Clark Rehabilitation And Skilled Nursing Center
CLARK REHABILITATION AND SKILLED NURSING CENTER in CLARKSVILLE, IN — inspection on October 29, 2025.
Found 2 citations. Severity: Standard violations.
Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.
Inspection Findings
10/9/25.
During an interview on 10/29/25 at 1:48 p.m., the Regional Nurse Consultant indicated, per
on 10/29/25 at 1:30 p.m.
The residents' diagnoses included, but were not limited to, Parkinson's
7/30/25, indicated the resident was to receive Hydrocodone-Acetaminophen 5-325 mg every 6 hours at 12:00 p.m., 6:00 p.m., 12:00 a.m. and 6:00 a.m. for chronic pain.
Review of the October 2025 controlled substance record indicated LPN 10 signed out the narcotic pain medication as administered on the following dates and times:-10/7/25 at 10:00 p.m.-10/8/25 at 2:00 a.m.-10/8/25 at 10:00 p.m.-10/9/25 at 2:00 a.m.
Review of the timeline provided by the Executive Director on 10/29/25 at 2:26 p.m. indicated the following:-The video camera footage reviewed indicated on 10/7/25 at 9:13 p.m., LPN 10 entered Resident D's room with a medication cup and then exited at 9:17 p.m.
From 9:17 p.m. on 10/7/25 to 3:30 a.m. on 10/8/25, LPN 10 did not enter the resident's room.-The video camera footage reviewed indicated, on 10/8/25 at 9:38 p.m., LPN 10 entered Resident D's room with a medication cup and water and exited at 9:38 p.m.
From 9:38 p.m. on 10/8/25 to 3:30 a.m. on 10/9/25, LPN 10 did not enter the resident's room. On 10/29/25 at 9:47 a.m., the Executive Director provided a current copy of the document titled Abuse Prohibition, Reporting and Investigation dated June 2023. It included, but was not limited to, Policy.It is the policy.to provide each resident with an environment that is free from.misappropriation of resident property.Misappropriation of Resident.Property.Deliberate misplacement.wrongful.use of a resident's property.without the resident's consent.The Past noncompliance began on 10/8/25 at 2:00 a.m.
The deficient practice was corrected by 10/15/25 after the facility implemented a systemic plan that included the following actions: A narcotic audit of all controlled records was conducted to review each resident for any discrepancies and unusual activity (10/9/25); All nursing staff were educated on misappropriation of resident property with an emphasis on medication administration and scope of practice for Certified Nursing Assistants (10/9/25); All appropriate residents were interviewed to determine if they had received all medications (10/9/25); Pain assessments were completed on all non-verbal residents (10/9/25); All employees that had potential access to divert medications were drug tested (10/10/25); The pharmacy conducted a 90 day audit for any narcotic discrepancies with no concerns (10/15/25).
This citation relates to Intake 2639587 3.1-28(a)
155697 10/29/2025
Clark Rehabilitation and Skilled Nursing Center 517 N Little League Blvd Clarksville, IN 47129
During an interview, on 10/29/25 at 1:48 p.m., the Regional Nurse Consultant indicated it was identified that on 10/8/25, Licensed Practical Nurse (LPN) 10 provided Certified Nursing Assistant (CNA) 11 with a resident's pain medication in a cup and CNA 11 entered Resident B's room with the medication cup.
Review of the timeline provided by the Executive Director on 10/29/25 at 2:26 p.m., indicated the following: -The video footage was reviewed starting on 10/8/25 at 10:30 p.m., LPN 10 entered Resident B's room at 10:40 p.m. with a medication cup and water. LPN 10 exited the room in less than a minute and then entered another resident's room, at which time, Resident B turned her call light on.
After exiting the other resident's room, LPN 10 went to the medication cart. CNA 11 entered Resident B's room, turned the call light off, exited the room and walked to the medication cart where LPN 10 was and said something to her. LPN 10 pulled open a drawer on the medication cart and withdrew a medication cup which she handed to CNA 11 along with a cup of water. CNA 11 took both the medication cup and water into Resident B's room and came out of the room empty handed.
The undated written statement from CNA 11 indicated, on 10/8/25, she had answered the call light for Resident B who told CNA 11 that LPN 10 brought in her medication but left before she could ask for pain medication.
Resident B asked CNA 11 to ask LPN 10 for a pain pill. CNA 11 found LPN 10 to let her know Resident B wanted pain medication. LPN 10 told CNA 11 that she had a feeling she was going to ask for that. LPN 10 told CNA 11 she had the pain medication right here and would CNA 11 mind to walk the medication to Resident B. CNA 11 told her she did not mind and took the medication and water to Resident B.
During an interview, on 10/29/25 at 2:50 p.m., CNA 7 indicated that CNA's could not administer medication to residents as it was not in their scope of practice.
During an interview, on 10/29/25 at 2:52 p.m., LPN 5 indicated that nurses could not give medications to the CNA's to administer to residents. On 10/29/25 at 2:27 p.m., the Executive Director provided a current copy of the document titled Certified Nursing Assistant (CNA) dated 10/14/25. It included, but was not limited to, Summary of Position Functions.The Certified Nursing Assistant.provides nursing and nursing related services to residents.Essential Position Functions.Provides direct care.Bathing.Dressing.Elimination/Toileting.Mobility.Transfer.Eating.Grooming.The Past noncompliance began on 10/9/25 at 10:41 p.m.
The deficient practice was corrected by 10/14/25 after the facility implemented a systemic plan that included that included the following: All nursing staff were educated on medication administration and scope of practice for Certified Nursing Assistants (10/9/25); One on one education completed with CNA 11 related to scope of practice and violation of company policy for completing a task outside of the scope of practice (10/14/25). 3.1-35(g)(2)
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Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.
Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.
Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.