Latest reports, citations, and penalties from CMS data
The person at the center of both findings was staff #103, listed on the facility's own staff roster as the Assistant Administrator....
A federal inspection on September 12, 2025, caught it in real time....
The citation had actually begun nearly a year earlier, on September 30, 2024....
That was one bathroom, on one floor, on one morning....
The resident, identified in inspection records as R705, last saw a psychiatric practitioner on December 5, 2024....
The warning had come one day too early to matter....
The aide, identified in inspection records only as CMA JJ, said she reported what she saw to a nurse, who told her they would take care of it....
The inspection was completed September 16, 2025, following a complaint....
The refrigerators held milk, juice, chocolate milk, and bags of salad....
That was what the Director of Nursing told a federal inspector on September 11, 2025....
When an inspector spoke with her on September 16, 2025, she said she didn't know how long she would be at the facility....
A staff member noticed she was wet and flagged it â R5 had just been changed before breakfast, so the wetness made no sense....
The problem was not a surprise to anyone running the facility....
The resident, identified in inspection records as Resident R1, was admitted to the facility on August 13, 2025, with sepsis, paraplegia, and a pressure ulcer....
The September 2025 inspection, triggered by a complaint, identified medication diversion as the central concern....
The steam table violation was straightforward....
The resident who actually needed the surgery, identified in inspection records only as Resident #10, found out what happened the night before his procedure....
Federal inspectors documented the violation during a complaint inspection on September 17, 2025....
The resident, identified in inspection records only as R1, sustained a bruise and abrasion while being moved from a wheelchair to a bed on August 11, 2025....
Federal inspectors visited the facility on September 13, 2025, following a complaint, and reviewed medication administration records for two residents....