Signature Healthcare At Parkwood
SIGNATURE HEALTHCARE AT PARKWOOD in LEBANON, IN — inspection on March 6, 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
the electronic health record.
The physicians relied on the nurses to monitor weights and to notify the
with the order.
Resident B's edema was stable, but the resident needed to be weighed weekly related
lounge watching T.V., a midline (intravenous line for medication administration) was present in the right upper arm.During an observation and interview, on 3/2/26 at 8:51 a.m., Resident J was sitting in his wheelchair in the hallway, a midline was present in his right upper arm and edema to his lower legs, ankles, and feet was noted bilaterally.
Resident J indicated he had gained weight from swelling, and the midline was placed to receive IV (intravenous) medication for the swelling. He was not sure how much weight he had gained because he was not weighed very often.During an observation, on 3/3/25 at 9:49 a.m., an empty IV medication bag, dated 3/2/26, hung on an IV pole.
The pharmacy label on the medication bag indicated Furosemide (a diuretic medication for edema or fluid buildup) 80 mg (milligram); intravenous.During an observation, on 3/5/26 at 1:46 p.m., Resident J was sitting in his wheelchair by the nurse's station, the midline had been removed, and edema was still noted bilaterally to his lower legs, ankles, and feet.The clinical record for Resident J was reviewed on 3/2/26 at 2:47 p.m.
The diagnoses included, but were not limited to, congestive heart failure, edema, and lymphedema.A care plan, with a start date of 1/24/23, indicated Resident J had a potential risk for nutritional risk and to obtain and document Resident J's weight per the order.A physician's visit note, dated 1/28/26, indicated the plan for Resident J's edema, lymphedema, and congestive heart failure included, but was not limited to, monitoring weekly weights.Documentation of weekly weights or a physician's order for weekly weights was not found in the EHR.A change in condition document, dated 2/20/26, indicated Resident J had experienced an increase in edema and shortness of breath. A physician's order was placed for IV Furosemide 80 mg and a 1 Liter fluid restriction from 2/25/26 to 3/2/26.The change in condition document did not include weight monitoring.A progress note, dated 2/25/26 at 12:30 p.m., indicated the Director of Nursing (DON) contacted the Medical Director (MD) to review Resident J's case and to confirm orders.
The order for IV Lasix 80 mg was confirmed, and Resident J was placed on daily weights.Documentation of daily weights or a physician's order for daily weights was not found in the EHR.
During an interview, on 3/5/26 at 3:34 p.m., the DON indicated she had spoken with the MD about Resident J and had placed the orders given by the MD.
The DON indicated she could not recall if the MD had ordered daily weights or if she had intended to put the resident on routine weight checks as a nursing measure but would contact the MD to confirm.During an observation and interview, on 3/5/26 at 3:34 p.m., the MD reply, via text message, to the DON, indicated Resident J was supposed to be a weekly weight.
The DON indicated she unfortunately did not place an order for weekly weights in the EHR.A current facility policy, titled Physicians Orders, dated as last revised 1/30/26 and received from the Clinical Support Nurse on 3/5/26 at 2:00 p.m., indicated .It is the standard of this facility that physician orders are followed, reviewed to ensure delivery of applicable care, being alert for changes in condition related to new orders, and need to notify the physician for.potential order changes as needed.Each resident will have physician's orders to guide the facility in caring for and treating each resident.Licensed Nurses and Medication Aides are expected to follow physician's orders.Licensed Nurses are expected to notify the physician with any concerns related to new physician orders or potential need for changes in orders.During physician visits and or rounding, physician's orders will be discussed with the physician and licensed staff for need for changes, such as new orders, discontinuing orders, or changing current orders.This citation relates to Intake 2743347.410 IAC (Indiana Administrative Code) 16.2-3.1-37(a)