Signature Healthcare Of Terre Haute
Inspection Findings
F-Tag F0657
F 0657 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Based on interview and record review, the facility failed to promptly revise the comprehensive care plan to reflect changes in regard to a resident's access to smoking for 1 of 4 residents reviewed for resident rights (Resident B). Findings include:Resident B's clinical record was reviewed on 11/5/25 at 10:44 a.m.
Diagnoses included nicotine dependence and major depressive disorder. His smoking status on his profile page included current everyday smoker. A current health care plan, dated 5/19/22 and edited 10/9/25, indicated the resident chose to smoke and was a risk for injury related to smoking. The resident had been evaluated and was deemed a safe smoker. Interventions included, but was not limited to, the following: resident must be at dining room door to enter courtyard on time in order to participate in supervised smoking breaks; resident will be allowed two cigarettes, or 15 minutes per smoking pass; resident will smoke in designated area in courtyard of southwest of building; smoking/tobacco material will be made available to resident by facility staff at designated smoke breaks; staff members supervising smokers must light cigarettes for resident; and smoking assessment completed at this time and resident has been deemed as a safe smoker.During an interview on 11/5/25 at 1:46 p.m., Resident B indicated he was no longer allowed to go out at smoke breaks. He indicated he had hit another resident in the nose and was told
he could no longer participate in smoke breaks.During an interview on 11/5/25 at 2:10 p.m., the Administrator indicated Resident B lost his smoking privileges after hitting another resident. She had spoken to him multiple times regarding his behaviors during smoke breaks. They had reviewed the Smoking Agreement with the resident multiple times due to his crowding behaviors, and on 8/31/25, he became physical and he lost his privilege to smoke. His care plan was not updated or the indication on his profile of him being an everyday smoker. This should have been done following the revocation of his smoking privileges.No specific facility policy regarding care planning provided. The facility followed CMS guidelines.This citation was in regard to intake 2655657.3.1-35(b)
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:
SIGNATURE HEALTHCARE OF TERRE HAUTE in TERRE HAUTE, 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 TERRE HAUTE, 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 SIGNATURE HEALTHCARE OF TERRE HAUTE or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.