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Complaint Investigation

Wabasso Restorative Care Center

September 2, 2025 · Wabasso, MN · 660 Maple Street
Citations 3
CMS Rating 1/5
Beds 44
Provider ID 245400
Healthcare Facility
Wabasso Restorative Care Center
Wabasso, MN  ·  View full profile →
Inspection Summary

WABASSO RESTORATIVE CARE CENTER in WABASSO, MN — inspection on September 2, 2025.

Found 3 citations. 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

FF0577
Resident Rights Deficiencies
Potential for Minimal Harm

Based on observation, interview and document review, the facility failed to ensure both recertification survey results, complaint investigations, and facility plans of correction were available for review.

This had the potential to affect all forty-three (43) residents residing in the facility, as well as family, visitors, and staff.Findings include:R5's brief interview for mental status (BIMS) dated 8/11/25, indicated R5 had moderately impaired cognition.On 8/27/25 at 3:50 p.m., R5 indicated he would like to see the results of the surveys that the State Agency (SA) conducted however, did not know where to locate them.On 8/27/25 at 4:00 p.m., a binder titled facility survey results was located in a plastic wall file by the front entrance behind the resident council minutes.

The survey results included in the binder consisted of the recertification survey results for 4/25/24, and complaint investigation results for 5/21/24, and 5/28/25.A review of Aspen Central Office (ACO-an online computerized federal document site which contains the surveys completed for facilities, including both recertification surveys, and complaint investigation) identified recertification surveys were completed on 6/29/23, 4/25/24, and 11/18/24.

Additionally, complaint investigations were completed and noted to have citations issued on the following dates: 12/28/22, 3/23/23, 7/12/23, 7/26/23, 2/28/24, 5/21/24, 9/24/24, 12/24/24, and 5/28/25.The facility survey result binder lacked the following: recertification surveys completed 6/29/23, and 11/18/24; facility's plan of correction for 4/25/24; complaint surveys completed 12/28/22, 3/23/23, 7/12/23, 7/26/23, 2/28/24, 9/24/24, and 12/24/24; facility's plan of correction for 5/21/24.

During an interview on 8/28/25 at 11:54 a.m., the corporate clinical care coordinator (CCCC) indicated the survey results were public knowledge and should contain all state agency surveys with facility plan of corrections.

The CCCC verified the facility survey binder did not contain all the required surveys or facility plans of correction.

During an interview on 9/2/25 at 4:39 p.m., the administrator was unable to locate the facilities survey binder however, indicated the residents take them and stated, they [survey results] disappear as fast as we put them out. A facility policy was requested for posting of survey results however, was not provided.

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

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

09/02/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Wabasso Restorative Care Center

660 Maple Street Wabasso, MN 56293

SUMMARY STATEMENT OF DEFICIENCIES

During an interview on 9/2/25 at 2:36 p.m., NA-C indicated she was working the medication cart on 8/21/25 and R1 was acting a little weird and a little distraught. NA-C further identified at approximately 8:00 a.m., R1 complained that her head hurt and she wanted some Tylenol.

During an interview on 9/2/25 at 2:42 p.m., NA-D indicated she was working on 8/21/25, when R1 reported that R2 had hit her and pulled her hair.

During an interview on 8/28/25 at 2:15 p.m., licensed practical nurse (LPN)-A, indicated she was working on 8/21/25, as a charge nurse and did not recall any incident between R1 and R2 that occurred that day. LPN-A stated on 8/22/25, R1 was upset and reported she was leaving the facility because she was scared of R2.

During an interview on 9/2/25 at 3:00 p.m., the director of nursing stated she was informed of the incident between R1 and R2 the day after it happened and described the incident as R2 pulled or touched [R1's] hair and she did not like it and was upset about it.

The facility implemented 15-minute checks on R1 and R2.

During an interview on 9/2/25 at 11:34 a.m., the administrator identified she was aware of the incident that occurred between R1 and R2 and the facility implemented 15-minute checks on R1 and R2 to assure they were not outside in the smoking area at the same time.

The Sheriff's Office Incident Report dated 8/21/25 at 7:21 p.m., R1's family member called to request a welfare check on R1 as R1 had reported R2 assaulted her.

The sheriff's deputy responded at 7:34 p.m. and R1 reported at 8 a.m. that morning, R2 pulled her hair, struck her in the back of the head, and pushed her wheelchair.

The deputy informed staff of the situation and staff stated that they would keep R1 and R2 separated.

Review of the facility's policy titled, Abuse, Neglect, and Exploitation last revised 4/25/25, indicated it was the policy of the facility to provide protections for the health, welfare, and rights of each resident by developing and implementing written policies and procedures that prohibit and prevent abuse, neglect, exploitation, and misappropriation of property.

Abuse was defined as the willful infliction of injury with resulting physical harm, pain, or mental anguish.

Physical abuse included and was not limited to hitting, slapping, punching, biting, and kicking.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

09/02/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Wabasso Restorative Care Center

660 Maple Street Wabasso, MN 56293

SUMMARY STATEMENT OF DEFICIENCIES

During an interview with R1 on 9/2/25 at 5:55 p.m., R1 indicated on 8/21/25 at approximately 8:00 a.m., R2 hit her in the back of the head, pulled her hair, and pushed her wheelchair into the fence in the smoking area. R1 stated, I immediately got a headache and got a Tylenol. R1 further identified she told several nursing staff immediately after it happened but could not remember who she had talked to. R1 identified the next day (8/22/25), R2 threatened her again and she called a family member to come and pick her up. R2 stated she discharged from the facility and was not going back. R2's quarterly MDS dated [DATE], indicated R2 had intact cognition and no behaviors.

Identified R2 had no upper extremity impairment, had lower extremity impairment and used a manual wheelchair. R2 was independent wheeling his wheelchair.

Diagnoses included paraplegia (paralysis of the legs and lower body), alcohol dependence, and adjustment disorder with mixed anxiety and depressed mood.

During an interview on 9/2/25 at 2:08 p.m., nursing assistant (NA)-A indicated she was working on 8/21/25, when the alleged incident occurred. NA-A stated at approximately 8:00 a.m., R1 reported that R2 had pulled her hair and punched her while outside in the smoking area. NA-A identified she told the assistant director of nursing and the charge nurse about the allegation immediately after R1 reported it and they placed R1 and R2 on 15-minute checks.

During an interview on 9/2/25 at 11:34 a.m., the administrator indicated she was notified of the incident on 8/21/25, however, did not know about R2 hitting R1.

The administrator verified the FRI was submitted late to the SA on 8/22/25, when she became aware of the hitting.The Sheriff's Office Incident Report dated 8/21/25 at 7:21 p.m., R1's family member called to request a welfare check on R1 as R1 had reported R2 assaulted her.

The sheriff's deputy responded at 7:34 p.m. and identified that R1 reported at 8 a.m. that morning, R2 pulled her hair, struck her in the back of the head, and pushed her wheelchair.

The deputy informed staff of the situation and staff stated that they would keep R1 and R2 separated.

Approximately 16 hours prior to the FRI was submitted to the SA.Review of facility policy titled The Abuse, Neglect, and Exploitation Policy last revised 4/25/25, indicated the facility was to report all alleged violations to the administrator, state agency, adult protective services, and all other required agencies (law enforcement when applicable) within specified timeframes: Immediately, but not later than 2 hours after the allegation was made for events that caused the allegation to involve abuse or result in serious bodily injury.

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 WABASSO, MN, (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 WABASSO RESTORATIVE CARE CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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