Helen Newberry Joy Hltcu Golden Leaves Living Cent
Inspection Findings
F-Tag F0686
F 0686 Level of Harm - Actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
putting her foot up when she's in bed. The DON admitted the resident should have had pressure-reduction boots or a similar pressure-reducing device in place.The Kardex of Resident R1 and the consultant report of 12/11/25 were reviewed with the DON. The DON said there should have been a physician's order and care plan intervention for the boot as ordered by the consultant physician. The DON said the Kardex should have included pressure-reducing interventions for staff to follow to promote healing of the existing PI and to prevent new PI from developing.After the interview, the DON went to her office and returned with the boot for Resident R1 as referenced by the physician consultant on 12/11/25. The DON said she did not know how long the boot had been in her office. She said she first noticed the boot in her office on 12/31/25 but did not know who it was for. The DON was asked what pressure-reducing devices or interventions were put in place until
the boot was received. The DON said, They [staff] should have been putting her foot up when she's in bed, and she should have had soft booties.The manufacturer's insert in the package with the boot contained the following information, in part: . [Brand name of boot redacted] eliminates pressure on the heel and toes, while dynamically positioning the foot in a neutral position for the treatment of foot and ankle contractures.
The floating heel design of the [brand name of boot redacted] eliminates pressure or friction on the heel, enhancing circulation vital to healing. The manufacturer's warning list on the insert included: .1. [brand name of boot redacted] requires a physician order.The policy Wound Care Guidelines dated as revised 7/16/2024 read, in part: . Elevate heels off mattress and support calves and ankles with a pillow or protective device float.The policy Skin and Wound Assessment dated as revised 1/14/2025 read, in part: .ALL [sic] residents that do have skin breakdowns and/or pressure ulcers receive necessary treatment and services to promote healing. Avoidable Pressure Ulcer: Means that the resident developed a pressure ulcer and that the facility did not do one or more of the following:Evaluate the resident's clinical condition and pressure ulcer risk factors;Define and implement interventions that are consistent with resident needs, resident goals, and recognized standards of practice;Monitor and evaluate the impact of the interventions; or revise the interventions as appropriate. The National Pressure Injury Advisory Panel (NPIAP) Prevention and Treatment of Pressure Ulcers/Injuries: Quick Reference Guide Recommendations, 4th edition, 2025 [https://npiap.com/page/InternationalGuidelines?hhsearchterms=2025] recommends, in part: .It is good practice to frequently reposition individuals at risk of pressure injuries who are seated out of bed. position seated individuals in such a way that reduces pressure, shear and friction. This includes: . ? position in which the individual's legs are elevated and supported so the heels are free from the support surface. It is good practice to elevate the heels of individuals at risk of pressure injuries, so the heels are not in contact with the support surface. We suggest using a heel offloading device that is appropriate to the individual's mobility and activity level. It is good practice to elevate the heels of individuals at risk of pressure injuries using standard pillows or cushions with sufficient height to ensure the heels are not in contact with the support surface.
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Helen Newberry Joy HLTCU Golden Leaves Living Cent in Newberry, MI 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 Newberry, MI, (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 Helen Newberry Joy HLTCU Golden Leaves Living Cent or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.