Nursing home
Twilight Gardens Nursing and Rehabilitation
196 W Main St, Norwalk, OH 44857 · Map
For profit - Corporation · Part of Cch Healthcare (32 facilities) · 94 certified beds
Twilight Gardens Nursing and Rehabilitation is a Medicare-certified nursing home in Norwalk, Ohio. CMS rates it 4 out of 5 stars overall (3/5 for staffing, 4/5 for health inspections). Nurse staffing is 4.41 hours per resident per day, above the Ohio average of 3.72. Its most recent inspection on Apr 24, 2025 cited 5 deficiencies.
CMS quality ratings
Ratings from the Centers for Medicare & Medicaid Services (CMS), updated monthly. 5 stars is the highest quality.
How Twilight Gardens Nursing and Rehabilitation compares
This facility vs. the Ohio and national averages, from CMS data. For staffing, higher is generally better; for turnover and deficiencies, lower is better.
| Metric | This facility | Ohio avg | National avg | Compared with the state |
|---|---|---|---|---|
| Total nurse staffing (hrs/resident/day) | 4.41 | 3.72 | 3.89 | above avg |
| RN staffing (hrs/resident/day) | 1.50 | 0.63 | 0.68 | above avg |
| Aide staffing (hrs/resident/day) | 2.36 | 2.14 | 2.34 | above avg |
| Nursing staff turnover | 53.1% | 49.8% | 46.4% | above avg |
| Deficiencies cited, last inspection | 5.0 | 10.2 | 9.5 | below avg |
Staffing
Hours per resident per day as reported to CMS. Higher numbers indicate more direct care time.
Staff turnover
Lower turnover typically indicates better working conditions and continuity of care. National average for nursing staff is 46.4%.
Recent health inspection
CMS inspects nursing facilities regularly. Deficiencies are categorized by severity.
What inspectors found at Twilight Gardens Nursing and Rehabilitation
Specific deficiencies cited in recent CMS health inspections, most recent first. Severity follows the CMS scope/severity scale. Source: CMS Care Compare.
- Potential for harm
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Resident Rights Deficiencies · Jan 22, 2026 · Full report (PDF) - Potential for harm
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · Apr 24, 2025 · Full report (PDF) - Potential for harm
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Quality of Life and Care Deficiencies · Apr 24, 2025 · Full report (PDF) - Potential for harm
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Pharmacy Service Deficiencies · Apr 24, 2025 · Full report (PDF) - Potential for harm
Provide care and assistance to perform activities of daily living for any resident who is unable.
Quality of Life and Care Deficiencies · Apr 24, 2025 · Full report (PDF)
Show all 12 deficiencies
- Potential for harm
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
Nutrition and Dietary Deficiencies · Oct 19, 2023 - Potential for harm
Provide and implement an infection prevention and control program.
Infection Control Deficiencies · Oct 19, 2023 - Potential for harm
Ensure that residents are free from significant medication errors.
Pharmacy Service Deficiencies · Oct 19, 2023 - Potential for harm
Ensure medication error rates are not 5 percent or greater.
Pharmacy Service Deficiencies · Oct 19, 2023 - Potential for harm
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Pharmacy Service Deficiencies · Oct 19, 2023 - Potential for harm
Provide care and assistance to perform activities of daily living for any resident who is unable.
Quality of Life and Care Deficiencies · Oct 19, 2023 - Potential for harm
Ensure that residents are fully informed and understand their health status, care and treatments.
Resident Rights Deficiencies · Jun 14, 2023
Read the full inspection reports on Medicare.gov Each inspection there has a “Read the full report” link with the inspectors’ written findings.
About this facility
- Address
- 196 W Main St
Norwalk, OH 44857 - CMS certification #
- 365517
- Ownership
- For profit - Corporation
- Certified beds
- 94
- Avg residents/day
- 72.1
- Provider type
- Medicare and Medicaid
- First certified
- 1980-07-03
- Chain
- Cch Healthcare (32 facilities)
- Setting
- Rural
Part of Cch Healthcare
Cch Healthcare operates 32 nursing facilities across the United States. View all Cch Healthcare facilities →
Not SLA enrolled. This facility hasn’t enrolled in resident survey verification. Learn about enrollment →
Location and nearby
Explore the area around Twilight Gardens Nursing and Rehabilitation using Google Maps.
Other public records
- Website says Respite stays, nurse 24 hours a day
- Staff pay 1 federal wage case with violations found, since 2004
- Workplace safety 2 OSHA workplace safety inspections since 2020, 2 violations cited
Full public records, with dates and sources
Care and services
From the community’s website
What Twilight Gardens Nursing and Rehabilitation says about itself, quoted from its own site. We have not checked these claims against licensing records. Ask about each one on a tour.
Staff pay and workplace safety
Federal records about how the employer here treats its staff.
Federal wage and hour cases
The Department of Labor checks that staff are paid minimum wage and overtime as the law requires.
- Findings for Mar 13, 2004 to Mar 11, 2006. Violations found: Overtime. Back wages: $8,189 owed to 24 employees. Employer as DOL recorded it: Twilight Gardens Home, Inc. (Twilight Gardens Healthcare Group, Inc.). Case 1435238.
Source: U.S. Department of Labor, Wage and Hour Division enforcement data, loaded Oct 15, 2026. Concluded cases only. The dates are the period in which DOL found violations, not when the case opened or closed. Back wages are what the employer agreed to pay; penalties are what DOL assessed. DOL does not publish a page for each case, so search the dataset by case number.
OSHA workplace safety inspections
OSHA inspects workplaces for staff safety, such as lifting, needles, chemicals and workplace violence. It does not inspect resident care.
- Apr 22, 2022: follow-up inspection, partial (health). Case closed May 31, 2022. No violations cited. OSHA record. OSHA recorded the employer as Twilight Gardens Nursing & Rehabilitation.
- Dec 21, 2020: complaint inspection, partial (health). Case closed Jul 26, 2021. 2 violations cited (2 serious). Penalties: $8,192 proposed, $4,096 now. OSHA record. OSHA recorded the employer as Twilight Gardens Nursing & Rehabilitation.
Details
- Serious: Respiratory protection (respirators, N95 fit testing) (1910.134(e)(1)). Penalty $8,192 proposed, $4,096 now. To be fixed by Jun 18, 2021.
- Serious: Respiratory protection (respirators, N95 fit testing) (1910.134(f)(2)). Penalty $0 proposed, $0 now. To be fixed by Jun 18, 2021.
Source: U.S. Department of Labor OSHA enforcement data, as of Oct 15, 2026, inspections since 2016. Penalties can change while a case is open or contested.
Location and nearby care
- Nearest hospital with an emergency room
- Fisher-Titus Hospital, Norwalk. 1.7 miles away, straight line. CMS overall hospital rating: 4 of 5 stars.
- Nearest Medicare nursing home
- Gaymont Care and Rehabilitation, Norwalk. 0.8 miles away, straight line.
- Nearest home health agency office
- Comfort Keepers, Norwalk. 0.9 miles away, straight line. Agencies travel to clients, so ask which ones serve this address.
- Nearest pharmacy
- Rite Aid. 0.9 miles away, straight line. From OpenStreetMap, which does not list every pharmacy, so one may be closer.
- Area
- USDA classes ZIP code 44857 as micropolitan (micropolitan core).
- Dialysis within 15 miles
- Fmc - Norwalk, Norwalk, 1.8 miles away, straight line (CMS rating 3 of 5 stars)
Firelands Bellevue Dialysis Center, Bellevue, 11.2 miles away, straight line (CMS rating 3 of 5 stars)
Davita Home Dialysis Services Of Sandusky Inc, Sandusky, 13.8 miles away, straight line (CMS rating 2 of 5 stars) - Hospice
- 10 Medicare hospices tell CMS they serve ZIP code 44857.
Stein Hospice Services, Inc, office in Sandusky, 15.0 miles away, straight line (CMS family survey rating 4 of 5 stars)
Mercy Health-New Life Hospice, office in Lorain, 24.8 miles away, straight line (CMS family survey rating 4 of 5 stars) - Nearest geriatric medicine practice
- Mercy Health Physicians Lorain Specialty Care LLC, Amherst. 25.0 miles away, straight line. 1 geriatric medicine doctor listed there.
Distances are straight lines from the community, not driving distance. Hospitals, home health, dialysis, hospice and doctors come from CMS provider data (CMS, hospital list updated Jul 22, 2026). Star ratings are CMS’s own.
Emergency and natural hazard risk
Public hazard maps for this location. Ask the community about its emergency plan, its generator and where residents would go in an evacuation.
- Flood zone
- Outside the high and moderate risk flood areas on FEMA's flood map (Zone X, minimal flood hazard, or not studied). (FEMA flood map)
- FEMA National Risk Index
- Overall: relatively low. By hazard: hurricane very low, inland flooding relatively moderate, wildfire very low, tornado relatively moderate, heat wave very low, earthquake very low. These are FEMA’s ratings for the census tract, compared with tracts nationwide. (FEMA, December 2025)
A flood zone describes the map at this point, not the building's elevation. In an emergency, follow the local emergency management agency.
What we checked
Every public source we searched for this community. “Nothing on record” means we found no record that matched it. A record can be missed when a name or address differs.
| Source | Data as of | What we found |
|---|---|---|
| U.S. Department of Labor wage and hour cases | Oct 15, 2026 | See above |
| OSHA workplace safety inspections since 2016 | Oct 15, 2026 | See above |
| FEMA flood map | See above | |
| USDA wildfire risk | Apr 15, 2026 | Not shown: FEMA rates wildfire risk here very low |
| FEMA National Risk Index | See above | |
| CMS hospitals, home health, dialysis, hospice and doctors; OpenStreetMap pharmacies | See above | |
| HUD Multifamily Properties - Assisted | Jul 6, 2026 | Nothing on record |
| State Veterans Homes (NASVH directory) | Sep 20, 2026 | Nothing on record |
| CMS Hospice - General Information | Aug 19, 2026 | Nothing on record |
| CMS Home Health Care Agencies | May 27, 2026 | Nothing on record |
| The community’s own website | See above |
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Frequently asked questions
Is Twilight Gardens Nursing and Rehabilitation a good nursing home?
CMS gives Twilight Gardens Nursing and Rehabilitation an overall rating of 4 out of 5 stars, including 3/5 for staffing and 4/5 for health inspections. These ratings come from the Centers for Medicare & Medicaid Services and are updated monthly.
How is Twilight Gardens Nursing and Rehabilitation staffed?
Twilight Gardens Nursing and Rehabilitation reports 4.41 total nurse hours per resident per day, compared with the Ohio average of 3.72.
Has Twilight Gardens Nursing and Rehabilitation had inspection problems?
Its most recent CMS inspection cited 5 deficiencies.
How many beds does Twilight Gardens Nursing and Rehabilitation have?
Twilight Gardens Nursing and Rehabilitation is certified for 94 beds.