Latest reports, citations, and penalties from CMS data
These medications are specifically designed as extended-release formulations that should never be crushed or opened....
Inspectors identified issues with how the facility handled medication supervision and self-administration protocols....
Dietary Aide #23 was observed rinsing dirty dishes, washing plates and trays while wearing gloves and an apron that contacted contaminated surfaces....
The resident, identified as R1 in the inspection report, subsequently died at the hospital after sustaining injuries from the fall....
The errors involved residents receiving incorrect medications and missing prescribed treatments....
The exposed outlet was positioned within arm's reach of the bed, creating potential shock and electrocution risks for the vulnerable resident....
However, inspection records show **the facility documented no response to either recommendation**....
**The therapeutic window between effective treatment and dangerous bleeding is narrow**, making precise dosing critical for patient safety....
The violations included potentially life-threatening incidents that could have resulted in serious harm to diabetic residents....
All three staff members provided the same concerning response: they would leave the bleeding resident alone to seek nursing assistance....
Two residents - both diagnosed with severe dementia and documented as daily wanderers - left the facility grounds undetected....
QAPI programs serve as the backbone of nursing home operations, designed to continuously monitor and improve care quality....
## Critical Security System Failures The elopement incident exposed multiple systemic failures in the facility's safety protocols....
This federal regulation requires facilities to maintain comprehensive medication administration protocols and report any errors that occur....
Federal regulations require nursing homes to provide at least 80 square feet per resident in multiple-occupancy rooms and 100 square feet for single rooms....
Inspectors found undated condiments and sauces in both kitchen areas and resident refrigerators, creating potential health risks for the facility's population....
Inadequate quality assurance program implementation and care plan oversight violations documented at Altoona nursing facility during federal inspection....
In September 2024, R22 sustained a **pelvis fracture** during a fall....
These reporting failures prevent state agencies from conducting proper oversight and additional investigations when necessary....
The witness, an agency nurse, failed to report the incident immediately as required....