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Complaint Investigation

Waters Of Clifty Falls, The

Inspection Date: October 20, 2025
Total Violations 1
Facility ID 155209
Location MADISON, IN
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Inspection Findings

F-Tag F0550

Resident Rights Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0550 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

Based on interview and record review, the facility failed to ensure staff treated a resident with respect and dignity for 1 of 3 residents reviewed for resident rights. (Resident C) Findings include:The clinical record for Resident C was reviewed on 10/20/2025 at 10:10 A.M. An admission Minimum Data Set (MDS) assessment, dated 8/22/2025, indicated the resident was cognitively intact. The resident's diagnoses included, but were not limited to, heart failure, depression, and hypertension. During an interview, on 10/20/2025 9:28 A.M., Resident C indicated that Certified Nursing Assistant (CNA) 2 said a lot of hurtful things. She made comments to her that nobody at the facility liked her, and she was a difficult resident to take care of and roll over. She reported it to management, and the CNA no longer takes care of her. A Resident Interview Document, dated 10/8/2025, indicated Registered Nurse (RN) 5 interviewed Resident C. The Resident was upset that CNA 2 told her she was hard to roll, and that other staff members talked about her. CNA 2 apologized to her later, but the Resident still felt ridiculed and embarrassed. CNA 2 also stated, There is three types of people in this facility. Those that take care of themselves, those that need a little help, and like Resident C that can't do anything on their own. During an interview, on 10/20/2025 at 11:14 A.M., CNA 3 indicated that she was in the room with CNA 2 made comments to Resident C. CNA 2 told the resident she was a difficult resident to care for. During an interview, on 10/20/2025 at 11:38 A.M., CNA 4 indicated that she and another staff member were providing Resident C with care when CNA 2 walked into the residents room. The resident made a remark that she was easy to care for, and CNA 2 told her she was one of the most difficult people at the facility to care for. When CNA 3 and CNA 4 exited the room CNA 2 stayed behind in the residents room. When the resident turned her call light on to be assisted with post assistance hygiene CNA 2 was no longer in the room, and Resident C no longer wanted to get out of bed. The current undated facility policy titled, Your Rights and Protections as a Nursing Home Resident, was provided by the Administrator on 10/20/2025 at 2:50 P.M. The policy indicated, .You have the right to be treated with dignity and respect . This citation relates to Intake 2638439. 3.1-3(t)

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 REPRESENTATIVE'S SIGNATURE

TITLE

(X6) DATE

FORM CMS-2567 (02/99) Previous Versions Obsolete

Facility ID:

If continuation sheet

Event ID:

📋 Inspection Summary

WATERS OF CLIFTY FALLS, THE in MADISON, IN inspection on recent inspection.

Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.

What this means: Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. All deficiencies must be corrected within required timeframes and are subject to follow-up verification.

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 MADISON, 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 WATERS OF CLIFTY FALLS, THE or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.
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