Countryside Meadows
Inspection Findings
F-Tag F0690
F 0690 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
not limited to, assist with incontinent care as needed, and check and change every two hours and as needed for incontinence.At the time of exit there were no care plans or documentation in the record indicating Resident D had adverse behaviors related to refusal of incontinence care, toileting, personal hygiene or false accusations.During an interview on 9/29/25 at 1:27 p.m. the Director of Nursing (DON) indicated Resident D's nephrostomy tube was currently dislodged and would be replaced soon at the hospital. She indicated she was going to check Resident D's orders to see what the current orders were for
the nephrostomy tube. The DON indicated the tube did not have a bag attached to it because it was not draining due to the dislodgment.During an interview on 9/29/25 at 1:36 p.m. the DON indicated she was going to clean up Resident D's orders, because the current order should have been to only change the dressing as needed for soilage and to flush the tube as needed.During an interview on 9/29/25 at 2:31 p.m.
the Unit Manager (UM) indicated Resident D's current nephrostomy tube that was in place was a new tube and was working properly as far as she knew. She indicated she was just about to change the dressing for Resident D's nephrostomy tube, because to her knowledge the dressing was to be changed, and the tube was to be flushed daily and as needed. The UM indicated the nephrostomy tube was not connected to a bag at this time because her other kidney was functioning properly and she was urinating as normal, so the nephrostomy tube was not draining. She indicated if it did start to drain staff would then connect a drainage bag and account for the output from the tube. The UM also indicated Resident D was not on a bowel and bladder program because the resident did not know when she needed to go, she could only feel when she had already voided. She was on a standard two hour check and change schedule.During an interview on 9/29/25 at 3:00 p.m. the Administrator indicated the UM must have misspoke, because the current order for Resident D's nephrostomy tube was to be changed only as needed (PRN) and the tube was still dislodged.On 9/29/25 the administrator provided an electronic copy of a current facility policy titled, Bowel and Bladder Program, dated 5/2019. This policy indicated, .If a resident is totally incontinent and unable to be placed on a toilet or bedpan, resident should be checked and changed every two hours.This citation relates to Intake 2583736.3.1-41(a)(1)
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COUNTRYSIDE MEADOWS in AVON, IN 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 AVON, IN, (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 COUNTRYSIDE MEADOWS or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.