaint cycles
Staffing
2 / 5
RN + nurse staffing
Quality measures
3 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
116
Certified beds
Average residents
105
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
Avante Centers
Operator or chain grouping
Approved since
1980-10-01
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Chain footprint
11 facilities
Chain averages 3 overall / 3 health / 3 staffing / 4 quality stars
Changed ownership
No
Within the last 12 months
Family council
Yes
Resident and family council reported
Sprinklers
Yes
Automatic sprinklers in all required areas
Staffing
Hours and turnover
RN hours / resident day
0.34
Registered nurse staffing · state 0.73 · national 0.68
LPN hours / resident day
1.01
Licensed practical nurse staffing · state 0.79 · national 0.87
Aide hours / resident day
2.20
Nurse aide staffing · state 2.34 · national 2.35
Total nurse hours
3.55
All reported nurse hours · state 3.86 · national 3.89
Licensed hours
1.35
RN + LPN hours · state 1.52 · national 1.54
Weekend hours
3.26
Weekend nurse staffing · state 3.51 · national 3.43
Weekend RN hours
0.24
Weekend registered nurse coverage · state 0.53 · national 0.47
Physical therapist
0.11
Reported PT staffing · state 0.10 · national 0.07
Adjusted RN hours
0.32
CMS adjusted RN staffing hours
Adjusted total hours
3.39
CMS adjusted total nurse staffing hours
Case-mix index
1.43
Higher values indicate more complex resident acuity
RN turnover
36%
Annual RN turnover · state 46% · national 45%
Total nurse turnover
38%
Annual nurse turnover · state 42% · national 46%
SNF VBP
Value-based purchasing
Program rank
9,622
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
23.09
Composite VBP score used to determine payment impact.
Payment multiplier
0.9831
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
0
Baseline 20.20% · Performance 22.48% · Measure score 0 · Achievement 0 · Improvement 0
Healthcare-associated infections
0
Baseline 7.52% · Performance 9.12% · Measure score 0 · Achievement 0 · Improvement 0
Total nurse turnover
7.74
Performance 32.04% · Measure score 7.74 · Achievement 7.74 · This facility did not have sufficient data to calculate a baseline period measure result.
Adjusted total nurse staffing
1.50
Baseline 3.80 hours · Performance 3.50 hours · Measure score 1.50 · Achievement 1.50 · Improvement 0
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 10.43% |
10.72%
0.3 pts better
|
No Different than the National Rate · Eligible stays 81 · Observed rate 11.11% · Lower 95% interval 6.2% |
| Discharge to community | 48.24% |
50.57%
2.3 pts worse
|
No Different than the National Rate · Eligible stays 53 · Observed rate 35.85% · Lower 95% interval 33.9% |
| Medicare spending per beneficiary | 1.55 |
1.02
0.5 pts worse
|
|
| Drug regimen review with follow-up | 60.18% |
95.27%
35.1 pts worse
|
Numerator 68 · Denominator 113 |
| Falls with major injury | 0.88% |
0.77%
0.1 pts worse
|
Numerator 1 · Denominator 113 |
| Discharge self-care score | 39.34% |
53.69%
14.3 pts worse
|
Numerator 24 · Denominator 61 |
| Discharge mobility score | 50.82% |
50.94%
0.1 pts worse
|
Numerator 31 · Denominator 61 |
| Pressure ulcers or injuries, new or worsened | 10.62% |
2.29%
8.3 pts worse
|
Numerator 12 · Denominator 113 · Adjusted rate 9.48% |
| Healthcare-associated infections requiring hospitalization | 9.11% |
7.12%
2 pts worse
|
No Different than the National Rate · Eligible stays 53 · Observed rate 15.09% · Lower 95% interval 5.08% |
| Staff COVID-19 vaccination coverage | 0% |
8.2%
8.2 pts worse
|
Numerator 0 · Denominator 100 |
| Staff flu vaccination coverage | 38.14% |
42%
3.9 pts worse
|
Numerator 74 · Denominator 194 |
| Discharge function score | 45.9% |
56.45%
10.6 pts worse
|
Numerator 28 · Denominator 61 |
| Transfer of health information to provider | 65.12% |
95.95%
30.8 pts worse
|
Numerator 28 · Denominator 43 |
| Transfer of health information to patient | 87.18% |
96.28%
9.1 pts worse
|
Numerator 34 · Denominator 39 |
| Resident COVID-19 vaccinations up to date | 18.18% |
25.2%
7 pts worse
|
Numerator 12 · Denominator 66 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 3.0 |
2.1
0.9 pts worse
|
1.9
1.1 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 3.0 · Observed 2.3 · Expected 1.5 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 1.1 |
1.2
0.1 pts better
|
1.8
0.7 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.1 · Observed 0.9 · Expected 1.3 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 96.3% |
97.8%
1.5 pts worse
|
93.4%
2.9 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 91.0% · Q2 96.2% · Q3 98.7% · Q4 100.0% · 4Q avg 96.3% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 100.0% |
99.2%
0.8 pts better
|
95.5%
4.5 pts better
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 100.0% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 1.5% |
2.6%
1.1 pts better
|
3.3%
1.8 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 2.2% · Q2 2.5% · Q3 1.3% · Q4 0.0% · 4Q avg 1.5% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 0.0% |
3.7%
3.7 pts better
|
11.4%
11.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents who lose too much weight | 4.4% |
5.9%
1.5 pts better
|
5.4%
1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 2.2% · Q2 2.9% · Q3 11.8% · Q4 2.2% · 4Q avg 4.4% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 1.8% |
15.7%
13.9 pts better
|
19.6%
17.8 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 4.3% · Q2 2.7% · Q3 0.0% · Q4 0.0% · 4Q avg 1.8% |
| Percentage of long-stay residents who received an antipsychotic medication | 4.4% |
9.8%
5.4 pts better
|
16.7%
12.3 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 4.5% · Q2 5.1% · Q3 5.7% · Q4 2.4% · 4Q avg 4.4% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.0%
About the same
|
0.1%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | 16.3% |
11.7%
4.6 pts worse
|
16.3%
About the same
|
Long Stay · 2024Q4-2025Q3 · Q1 4.3% · Q2 31.0% · 4Q avg 16.3% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 6.7% |
9.8%
3.1 pts better
|
14.9%
8.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 17.6% · Q3 3.1% · Q4 7.1% · 4Q avg 6.7% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.0% |
0.4%
0.4 pts better
|
1.0%
1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 0.0% |
0.8%
0.8 pts better
|
1.7%
1.7 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 12.1% |
12.5%
0.4 pts better
|
19.8%
7.7 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 10.8% · Q2 14.9% · Q3 13.8% · Q4 9.3% · 4Q avg 12.1% |
| Percentage of long-stay residents with pressure ulcers | 7.5% |
5.1%
2.4 pts worse
|
5.1%
2.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 8.2% · Q2 10.1% · Q3 6.4% · Q4 5.3% · 4Q avg 7.5% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 96.6% |
94.3%
2.3 pts better
|
81.7%
14.9 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 95.5% · Q2 95.4% · Q3 96.8% · Q4 98.7% · 4Q avg 96.6% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 18.1% |
9.3%
8.8 pts worse
|
12.0%
6.1 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 18.1% · Observed 16.7% · Expected 10.3% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 0.8% |
1.5%
0.7 pts better
|
1.6%
0.8 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 1.2% · Q2 0.9% · Q3 0.0% · Q4 1.4% · 4Q avg 0.8% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 98.5% |
94.7%
3.8 pts better
|
79.7%
18.8 pts better
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 98.5% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 36.8% |
26.2%
10.6 pts worse
|
23.9%
12.9 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 36.8% · Observed 31.9% · Expected 20.7% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2024-07-11 · Fire 2024-07-11
4 health deficiencies
Top issue: Infection Control (1 deficiency)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Cycle 3
Health 2023-03-01 · Fire 2023-03-01
3 health deficiencies
Top issue: Nursing and Physician Services (1 deficiency)
3 fire-safety deficiencies
Top issue: Emergency Preparedness (2 deficiencies)
Fire safety
Fire-safety citations
F · Potential for more than minimal harm
2023-03-01
E34 · Emergency Preparedness Deficiencies
Fire Safety
Provide a means of sharing information on occupancy/needs.
Corrected 2023-03-06
F · Potential for more than minimal harm
2023-03-01
E35 · Emergency Preparedness Deficiencies
Fire Safety
Provide family notifications of emergency plan.
Corrected 2023-03-10
D · Potential for more than minimal harm
2023-03-01
K918 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2023-03-14
Inspection history
Recent health citations
E · Potential for more than minimal harm
2025-12-04
F842 · Resident Assessment and Care Planning Deficiencies
Health
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected 2026-02-01
D · Potential for more than minimal harm
2025-12-04
F644 · Resident Assessment and Care Planning Deficiencies
Health
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Corrected 2026-02-01
D · Potential for more than minimal harm
2025-12-04
F656 · Resident Assessment and Care Planning Deficiencies
Health
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected 2026-02-01
D · Potential for more than minimal harm
2025-12-04
F684 · Quality of Life and Care Deficiencies
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2026-02-01
D · Potential for more than minimal harm
2025-12-04
F689 · Quality of Life and Care Deficiencies
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2026-02-01
D · Potential for more than minimal harm
2025-12-04
F692 · Quality of Life and Care Deficiencies
Health
Provide enough food/fluids to maintain a resident's health.
Corrected 2026-02-01
D · Potential for more than minimal harm
2025-12-04
F695 · Quality of Life and Care Deficiencies
Health
Provide safe and appropriate respiratory care for a resident when needed.
Corrected 2026-02-01
D · Potential for more than minimal harm
2025-12-04
F756 · Pharmacy Service Deficiencies
Health
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Corrected 2026-02-01
D · Potential for more than minimal harm
2025-12-04
F757 · Pharmacy Service Deficiencies
Health
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Corrected 2026-02-01
D · Potential for more than minimal harm
2025-12-04
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2026-02-01
D · Potential for more than minimal harm
2025-09-10
F770 · Administration Deficiencies
Health
Provide timely, quality laboratory services/tests to meet the needs of residents.
Corrected 2025-10-02
D · Potential for more than minimal harm
2024-07-11
F695 · Quality of Life and Care Deficiencies
Health
Provide safe and appropriate respiratory care for a resident when needed.
Corrected 2024-08-10
D · Potential for more than minimal harm
2024-07-11
F732 · Nursing and Physician Services Deficiencies
Health
Post nurse staffing information every day.
Corrected 2024-08-10
D · Potential for more than minimal harm
2024-07-11
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2024-08-10
D · Potential for more than minimal harm
2024-07-11
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2024-08-10
F · Potential for more than minimal harm
2023-03-01
F761 · Pharmacy Service Deficiencies
Health
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.
Corrected 2023-03-29
E · Potential for more than minimal harm
2023-03-01
F695 · Quality of Life and Care Deficiencies
Health
Provide safe and appropriate respiratory care for a resident when needed.
Corrected 2023-03-11
C · Minimal harm
2023-03-01
F732 · Nursing and Physician Services Deficiencies
Health
Post nurse staffing information every day.
Corrected 2023-03-29
Penalties and ownership
What sits behind the stars
Ownership
Ag Holdings, Inc.
5% Or Greater Direct Ownership Interest · Organization
Sisel Klurman 2001 Revocable Trust
5% Or Greater Indirect Ownership Interest · Organization
Ben-Aviv, Zipora
5% Or Greater Indirect Ownership Interest · Individual
Debbie Klurman 1994 Trust
5% Or Greater Indirect Ownership Interest · Organization
Deena Klurman Kranz 2000 Trust
5% Or Greater Indirect Ownership Interest · Organization
Klurman, Deena
5% Or Greater Indirect Ownership Interest · Individual
Mona Mizrachi 1994 Trust
5% Or Greater Indirect Ownership Interest · Organization
Biegasiewicz, Kimberly
Corporate Director · Individual
Biegasiewicz, Kimberly
Corporate Officer · Individual
Boyd, David
Corporate Director · Individual
Boyd, David
Corporate Officer · Individual
Hornack, John
Corporate Officer · Individual
Lewis, Tasia
W-2 Managing Employee · Individual
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#3
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