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Complaint Investigation

Brandon Woods Of Dartmouth

September 4, 2025 · South Dartmouth, MA · 567 Dartmouth Street
Citations 1
CMS Rating 2/5
Beds 118
Provider ID 225233
Healthcare Facility
Brandon Woods Of Dartmouth
South Dartmouth, MA  ·  View full profile →
Inspection Summary

Brandon Woods of Dartmouth in SOUTH DARTMOUTH, MA — inspection on September 4, 2025.

Found 1 citation. Severity: Standard violations.

Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.

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Inspection Findings

FF0580
Resident Rights Deficiencies
Potential for More Than Minimal Harm

normal oxygen saturation level.

The Physician said that is a significant change in condition and she expected to be notified immediately.

During an interview on 9/04/25 at 1:45 P.M., the Unit Manager said that Resident #1 was on oxygen as needed and said she was unaware that Resident #1 required the use of continuous oxygen.

The Unit Manager said that she was unaware that Resident #1 had a low oxygen saturation level and required a higher oxygen Liter flow to maintain normal oxygen levels.

The Unit Manager said that she expected nurses to notify the Physician or NP of a low oxygen saturation level.

The Unit Manager said that a low oxygen saturation level is a change in condition and should be reported to the Provider so that it can be addressed immediately.During a telephone interview on 9/04/25 at 2:04 P.M., Nurse Practitioner (NP) #1 said that she was not notified that Resident #1 had an oxygen saturation level of 84% and was not notified that he/she required a higher level of Liter flow to maintain normal oxygen saturation levels.

The NP said that it was her expectation that nurses would notify her if a resident had a low oxygen saturation level and/or required a higher Liter flow to maintain normal oxygen saturation level.

The NP said that is considered a significant change in condition and she should be immediately notified.

Review of Resident #1's medical record indicated that there was no documentation to support that Nurse #2 notified his/her NP or Physician of Resident #1's low oxygen saturation level and requiring a higher Liter flow of oxygen.

During an interview on 9/04/25 at 2:25 P.M., the Director of Nursing (DON) said she was not notified that Resident #1 had an oxygen saturation level of 84% and required a higher liter flow of oxygen to maintain normal oxygen saturation levels.

The DON said that it was her expectation that nurses notify the Provider immediately of a low oxygen saturation level as well as if a resident required a higher Liter flow of oxygen to maintain normal oxygen levels.

The DON said that a low oxygen saturation level and requiring a higher Liter flow of oxygen is considered a change in condition and requires immediate notification to the Provider.

Facility ID:

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 DARTMOUTH, MA, (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 Brandon Woods of Dartmouth or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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