High View Rehab: Exposed Bed Hardware Injures Resident - ME
Two surveyors documented the skin tear on March 31, 2025, at 11:22 in the morning. The resident, identified in inspection records as R3, had the wound on their right upper forearm. The mattress beneath them measured 36 inches. The bed frame measured 39 inches. That three-inch gap was not a rounding error or a matter of interpretation. It was a physical space where metal hardware sat uncovered and reachable.
By early afternoon that same day, the facility's own Maintenance, Housekeeping, and Laundry Supervisor confirmed what the inspectors had already seen. The mattress does not fit the frame, the supervisor said. The numbers were not in dispute.
What that gap meant in practice was a mechanical hinge, a screw, and exposed metal edges where plastic caps were no longer in place. For a person lying in that bed, repositioning in the night, reaching for a call button, shifting weight, the hardware was there. The skin tear on R3's forearm was documented on the same visit.
The inspection report does not say how long the mattress had been in that bed. It does not say how long the plastic caps had been missing. It does not say whether anyone at the facility had noticed the gap before two outside surveyors walked into the room.
What the report does say is that the Maintenance Supervisor, when asked, knew immediately that the mattress did not fit. The measurements came without hesitation. Thirty-six inches. Thirty-nine inches. The supervisor knew the numbers. The mismatch was not a surprise.
That detail sits at the center of what inspectors found at High View. The problem was not hidden. It was not a complex clinical judgment call or a documentation gap buried in a chart. It was a bed that did not fit its mattress, with metal hardware exposed at the edges, in a room where a resident was sleeping. The supervisor responsible for maintaining that equipment confirmed the dimensions on the spot.
Skin tears in elderly residents are not minor inconveniences. The skin of older adults, particularly those in long-term care, is fragile in ways that make even brief contact with a sharp surface consequential. A tear can become an entry point for infection. For residents with limited mobility, poor circulation, or compromised immune function, what begins as a laceration from a bed frame can become something that requires weeks of wound care, or worse.
The inspection report does not describe R3's overall health or mobility. It does not describe the severity of the skin tear beyond its location. What it establishes is the sequence: a mattress that did not fit, hardware that was exposed, a resident with a wound on the arm closest to where that hardware sat.
High View Rehabilitation and Living Center is a long-term care facility in Madawaska, a small city in Aroostook County in the far north of Maine, near the Canadian border. The April 9 inspection covered health standards at the facility.
The surveyors' notes reference additional findings under a separate citation, F700, suggesting the bed equipment issue was part of a broader set of concerns documented during the same visit. The full scope of those additional findings is not detailed in this portion of the inspection record.
What is detailed is the bed in R3's room on the morning of March 31. The mattress too small. The frame too wide. The hinge exposed. The screw exposed. The plastic caps gone. And a skin tear on the forearm of the person who had been sleeping there.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for High View Rehabilitation and Living Center from 2025-04-09 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.
Editorial process: Inspection findings are extracted from CMS source documents and synthesized using AI, reviewed for factual accuracy against the original report by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: August 9, 2026 · Our methodology
HIGH VIEW REHABILITATION AND LIVING CENTER in MADAWASKA, ME was cited for violations during a health inspection on April 9, 2025.
Two surveyors documented the skin tear on March 31, 2025, at 11:22 in the morning.
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.