Tabor Manor Care Center
Inspection Findings
F-Tag F0580
F 0580 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
daughter. Staff C stated the DON looked at the admission paperwork and found the phone number and called Resident #1's POA / daughter. Staff C acknowledged Resident #1's POA / daughter was upset she was not called earlier to notify that Resident #1 had been transferred to the ED related to a fall from a lift.
On 11/10/25 at 11:52 AM the DON stated she did not come into the facility on [DATE REDACTED] until 12:00 PM. The DON stated she was not at the facility when the fall occurred. The DON explained Resident #1 had a 2mm subdural hematoma and a fracture from C7 - T6. The DON stated she did not know if Staff C notified the physician of the transfer. The DON stated Staff C did not notify Resident #1's family about the fall or transfer to the ED. The DON acknowledged the fall had occurred around 10:00 AM on 11/5/25. The DON acknowledged Resident #1's family was not notified for 2 hours. The DON explained Staff C said she could not find Resident #1's POA phone number on the printed paper that she had. The DON said Resident #1's POA's phone number was under other and did not populate on the transfer face sheet. The DON explained education was provided to Staff C about other places to look for emergency contact information. The DON stated her expectation was that family / POA would have been notified earlier than when she notified. The DON stated the facility's expectation was family / POA would be notified immediately of any emergency incidents that require intervention. Review of policy updated 6/2/25 titled, Policy Notification of Family/POA documented the purpose was to ensure staff are informed of when to notify families, POA's and physicians of any changes. Nursing staff must notify families, POAs and physicians of any changes of condition, falls or incidents involving loved ones. Members of the nursing staff must document in the EHR of notification of family and physician.
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Printed: 04/13/2026 Form Approved OMB No. 0938-0391
Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
B. Wing
A. Building
(X3) DATE SURVEY COMPLETED
11/13/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Tabor Manor Care Center
209 Main Street Tabor, IA 51653
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)
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
expectation for all skin assessments with a description of the wound. On 11/13/25 at 10:40 AM Staff C, Registered Nurse (RN) stated skin assessments are supposed to be completed weekly. Staff C stated the weekly skin assessment should include measurements and a description of the wound.On 11/12/25 at 3:09 PM the DON stated she would have expected there would have been more documentation in the Progress Notes with wound size and description. The DON stated it was discovered documentation could have been better related to wound assessments during the mock survey that was concluded 11/3/25 - 11/7/25. Review of policy dated 2/28/24 titled, Protocol for Wound Assessments documented when a skin concern arises,
the nurse shall complete skin assessment in the EHR. Physician notification for ongoing treatment/intervention, electronic medication administration record update to reflect current treatment/intervention. Weekly measurements obtained by the nurse and reflected in residents electronic medication administration records.
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Tabor Manor Care Center in Tabor, IA 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 Tabor, IA, (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 Tabor Manor Care Center or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.