Milton Home, The
Inspection Findings
F-Tag F0689
F 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
indicated Resident B's seatbelt and 3 of the 4 floor safety restraints were still properly secured, but the left front floor restraint was loosened. Employee 3 indicated Resident B had not complained of pain, but due to
the scrapes on his head and right arm, she had called for EMS services.During an observation with Employee 3, of the process to secure a wheelchair in the facility bus, on 11/6/2025 at 10:00 A.M., a red level was noted under the front left footrest of the wheelchair and able to be accessed by the feet of resident's in the wheelchair. Employee 3 pushed the red lever and the floor security restraint strap loosened when the wheelchair was purposely tipped to the right side for demonstration. Once the wheelchair was completely placed on it's right side, on the floor of the bus, the security strap on the left front was still attached to the floor of the bus, but was extremely loose. The other 3 security restraint straps remained locked in place and had not loosened when the wheelchair was tipped to the side.During an interview, on 11/6/2025 with a Customer Service Representative (CSR) 4, for the wheelchair floor securement device manufacturer, they indicated the red lever on the floor securement was an emergency release level. CSR 4 indicated the floor securment device was designed so the passengers using the floor securement device were not to have access to the red release lever on the device. CSR 4 indicated if the wheelchair had been properly secured, the straps on the floor securement system would have been at a 45 degree angle, leaving too much room between the resident's foot and the emergency release lever, to prevent accidental engagement. CSR 4 indicated the emergency release lever was to be on the outside of the safety straps not on the inside of the safety straps. The CSR 4 representative indicated the whelechair had been improperly installed by Employee 3, which had allowed the emergency release device to have been activated, which had led to the loosening of the restraint safety strap and the tipping of Resident B's wheelchair.During an interview with the RNC, on 11/6/2025 at 2:00 P.M., she indicated the facility had spoken with the manufacturer of the floor securement devices and had found that Resident B's wheelchair had likely fell over, on 10/27/2025, because Employee 3 had incorrectly secured the wheelchair in the facility bus.Review of Employee 3's skill valadation check off sheet, provided by the RNC on 11/6/2025 at 2:00 P.M. indicated she had been found competent regarding securing a wheelchair correctly in the facility bus, on 1/25/2025.This citation relates to Intake 2654973 and 2658962.3.1-45(a)
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If continuation sheet
MILTON HOME, THE in SOUTH BEND, 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 SOUTH BEND, 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 MILTON HOME, THE or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.