Latest reports, citations, and penalties from CMS data
That resident, identified in inspection records only as Resident 1, had a documented history of dementia and had told staff he wanted to go home....
Immediate jeopardy is the most serious level of harm the federal government assigns during nursing home inspections....
The deficiency, tagged F0678, cited the facility for failures in its Basic Life Support procedures....
That is what federal inspectors found when they arrived at Meadowview Rehabilitation and Nursing Center on October 22, 2025....
The resident had been discharged from physical therapy on September 5, 2025....
The care plan is the document that governs how a resident is treated day to day....
The citation, recorded under F0558, described conditions that affected more than one resident....
A cart stocked with gowns and gloves hung outside the room....
The gowns, required by the facility's own infection control policy when staff change briefs, perform catheter care, or treat wounds, were never put on....
When a bag does touch the floor, the IP said, it should be replaced entirely....
The Director of Nursing placed a call to the facility's Nurse Consultant on speakerphone....
Federal inspectors classified the incident as causing actual harm....
The inspection was triggered by a complaint, filed under Complaint Number 2630192....
The facility's own policy made the expectation plain....
Not the on-call nurse practitioner....
The medication was Entresto, a drug used to treat heart failure and high blood pressure....
The incident was recorded on facility surveillance....
She did not verify that isolation orders had been entered....
The burn and wound center physician had ordered cocoa butter to be applied three times per day....
Nobody had a system in place to make sure the doors were locked in the first place....