Seven Hills Health & Rehabilitation Center
Inspection Findings
F-Tag F0686
F 0686 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
(DON). The DON was asked the reason the order for wound care on the coccyx placed on 5/19/25 for Resident #3 did not show onto the TAR. She reviewed Resident #3's medical record and stated that order was placed under other and the nurse that placed the order should have checked MAR or TAR for the order to show onto the administration record, but the nurse did not enter the order correctly. She further reviewed
the medical record and concluded the order should have been discontinued as Resident #3 currently did not have a wound on coccyx. Resident #8On 9/9/25 at 12:45 PM, an interview was conducted with Resident #8. She stated the facility was performing wound care on both sites every other day but the facility was very inconsistent doing her wound care. She further stated she could not recall having her wound treatment since last Wednesday (9/3/25) when the wound care physician assessed the wounds. A review of physician orders was conducted. Orders stated, Wound care: right breast dated 8/10/25: cleanse area to right breast with Dankins pat dry and apply xeroform, then dry 4x4 and cover with dry border gauze every day shift and as needed if soiled or not intact. Another physician order dated 8/16/25 stated wound care: sacrum-cleanse sacrum wound, apply collagen filler and calcium ag w/silver to wound bed and cover with silicone superabsorbent dressing until resolved, every day shift every 2 day(s) for Wound Management.A wound care assessment dated [DATE REDACTED] stated, wound chest full thickness treatment plan: xeroform gauze apply every two days and as needed. Stage 4 pressure wound sacrum full thickness, treatment plan: alginate calcium w silver to apply once daily and as needed.A review of Resident #8's TAR stated Wound Care: Right Breast: Cleanse area to right breast with Dakins 0.125% solution. Pat dry. Apply Xeroform, then dry 4x4 and cover with dry border gauze. everyday shift for wound management evaluate for s/s pain. On 9/4 and 9/5, this was not documented and left blank.The TAR also stated, Treatment Wound care: sacrum-cleanse sacrum wound with NS or WCC. Pat Dry. Skin Prep around peri-wound. Apply collagen filler and calcium ag w/silver to wound bed and cover with silicone superabsorbent dressing until resolved. every day shift every 2 day(s) for Wound Management. This treatment was not documented on 9/5 as it was left blank. Wound treatments placed onto the TAR did not correspond with the treatment plan ordered by the physician. On 9/9/25 at 1:15 PM, a follow-up interview was conducted with Wound Care Nurse. She reviewed Resident #8's orders and stated she took responsibility of the mistake and that the wound on sacrum was supposed to be done every day instead of every other day. She further reviewed Resident #8's TAR documentation and stated she was not sure why wound care had not been documented on 9/4/25 or 9/5/25. The DON was also made aware that Treatment plan placed by the physician for Resident #8 did not correspond with the physician's orders entered into the treatment administration record. She stated that the wound on the chest was supposed to be performed every other day and the wound on sacrum was supposed to be documented daily. The DON acknowledged the order frequency was placed wrong and stated she was going to fixed it and properly document it. She was also made aware that the wound care treatment documentation was left blank for 9/4/25 and 9/5/25. She stated all documentation should be completed at the time performed.The facility policy Manage Wound Care stated, Policy stated the treatment worder will be documented on the Treatment Administration Record.The facility policy Nursing clinical Documentation states, The facility clinical staff will document the provision of care and services according to nursing standards and regulatory requirements. When completed, documentation will accurately reflect
the clinical care and other services provided to the resident and ensure that the appropriate information is available to all interdisciplinary team members. Documentation in the medical record of each resident should provide 1. A complete account of the resident's care treatment and response to the care. All entries
in the medical record should be accurate, legible, dated, and timed.
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SEVEN HILLS HEALTH & REHABILITATION CENTER in TALLAHASSEE, FL 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 TALLAHASSEE, FL, (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 SEVEN HILLS HEALTH & REHABILITATION CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.