Seaford Center: Care Planning Deficiency - DE
Resident 113 was admitted to the facility in October 2024. By March, wound care staff were documenting a pattern that would persist for months.
On March 20, wound nurse practitioner E12 noted that the resident "was non-compliant with turning and repositioning and tells staff to leave her alone." A week later, the same nurse practitioner documented identical behavior.
The refusals continued through September. During interviews with federal inspectors, multiple staff members described a resident who consistently rejected care.
"R113 would refuse to have her wounds touched and resisted care," wound nurse practitioner E12 told inspectors on September 4.
Nurse practitioner E16 confirmed the resident "was resistant to care and refused to get out of bed."
Wound nurse E17 described the resident as "behavioral, resistant to care and would refuse to allow staff to turn and reposition her."
The pattern was clear to frontline staff. Certified nursing assistant E18 told inspectors the resident "was very behavioral, would constantly refuse care and refuse to get out of bed."
Despite months of documented refusals involving wound care and basic positioning, the facility never created a care plan to address the behavior.
Registered nurse E6 acknowledged the oversight during interviews. The nurse "confirmed that a care plan for refusals should have been completed" for the resident.
Federal regulations require nursing homes to develop comprehensive care plans that address all resident needs. When residents consistently refuse necessary care, facilities must create individualized approaches with specific goals and timeframes.
Seaford Center's care plan for Resident 113 "lacked evidence for refusals of care that included individualized objectives, goals, and timeframes to meet R113's needs," inspectors found.
The failure meant staff had no systematic approach to address behavior that could worsen the resident's wounds and overall health. Turning and repositioning prevents pressure sores and promotes healing of existing wounds.
Without a care plan, each interaction became a new confrontation. Staff faced a resident who told them to leave her alone, with no guidance on alternative approaches or strategies to gain cooperation.
The resident's refusal to get out of bed compounded the risks. Prolonged bed rest can lead to muscle weakness, blood clots, and additional pressure wounds.
Wound care refusals presented immediate dangers. Untreated wounds can become infected, requiring hospitalization or leading to sepsis.
The inspection occurred after a complaint triggered the September review. Inspectors examined thirty residents and found the care plan failure affected one person.
The deficiency carried a designation of "minimal harm or potential for actual harm" affecting "few" residents. But for Resident 113, the impact was direct and ongoing.
Multiple staff members recognized the problem during interviews. The wound nurse practitioner had documented the refusals twice in March. The wound nurse, registered nurse, and certified nursing assistant all described the resident's behavior to inspectors.
Yet no one had created a formal plan to address the refusals.
Care plans typically include approaches like offering choices, involving family members, adjusting timing of care, or consulting behavioral specialists. Some residents respond better to specific staff members or modified procedures.
The facility's nursing home administrator and quality manager received the findings during an exit conference on September 9.
Seaford Center now faces federal requirements to correct the deficiency and demonstrate how it will prevent similar failures. The facility must show it can identify residents who refuse care and develop individualized plans to meet their needs.
For Resident 113, the months without a care plan meant confronting the same refusals repeatedly, with wounds that needed attention and positioning that remained unchanged.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Seaford Center from 2025-09-09 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: June 20, 2026 · Our methodology
SEAFORD CENTER in SEAFORD, DE was cited for violations during a health inspection on September 9, 2025.
Resident 113 was admitted to the facility in October 2024.
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.