Southwood Healthcare Center

F 0600 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few

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

policy indicated, .Policy: .CNA's.provide patient centered care by monitoring patient care needs and safety

on a routine basis throughout the day.Procedure: 1. CNA's will routinely monitor residents.for routine care needs and safety.referred to as rounding.2. Rounding will be completed by CNA to safely transfer care between on-coming and off-going shifts.3. Nurses will monitor that rounding schedule is adequate and complete for meeting resident needs. On [DATE REDACTED] at 10:50 a.m., the RDCO provided an undated document titled, Abuse & Neglect & Misappropriation of Property, and indicated it was the policy currently being used by the facility. The policy indicated, .Neglect: In Indiana, neglect is defined as failure to provide goods and services as necessary to avoid physical harm, mental anguish, or mental illness (Deprivation of services).

Examples: An action or lack of action that actually harms a resident such as.7) An action or lack of action that places one or more residents in a life-threatening situation, such as.c) Staff failing to identify, assess, monitor, and respond to residents suffering an acute condition.II. Training: 1. Provide education and training upon hire, annually and as needed for re-training to include but not limited to.e. Observations that may identify abuse or neglect.III. Prevention.3. Staffing is established based on census, acuity level, needs, and is posted daily in a conspicuous area for residents, family and visitors. The immediate jeopardy that began

on [DATE REDACTED] was removed on [DATE REDACTED], when the facility ensured a systemic plan to include education and monitoring of staff to ensure staff provided supervision and required care to all residents residing at the facility. The noncompliance remained at the lower scope and severity level of no actual harm with the potential for more than minimal harm that is not immediate jeopardy because of the facility's need for continued monitoring. This citation relates to Intakes 2635111 and 2635242. 3.1-27(a)(3)

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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

10/09/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Southwood Healthcare Center

2222 Margaret Ave Terre Haute, IN 47802

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 0725 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few

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

and stopped all staffing audits except daily staffing calls. Then when the current Administrator started, they began to do staffing audits again. During an interview, on [DATE REDACTED] at 8:55 a.m., the Administrator indicated

the daily staffing calls were with their corporate office. They discuss the census and the staffing numbers.

Corporate would suggest that they may require more staff, so they would advertise and offer different incentives. The QAPI had begun performing staffing audits after she started her position as the Administrator. During an interview, on [DATE REDACTED] at 10:40 a.m., Resident N indicated the same nurse aide usually worked the unit on night shift. When Resident N requested Tylenol, the nurse aide had to let the nurse know so it could be administered. Resident N had to wait a long time sometimes to get the Tylenol

after she requested it. She heard the staff say there was only one nurse covering three units, but she was not sure. She knew they did not have very many staff who worked the night shift, and it was not enough.

Resident N indicated she turned her call light on this morning before 6:00 a.m. to request Tylenol, and it took the nurse aide approximately half an hour to answer the call light. The nurse aide told the resident she would let the nurse know she wanted Tylenol. The nurse gave her the Tylenol at 7:00 a.m. with her other morning medications. She thought this type of thing happened because they did not have enough staff and could not get to the residents more quickly. During an interview, on [DATE REDACTED] at 10:55 a.m., Resident P indicated it took a long time for him to get his pain medication. He had to request medication and waited as long as nine hours after his request until he received it. There was no nurse specifically assigned to his unit, so he had to wait for one to come to the unit and give him the pain medication after he asked for it. During

an interview, on 10/9/

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If continuation sheet