Federal inspectors found multiple wheelchair safety violations at Balmoral Home during a November complaint investigation. One resident's seatbelt was tied in a knot to the armrest cushion instead of being properly fastened. The maintenance supervisor explained the knotted material "was not secure" and said screws should be added to properly secure the seatbelt.
Another resident's wheelchair had broken brakes wrapped in blue tape that provided no grip or traction. Maintenance Supervisor V14 told inspectors the smooth tape "causes improper breaks" and creates "an overall safety issue." V14 witnessed rubber falling off the wheelchair wheels as the resident entered the building.
"R14's wheelchair may cause property damage, accidents and injury to R14," the maintenance supervisor told inspectors, adding that the lack of functioning brakes "could cause R14 to run into a wall."
A third resident complained repeatedly about their wheelchair being broken. The Director of Nursing acknowledged the resident "was not pleased" and sought help getting a new wheelchair, but staff told them to wait because insurance might not cover both a wheelchair and walker if they later qualified for the walking device.
The Administrator admitted one wheelchair's divider was touching the wheel and needed screw replacement, making the wheels "hard" to operate. Despite acknowledging that "it is important to make sure the wheelchairs are in good working condition for resident safety," the facility continued using the defective equipment.
The facility's own policy states that "defective or worn devices are repaired or discarded," but inspectors found multiple wheelchairs in dangerous condition still being used by residents.
The nursing home is disputing the citation.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Balmoral Home from 2025-11-26 including all violations, facility responses, and corrective action plans.