Parkwood Skilled Nursing: Record Gaps Found - MO
The auditing system was supposed to catch it. When a treatment wasn't completed, it was supposed to turn red. She reviewed those audits. She had not seen red. And yet, when inspectors arrived on September 10, 2025, they found blank entries on the treatment administration records, the logs where nurses are supposed to sign off each time a wound care treatment is completed.
A blank meant one of two things: the treatment wasn't done, or it was done and nobody wrote it down. Neither answer is good.
The inspection, a complaint investigation, cited Parkwood under F0842, which covers the accuracy and completeness of medical records. The level of harm was classified as minimal harm or potential for actual harm, and the finding affected a small number of residents. But the details inspectors documented point to something more corrosive than a paperwork technicality: a gap between what the facility's own tracking system was supposed to catch and what was actually happening to residents' records.
The treatment administration record, called a TAR, is the document that follows a wound from discovery to healing. When a wound is found, a nurse is supposed to assess it, contact the physician, get orders, and document the location, description, and measurements. A wound practitioner stages the wound. After that, every treatment gets logged on the TAR when it's completed. If a treatment can't be completed, staff are supposed to write why in the nurse notes. The system only works if people fill it in.
The unit manager explained to inspectors how the auditing process was supposed to function. If something wasn't completed, it would show up red. She had not seen red. She could not explain why there would be a blank.
One notation on the records did have an explanation: an "H" marked next to certain entries meant the resident had been hospitalized and the medication was held. The unit manager said she expected staff to accurately document when a resident left the facility and when they returned. That expectation, it turned out, was not always being met.
The administrator, interviewed the same morning at 8:55 a.m., described the same chain of responsibility. When a resident is admitted or readmitted, the admitting nurse enters the treatment orders into the computer. Treatments get documented when they're completed. If a treatment isn't completed, staff document why and notify the physician. A blank on the TAR meant it was not signed out.
Then the administrator said something that sat in tension with everything else: treatments are being completed.
If treatments were being completed, the blanks were a documentation failure. If the blanks reflected treatments that weren't done, they were something else. The inspection report does not resolve that question. What it records is that the administrator expected staff to follow physician orders, follow facility policies, and keep records that were complete and accurate. The records were not complete and accurate.
Wound care in a skilled nursing facility is not a minor administrative function. Residents who arrive at these facilities often come with wounds already developing, or they develop them during a stay from immobility, poor circulation, or other conditions that come with age and illness. The treatment record is how a facility tracks whether a wound is getting better or worse, whether treatments are being delivered on schedule, and whether a physician needs to be called because something has changed. A blank on that record is a hole in that tracking.
The unit manager said she expected staff to accurately document. The administrator said the same. Both described systems designed to ensure it happened. The audits were supposed to catch failures. The audits, according to the unit manager, had not shown her a single red flag.
The blanks were there anyway.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Parkwood Skilled Nursing and Rehabilitation Center from 2025-09-10 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: September 22, 2026 · Our methodology
PARKWOOD SKILLED NURSING AND REHABILITATION CENTER in MARYLAND HEIGHTS, MO was cited for violations during a health inspection on September 10, 2025.
The auditing system was supposed to catch it.
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.