Waters of Georgetown: Insulin Delays All Month - IN
The resident, identified in inspection records only as Resident L, had a physician's order requiring Lantus, a long-acting insulin, at 9:00 a.m. every morning. On thirteen separate days in March, that dose arrived more than an hour late. On March 24, it came at 11:41 a.m., two hours and forty-one minutes after it was due.
The pattern repeated itself across a second insulin prescription. Resident L also received Humalog, a short-acting insulin given before meals and at bedtime, on a sliding scale at 7:30 a.m., 11:30 a.m., 4:30 p.m., and 10:00 p.m. On fourteen additional occasions in March, that medication arrived late. On March 7, the 10:00 p.m. dose wasn't given until 12:25 a.m. the following morning. On March 25, the 4:30 p.m. dose came at 6:40 p.m.
In total, across both prescriptions, inspectors documented more than two dozen late administrations over a single month.
Resident L knew it. When inspectors interviewed her on the morning of March 30, she told them she was at the facility for two reasons: pain management and diabetes management. The facility, she said, had failed at both. She could not get her pain medication or her diabetic medication on time.
The explanation offered by staff was logistical. A staff member identified in the report as Staff Member 6 told inspectors that medication passes were interrupted when nurses had to stop and help aides with full-body mechanical lifts, assist with two-person resident transfers, or walk outside between separate freestanding buildings, called Villas, to trade places with an aide in another building. The facility's campus requires staff to go outdoors to move between these structures.
In other words, the same nurse responsible for delivering time-sensitive medication to a diabetic resident was also being pulled away to cover physical care tasks and staff rotations across the property. The medication cart stopped. The clock kept running.
Long-acting insulin like Lantus is designed to work on a schedule. It provides baseline glucose control over a roughly 24-hour period, and consistent timing is part of how it functions. Short-acting insulin like Humalog is calibrated to meals, timed to prevent blood sugar spikes in the hours after eating. When either arrives significantly late, or arrives at unpredictably different times from one day to the next, the body's glucose levels don't respond the way the prescribing physician intended.
The Regional Director of Operations provided inspectors with a copy of the facility's own medication administration policy, dated January 25, 2019. The policy states that medications are administered as prescribed, in accordance with good nursing principles and practices. The medication administration record is to be initialed by the person administering the dose.
The records were initialed. The times were documented. The pattern was plain.
Inspectors cited the facility under Indiana Administrative Code and tied the deficiency to three separate complaint intakes, meaning at least some of what they found was triggered by complaints filed before the March 30 visit.
Resident L was described in her care plan as having intact cognition. She understood what was happening to her. She told inspectors directly. The facility's own records confirmed it.
The inspection report rated the level of harm as minimal harm or potential for actual harm, and noted that some residents were affected. Whether Resident L experienced measurable harm from the delays, the report does not say. What the report does say is that on March 9, her long-acting morning insulin came at 11:32 a.m., and her short-acting morning dose came at 10:50 a.m., meaning the short-acting dose, meant to precede a meal, arrived before the long-acting dose that was supposed to have been given two and a half hours earlier.
She was still there when inspectors arrived.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Waters of Georgetown, The from 2026-03-30 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 18, 2026 · Our methodology
WATERS OF GEORGETOWN, THE in GEORGETOWN, IN was cited for violations during a health inspection on March 30, 2026.
The resident, identified in inspection records only as Resident L, had a physician's order requiring Lantus, a long-acting insulin, at 9:00 a.m.
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.