Latest reports, citations, and penalties from CMS data
His doctor had ordered Diltiazem 120 milligrams daily but specified the medication should be held if his systolic blood pressure dropped below 110....
Federal inspectors found that Altenheim failed to implement its antibiotic stewardship program during a complaint investigation completed October 21....
Electronic health records showed no documented refusals during that time....
The facility's own Director of Nursing admitted she was unaware of the missing documentation until inspectors pointed it out....
Federal inspectors cited the facility for immediate jeopardy to resident health and safety after the October 20 incident....
Staff B, a registered nurse, committed multiple infection control breaches during an 11:30 AM wound care session on October 19....
The January 27 incident began when the nurse arrived to check the resident's blood sugar and administer insulin....
Federal inspectors observed the practice on October 20 during the lunch shift at Aventura at Carriage Inn....
Resident 2 fell from his wheelchair on September 30, 2025, sliding slowly to the floor despite having his brakes locked....
Video from June 6 shows the aide at Jennings Hall using a ceiling lift by herself to move Resident #74 from a recliner to her bed....
Resident #15 had been living at the facility since April 8 with intact mental capacity but no physician's authorization for self-medication....
The resident scored 15 out of 15 on cognitive assessments, indicating full mental awareness of their care....
The resident would plead "please don't drop me" during these interactions....
This technique violates manufacturer guidelines for safe operation....
Federal inspectors found the facility violated safety standards for mechanical lifts and wheelchair transport, causing actual harm to the resident....
Resident 79 arrived at the facility on September 30 with urinary retention and required a foley catheter....
The facility admitted the resident in 2024 with serious heart conditions including congestive heart failure and a left ventricular assist device....
The resident's indwelling catheter became occluded frequently, and sediment in the urine was common, the nurse told federal inspectors....
The resident was eating a breakfast sandwich and drinking coffee when the nursing assistant left to help a colleague with another resident transfer....
The complaint that triggered the October inspection centered on what should have been a straightforward records request....