Harborside Health & Rehabilitation
Inspection Findings
F-Tag F0842
F 0842 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
record reviews and staff interviews, for two (2) of seven (7) sampled residents, the facility staff failed to ensure residents' records contained accurate information. As evidence by:(1). Staff documented Resident #1 had a Gastrostomy Tube (G-tube) instead of a Jejunostomy Tube (J-Tube). (2) Staff documented Resident #4 had a right check bruise instead of a right eyebrow bruise. The findings included:1.Resident #1 was admitted on [DATE REDACTED] with multiple diagnoses including Gastrostomy Status, Dysphagia, Encephalopathy, and Acute Respiratory with Hypoxia.A history and physical dated 07/25/25 documented in part, Gastrointestinal [system]-soft, non-distended, J-Tube.Assessment and Plan- Dysphagia Continue TF (tube feeding) per J-tube.A nursing progress note dated 07/29/25 at 5:28 PM documented in part, Abdomen is soft and non-tender with positive bowel sounds on all four quadrants . G- tube feeding is in progress. A nursing progress note dated 08/15/25 at 8:53 PM documented in part, On continuous G-tube feeding for nourishment. G-tube is intact, patent and infusing well. Abdomen is soft to slight touch, non-distended.A nursing note dated 09/05/25 at 7:50 AM documented in part, Resident is G-tube dependent, G-tube intact and patent. No foul smelling discharge noted at the G-tube site. Nepro infusing @ 40 ml(milliters)/ hr (hour)with hydration water flush 240 ml every 4 hrs. During a face-to-face interview on 09/19/25 at 10:35 AM, Employee #3 (RN/Unit Manger) stated that the staff documented g-tube in error. The resident had a J-tube and not a G-tube. 2.Resident #4 was admitted to the facility on [DATE REDACTED] with multiple diagnoses including Dementia. A nursing note dated 08/26/25 at 11:09 AM documented in part, It was brought to this writer attention that, [resident's name] has skin discoloration on the right side on the top of her eye.On head-to-toe assessment, skin alteration noted on the top of the resident right eye. Appear yellow purplish measuring 1.1cm x 1.1cm, and on resident right upper lateral harm 3 spot of same color.A nursing note dated 08/26/25 at 5:18 PM documented in part, Small discoloration to right cheek remains the same no discomfort noted or s/s of pain.A care plan dated 08/27/25 documented in part, Focus- [Resident's name] has [a] skin discoloration.Intervention-monitor the resident discoloration site on her right forehead.During a face-to-face interview on 09/19/25 at 2:25 PM, Employee #4 (RN/Unit Manager) stated that the nurses note dated 08/26/25 at 5:18 PM was an error. The resident had a bruise above her right eyebrow not her right cheek.
Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date
these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.
LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE
TITLE
(X6) DATE
FORM CMS-2567 (02/99) Previous Versions Obsolete
Facility ID:
If continuation sheet
Event ID:
Harborside Health & Rehabilitation in WASHINGTON, DC inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
Frequently Asked Questions
- What is an F-tag violation?
- F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
- Were these violations corrected?
- Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
- How often do nursing home inspections happen?
- CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
- What should families do about these violations?
- Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in WASHINGTON, DC, (5) Report new concerns to state authorities.
- Where can I see the full inspection report?
- Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from Harborside Health & Rehabilitation or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.