Latest reports, citations, and penalties from CMS data
Two residents experienced dangerous delays in receiving ordered laboratory work that could have detected serious health problems....
However, federal surveyors identified a fundamental flaw in the facility's approach....
The incident involved **60 oxycodone/acetaminophen tablets** belonging to one resident and **30 oxycodone tablets** belonging to another....
The citation references WAC 388-97-0640 (6)(a)(b), indicating violations related to facility operations and resident care standards....
Inspectors found that a resident prescribed antibiotics for a urinary tract infection was not properly tracked or monitored according to established protocols....
The missed medications included **Levetiracetam**, a critical anti-seizure medication prescribed at 750 mg twice daily....
The damaged door exposed multiple construction nails with sharp points facing into the room....
Inspectors documented water temperatures reaching **124 degrees Fahrenheit** in a shower room sink and **123.2 degrees Fahrenheit** in a resident room sink....
Federal surveyors found that weekly audits conducted by nurse managers from February through May 2025 were fundamentally flawed in their design and execution....
The patient, who has paraplegia, seizure disorder, and dysphagia (difficulty swallowing), was found unresponsive and required a code blue emergency response....
Despite these critical warning signs, nursing staff failed to contact medical providers or emergency services for nearly 10 hours....
The resident had an above-knee amputation of his left leg and required a specialized leg rest attachment for his wheelchair due to his medical conditions....
According to facility records, the aide turned the resident onto her side, then completely turned away to retrieve supplies from an overbed table....
Inspectors found multiple documented incidents where residents physically attacked other residents, yet none were reported to state authorities....
These dangerous bacteria can cause life-threatening infections that are extremely difficult to treat due to their resistance to multiple antibiotics....
Inspectors observed multiple healthcare workers improperly following these critical safety protocols while caring for vulnerable residents....
According to the inspection report, this transition created dangerous gaps in medical coverage that lasted over a month....
These individuals may wander, fall, become agitated, or engage in behaviors that could harm themselves or others....
June showed similar patterns with AM temperatures recorded just 3 out of 30 days and PM temperatures documented only 2 out of 30 days....
This created dangerous delays during critical moments when every second matters for patient survival....