Pulaski Health Care Center: Bowel Monitoring Failure - IN
Inspectors arrived on August 22, 2025, responding to a complaint. What they found in the bowel movement logs told the story plainly: between July 1 and August 19, a resident had documented bowel movements on only ten days out of fifty. The gaps ran as long as five days at a stretch. There was no record that anyone at the facility had sought a physician's order for a laxative, an enema, a dietary change, or anything else.
The resident was taking hydrocodone-acetaminophen twice a day. Opioids are among the most reliably constipating medications in common use, and this resident's care plan, dated November 2024, already flagged chronic pain and a history of a right humerus fracture as the reasons for the pain medication. The same care plan called for staff to observe for effectiveness of the medications. Whether anyone was doing that is not reflected in the records inspectors reviewed.
The resident also had iron deficiency anemia, documented in a separate care plan from the same November date. The plan called for daily iron tablets and monitoring of whether the medication was working. Iron supplements are also a well-known contributor to constipation.
So the facility had a resident on two medications, both associated with constipation, with a care plan explicitly requiring staff to watch for medication effectiveness, and across nearly seven weeks, no one documented any response to a pattern that should have been visible in the logs every nurse aide and nurse on the floor had access to.
The resident required substantial to maximal assistance with toileting hygiene and was frequently incontinent of bowel and bladder. That level of dependence means staff were involved in the resident's toileting routinely. They would have known.
When inspectors raised the concern during an interview at 1:00 p.m. on August 22, the Director of Nursing and a Regional Nurse Consultant were both present. Neither offered any further information.
Inspectors also requested a copy of the facility's bowel protocol policy. The facility did not provide one.
The citation was classified as minimal harm or potential for actual harm, meaning inspectors determined the resident had not yet suffered a documented serious injury from the lapse. Constipation in a person taking daily opioids can progress to impaction, which is painful, sometimes dangerous, and in vulnerable residents can require manual disimpaction or hospitalization. The inspection record does not indicate whether the resident experienced any of those outcomes.
What the record does show is a gap between what the care plan promised and what the logs reflect. The care plan said staff would monitor effectiveness of medications. The bowel movement documentation shows ten entries across fifty days and no treatment orders. Those two facts don't reconcile.
The facility is located at 624 East 13th Street in Winamac, a small city in northern Indiana. The inspection was conducted August 22, 2025, and the event was tied to a complaint intake logged before inspectors arrived, meaning someone had already flagged a concern before the visit.
The resident was still there when inspectors came. The logs were still showing the same pattern they had shown all summer.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Pulaski Health Care Center from 2025-08-22 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: Official federal inspection data from the Centers for Medicare & Medicaid Services (CMS).
Editorial process: AI-synthesized regulatory data, reviewed for accuracy by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: July 3, 2026 · Our methodology
PULASKI HEALTH CARE CENTER in WINAMAC, IN was cited for violations during a health inspection on August 22, 2025.
Inspectors arrived on August 22, 2025, responding to a complaint.
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.