Waters Of Clifty Falls, The
Inspection Findings
F-Tag F0689
F 0689 Level of Harm - Actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
sharp part of the wheelchair causing some skin tears and lacerations of the lower extremities. The physical exam indicated the resident had a 5 centimeter (cm) circumferential laceration of the right lower leg, one skin tear proximal. On the right leg there were four small skin tears. All skin tears were 2 cm in length. The 5 cm laceration to the left lower leg was numbed using lidocaine, irrigated with high-pressure irrigation and 2 X (by) 4 sutures were placed in a running fashion to approximate each side. The total of 5 X 2 cm small skin tears were irrigated with normal saline and Dermabond (a skin adhesive to hold wounds together) was placed. A Progress Note, dated 08/23/2025 at 12:00 P.M., indicated the resident returned from the hospital.
The resident was noted to have glue to the skin tears on the right calf and six sutures and skin glue to the wound on the left calf. There were new orders to cleanse the areas daily and monitor for redness, discharge, fever, or worsening in condition. The resident family was aware and at bedside. A Wound Assessment Report, dated 08/27/2025, indicated the resident had a skin tear to the left lower posterior leg.
The wound measured 6.50 cm X 4.20 cm. The wound had sutures. A Wound Assessment Report, dated 08/27/2025, indicated the resident had a skin tear to the right lower posterior leg. The wound measured 10.10 cm X 2.50 cm. A Wound Assessment Report, dated 09/17/2025, indicated the residents skin tears to
the right and left lower legs were healed. The current facility policy titled, GUIDELINES FOR INCIDENTS/ACCIDENTS/FALLS, dated 06/30/2023, was provided by the Administrator on 11/18/2025 at 1:21 P.M. The policy indicated, .The facility will ensure that incidents and accidents that occur involving residents are identified, reported, and resolved.This citation related to Intake 2598682.3.1-45(a)(1)3.1-45(a)(2)
Event ID:
Facility ID:
If continuation sheet
Printed: 04/13/2026 Form Approved OMB No. 0938-0391
Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
B. Wing
A. Building
(X3) DATE SURVEY COMPLETED
11/18/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Waters of Clifty Falls, The
950 Cross Ave Madison, IN 47250
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)
F-Tag F0908
F 0908 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
circumferential laceration of the right lower leg, 1 skin tear proximal. On the right leg there were four small skin tears. All skin tears were 2 cm in length. The 5 cm laceration to the left lower leg was numbed using lidocaine, irrigated with high-pressure irrigation and 2 X (by) 4 sutures were placed in a running fashion to approximate each side. The total of 5 X 2 cm small skin tears were irrigated with normal saline and Dermabond (a skin adhesive to hold wounds together) was placed. A Progress Note, dated 08/23/2025 at 12:00 P.M., indicated the resident returned from the hospital. The resident was noted to have glue to the skin tears on the right calf and six sutures and skin glue to the wound on the left calf. There were new orders to cleanse the areas daily and monitor for redness, discharge, fever, or worsening in condition. The resident family was aware and at bedside.The current, undated, facility policy titled, Nursing-Annual Inspections, was provided by the Administrator on 11/18/2025 at 1:21 P.M. The policy indicated, .Wheelchairs: Check all wheelchairs for proper operation and needed repairs.This citation related to Intake 2598682.3.1-19(bb)
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Facility ID:
If continuation sheet
WATERS OF CLIFTY FALLS, THE in MADISON, 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 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.