Cadia Rehabilitation Silverside: Skin Injury Unreported - DE
The resident, identified in inspection records as R43, had been at the facility for less than a month when the incident happened. He was admitted on March 5, 2026, and his intake assessment documented that he needed help setting up his meals. On the morning of March 30, a registered nurse noted that R43 had placed his coffee cup on the bed railing, let go of it, and the cup fell back into his lap. He wasn't wearing pants. The coffee spilled across both upper thighs. The nurse documented nonblanchable redness across both legs, with the skin still intact, and noted that R43 denied pain after morning care was completed.
That afternoon, the facility's wound care nurse evaluated the area and found no scalded skin. R43 still denied pain. A nurse practitioner also reviewed him that day and noted in her progress entry to refer to the skin assessment.
The situation changed overnight.
Just after midnight on March 31, a nurse performing incontinence care found a broken blister on R43's right upper thigh. The wound was cleaned with saline, patted dry, and treated with skin prep. That note, though, wasn't entered into the record until April 1 at 8:57 in the morning, logged as a late entry.
The facility's own incident documentation showed that the physician, identified as E23, wasn't notified about the blister until April 1 at 8:38 AM, more than 24 hours after it was found.
When inspectors interviewed the nurse practitioner on April 23, she confirmed she had been told about the coffee spill on March 30. But when she checked the physician communication binder herself, she found no record that anyone had notified a provider about R43's change in skin condition on March 31, the night the blister appeared. She confirmed it directly: the notification hadn't happened.
That gap is what inspectors cited. The finding was not about the spill itself, or the initial redness, or whether the wound care nurse's assessment on the afternoon of March 30 was adequate. The citation was specific: when R43's skin condition changed the following night, moving from intact redness to a broken blister, no one contacted the on-call provider.
The deficiency was classified as minimal harm or potential for actual harm, affecting few residents. Inspectors reviewed three residents for accident hazards and found the lapse in one case.
The finding was presented on April 27 to a group that included the nursing home administrator, the director of nursing, the chief operating officer, and two corporate nurses.
What the record doesn't answer is what R43's recovery looked like after the blister was found, or whether the delayed notification changed anything about how his wound was treated. The inspection report documents the gap in communication. It doesn't document what came after.
R43 had been at Cadia Rehabilitation Silverside for 25 days when he spilled that coffee. He needed help setting up his meals. He was sitting on the edge of his morning without pants when the cup fell, and the redness that followed turned into something worse by midnight. His doctor found out the next day.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Cadia Rehabilitation Silverside from 2026-04-27 including all violations, facility responses, and corrective action plans.
Download the official CMS inspection PDF from Medicare.gov
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 19, 2026 · Our methodology
CADIA REHABILITATION SILVERSIDE in WILMINGTON, DE was cited for violations during a health inspection on April 27, 2026.
The resident, identified in inspection records as R43, had been at the facility for less than a month when the incident happened.
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.