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Complaint Investigation

Summit City Nursing And Rehabilitation

February 23, 2026 · Fort Wayne, IN · 2940 N Clinton St
Citations 1
CMS Rating 5/5
Beds 63
Provider ID 155159
Healthcare Facility
Summit City Nursing And Rehabilitation
Fort Wayne, IN  ·  View full profile →
Source Document
Official CMS Inspection Report (Medicare.gov)
Downloaded from CMS/Medicare.gov. Reflects what state inspectors documented and does not include the facility's plan of correction, which is submitted separately. Facilities may have taken corrective actions since this report was released.
Inspection Summary

SUMMIT CITY NURSING AND REHABILITATION in FORT WAYNE, IN — inspection on February 23, 2026.

Found 1 citation. 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

FF0761
Pharmacy Service Deficiencies

Based on interview, record review and observation, the facility failed to ensure staff were present

an observation on 2/23/26 at 9:42 AM, Resident B's medications were observed on the bedside table in a pill cup.In an interview, on 2/23/26 at 9:42 AM, Resident B indicated he self-administrated his medications and he often had the nurse place the medications on his bedside until he was ready to take the medications.

Resident B indicated the medications on his bedside table were his morning medications and he preferred to take the medications later in the morning.In an interview, on 2/23/26 at 9:56 AM, Qualified Medication Assistant (QMA) 2 indicated Resident B self-administered his medications. QMA 2 indicated he placed the medications at bedside on 2/23/26 for Resident B to take when Resident B was ready. QMA 2 reviewed the orders and indicated he was unable to find an order for self-administration of medications for Resident B.Resident B's record review was completed on 2/23/26 at 10:41 AM, diagnoses included chronic obstructive pulmonary disease, chronic kidney disease, hepatic encephalopathy, seizures and congestive heart failure.An admission Minimum Data Set (MDS) assessment dated 12/2025, indicated Resident B had a Brief Interview of Mental Status of 15/15 (cognitively intact).Resident B's assessments were reviewed, there was no self-administration of medications assessment completed.Resident B's orders were reviewed, there were no orders for self-administration of medications.

The Medication Administration Record (MAR), dated 2/2026, indicated QMA 2 administered the following medications to Resident B on 2/23/25 at 7 AM. acyclovir (antiviral) 800 mgcarvedilol (hypertensive) 6.25 mgcyanocobalamin (vitamin B12) 500 mcgfolic Acid (vitamin B9) 1 mgfurosemide (diuretic) 40 mggabapentin (anticonvulsant) 200 mgempagliflozin (antidiabetic) 10 mglevetiracetam (anticonvulsant) 500 mglinaclotide (guanylate cyclase-c agonists) 72 mcgmagnesium oxide (antacid) 400 mgmen's Daily vitamin 8 mgguaifenesin (expectorant) 600 mgomeprazole (antiacid) 20 mgranolazine (antianginal) 500 mgsenna (stool softener) 8.6 mgthiamine (vitamin B1) 100 mgvitamin D3 50 mcg

During an interview, on 2/23/26 at 11:33 AM, the Director of Nursing (DON) indicated Resident B did not have a self-administration of medication evaluation upon admission.

The DON indicated Resident B did not have an order to self-administration of medications.

The DON indicated the nurse should stay with the resident until medications were consumed by the resident. A policy, last revised 1/2025, titled self-administration of medications, was provided by the DON on 2/23/26 at 11:33 AM.

The policy indicated a physician provided a self-administration of medication order and the resident will be assessed to determine the ability to self-administer medicationsThis citation relates to Intake 2737108.3.1-25(b)(3) 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 TITLE (X6) DATE REPRESENTATIVE'S SIGNATURE

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 FORT WAYNE, 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 SUMMIT CITY NURSING AND REHABILITATION or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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About This Inspection Report

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.