Richland Bean Blossom: MDS Assessment Failures - IN
The facility's MDS coordinator admitted to inspectors that she had incorrectly marked assessments for residents with diagnosed anxiety disorders and bipolar conditions. The errors occurred despite residents actively receiving psychiatric medications for these conditions.
Resident 27 presented the clearest example of the documentation failures. The person carried active diagnoses of generalized anxiety disorder, major depressive disorder, and dementia. Medical records showed the resident had been prescribed Lorazepam, an anti-anxiety medication, at doses of 0.5 milligrams twice daily and 1 milligram once in the morning specifically for generalized anxiety disorder.
Yet the facility's quarterly MDS assessment dated March 30 indicated no active anxiety diagnosis.
During her interview with inspectors, the MDS coordinator acknowledged the error. She confirmed that Resident 27 did have an active anxiety disorder diagnosis and that the quarterly assessment "should have been marked yes" instead of no.
The MDS coordinator corrected similar problems for Resident 4, whose clinical record documented bipolar disorder and anxiety. An annual MDS assessment from March 11 incorrectly indicated this resident was not considered by the state's PASARR process to have a serious mental illness, despite a Level II PASARR evaluation completed in March 2023.
Federal guidelines require facilities to identify active diagnoses that directly relate to residents' functional, cognitive, mood, or behavioral status during a seven-day lookback period. The RAI manual specifically instructs staff to review medication sheets and doctor's orders when determining active diagnoses.
The facility administrator and MDS coordinator told inspectors they had no written policy for completing MDS assessments. Instead, they said they followed the RAI manual, though their documentation errors suggest inconsistent application of federal guidelines.
MDS assessments serve multiple critical functions beyond care planning. Medicare uses this data to determine reimbursement rates for nursing home services. Accurate mental health documentation ensures residents receive appropriate therapeutic interventions and that facilities receive proper payment for specialized care requirements.
The documentation failures extended beyond simple clerical errors. Resident 27's case showed a systematic disconnect between clinical reality and official records. The person was receiving daily psychiatric medications for a condition that didn't officially exist according to the facility's federal reporting.
Generalized anxiety disorder, as documented in Resident 27's clinical record, involves excessive, uncontrollable worry about everyday situations lasting at least six months. Major depressive disorder causes persistent sadness and loss of interest in activities. These conditions require specific nursing monitoring and can significantly impact a resident's daily functioning and care needs.
The combination of these mental health conditions with dementia creates complex care requirements. When facilities fail to accurately document such diagnoses in MDS assessments, care teams may miss critical interventions or monitoring protocols.
Federal inspectors reviewed 24 residents' MDS assessments for accuracy and found errors affecting two people. While the inspection classified the violations as causing minimal harm, the documentation failures could have broader implications for care quality and federal oversight.
The facility's lack of written MDS policies contributed to the assessment errors. Without standardized procedures, staff relied on individual interpretation of federal guidelines, leading to inconsistent documentation practices.
Resident 4's case highlighted additional complexities in mental health documentation. The PASARR process determines whether nursing home residents with mental illness or intellectual disabilities require specialized services. Incorrect PASARR coding could affect access to psychiatric care or specialized programming.
The MDS coordinator's admission that she corrected Resident 4's assessment after the inspection suggests awareness of the documentation problems. However, the timing raises questions about how long residents' mental health conditions went undocumented in official records.
Both residents affected by the documentation errors had complex psychiatric diagnoses requiring ongoing medication management and monitoring. The assessment failures occurred despite clear clinical evidence in medical records and active medication orders confirming these conditions.
The inspection found no written policies governing one of the most critical documentation processes in nursing home care, leaving staff to navigate complex federal requirements without facility-specific guidance.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Richland Bean Blossom Health Care Center from 2026-04-10 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
RICHLAND BEAN BLOSSOM HEALTH CARE CENTER in ELLETTSVILLE, IN was cited for violations during a health inspection on April 10, 2026.
The errors occurred despite residents actively receiving psychiatric medications for these conditions.
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.