Majestic Care Of North Vernon
Inspection Findings
F-Tag F0921
F 0921 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and
the public.
Based on observation, interview, and record review, the facility failed to provide safe water temperatures for 5 of 9 resident bathrooms and 1 of 2 common area bathrooms observed. (Rooms C 101, C 102, D 114, D 115, D 116, and Women's Visitor Restroom)Findings include:During an observation, on 10/27/2025 at 10:35 A.M., the water in the Women's Visitor Restroom in the main hallway was hot to touch, not able to hold the hand under the water. The door was unlocked, unless it was in use and several residents had independently passed by the restroom.During an observation and interview, on 10/27/2025 at 10:40 A.M., Resident Room D 116's bathroom sink water was hot to touch. Resident E indicated she had no concerns with her water.During an observation, on 10/27/2025 from 10:47 A.M. to 11:01 A.M., the Maintenance Director checked the water temperatures in the following rooms:-Room D-116 the water temperature was 124.0 degrees Fahrenheit,-Room D-115 the water temperature was 122.5 degrees Fahrenheit,-Room D-114 the water temperature was 124.3 degrees Fahrenheit,-Room C-101 the water temperature was 123.3 degrees Fahrenheit,-Room C-102 the water temperature was 123.0 degrees Fahrenheit, and-Women's Visitor Restroom the water temperature was 134.5 degrees Fahrenheit.The Maintenance Director indicated the Women's Restroom had its own on demand water heater. They had placed a piece of tape over the dial that indicated to stop and do not touch. They had put the tape in place because people were adjusting the temperature on their own. The door to the restroom was only locked from the inside while in use. It was open for anyone to use but did have a sign on the door that the restroom was for visitors and care team members only. The water temperature should be 115 degrees Fahrenheit. He checked them daily in each hallway. He drained the water from the on-demand unit at that time and was going to adjust
the water to the resident rooms.During an interview, on 10/27/2025 at 11:05 A.M., the Administrator indicated there had not been concerns of hot water temperatures or any burns from the water. During an interview, on 10/27/2025 at 11:07 A.M., the Director of Nursing (DON) indicated there had not been any reported burns in the building.During an interview, on 10/27/2025 at 11:20 A.M., the Administrator indicated
the Maintenance Director was going to lock the Women's Bathroom at that time so no residents would be able to access it. They had also adjusted the temperatures for the residents' rooms. They would be monitoring the water temperatures until they were the correct temperatures.The September and October 2025 temperature logs were reviewed and indicated the water temperatures were 115 degrees Fahrenheit
on the following dates:-09/01/2025 through 09/05/2025,-09/22/2025 through 09/26/2025,-10/06/2025 through 10/09/2025,-10/10/2025, and-10/20/2025 through 10/24/2025.No other dated temperature logs were provided.The current facility policy titled, Water Temperatures was provided by the Administrator on 10/27/2025 at 11:20 A.M. The policy indicated, .To maintain appropriate water temperatures in resident/patient care areas.Water temperatures will be set to a temperature of no more than the state's allowable minimum and maximum water temperature.
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:
MAJESTIC CARE OF NORTH VERNON in NORTH VERNON, 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 NORTH VERNON, 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 MAJESTIC CARE OF NORTH VERNON or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.