Advanced Center for Nursing & Rehab: Methadone Gap - CT
The dose was ordered for 6 AM. It was never given.
The registered nurse supervising the overnight shift that morning, identified in inspection records as RN #3, told inspectors during an interview on August 20 that she had not known the methadone wasn't administered. She also could not explain why the drug was unavailable in the facility to begin with.
The licensed practical nurse who would have given the medication, identified as LPN #16, was not interviewed. Inspectors noted they attempted to reach her during the survey but were unable to.
The advanced practice registered nurse who had ordered the methadone was clearer. In an interview that afternoon, APRN #1 told inspectors the medication should have been given as prescribed. There was no ambiguity in the order. The drug simply wasn't there, and nobody gave it.
The director of nursing said the same thing in her own interview at 2:30 PM: Resident #16 should have received the methadone as ordered. Then she said she could not explain why it had not been available for administration.
That answer, from the person overseeing nursing operations at the facility, was the center of what inspectors documented.
Methadone is not a medication that can be skipped without consequence. It is used to treat opioid use disorder and, in some cases, chronic pain, and missing a dose can trigger withdrawal symptoms that are physically severe. The facility's own policy on methadone maintenance, dated September 2020, directed staff to provide continued access to the drug and specified that after a resident's admission, a licensed nurse was responsible for retrieving the resident's methadone bottles from a clinic and keeping them available for administration until the resident's next scheduled clinic appointment.
That system, by the facility's own written account of how it was supposed to work, existed specifically to prevent what happened to Resident #16.
Inspectors classified the violation under F0684, which addresses the standard of care residents are entitled to receive, and rated the level of harm as minimal harm or potential for actual harm, with few residents affected. The facility was cited following a complaint inspection.
What the inspection record does not contain is any explanation from the facility of how the breakdown occurred, who was responsible for retrieving the medication, or whether anyone attempted to obtain it once the gap was identified. The night supervisor didn't know the dose had been missed. The director of nursing couldn't account for where the drug was. The nurse who would have administered it didn't speak to inspectors.
Resident #16 went without a prescribed medication that the facility had committed, in writing, to keep on hand.
The inspection was completed August 20, 2025.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Advanced Center For Nursing & Rehabilitation from 2025-08-20 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: This article is based on inspection data downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases inspection reports in bulk; we publish the findings as documented by state surveyors in the official Form CMS-2567 Statement of Deficiencies.
Plan of correction: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to state survey agencies and those responses may not be reflected in CMS data at the time of publication. The absence of a plan of correction in our data does not mean one was not filed. Readers who want information about corrective steps taken are encouraged to contact the facility directly or their state survey agency.
Corrections may have occurred: Inspection reports reflect conditions observed on the date of the survey. Facilities may have implemented corrections, staffing changes, additional training, or other remediation since the report was issued. We report what CMS provides and encourage readers to seek current information from the facility.
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Last verified: November 3, 2026 · Our methodology
ADVANCED CENTER FOR NURSING & REHABILITATION in NEW HAVEN, CT was cited for violations during a health inspection on August 20, 2025.
She also could not explain why the drug was unavailable in the facility to begin with.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.