Adept Nursing & Rehab Of South Sioux City
Inspection Findings
F-Tag F0684
F 0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Level of Harm - Minimal harm or potential for actual harm
Licensure Reference Number 175 NAC 12-006.09Based on record review and interview; the facility failed to follow physician's orders for Resident 1's daily weights. The sample size was 4 and the facility census was
- 41. Findings are: A record review of Resident 1's Minimum Data Set (MDS-federally mandated
comprehensive assessment used to create resident care plans) dated 8/21/25 revealed the resident had debility with cardiorespiratory (heart and lung) conditions including atrial fibrillation (abnormal heart rhythm), Congestive Heart Failure (CHF-failure of the heart to beat effective and having the potential for buildup of excess fluid lungs, legs, and other parts of the body), Hypertension (high blood pressure) and Renal insufficiency (declined in or non-optimal kidney function), and was taking insulin, antipsychotic, antibiotic, and diuretic (reduces fluid volume by increasing urine output) medications. The resident's weight was 216 pounds with no significant loss or gain.A record review of Resident 1's Care Plan dated 8/15/25 revealed the resident took a diuretic medication for CHF.A record review of Resident 1's admission orders dated 8/15/25 revealed an order for daily weights for 4 days and then weekly weights for 4 weeks. A record
review of Resident 1's Medication Administration Record dated August 2025 revealed the resident's scheduled daily weights for 8/16/25 and 8/17/25 were not completed. During an interview on 9/23/25 at 11:30 AM the Assistant Director of Nursing confirmed that the daily weight orders on 8/15/25 at the time of admission were not completed on 8/16/25 or 8/17/25 as ordered to ensure monitoring of the effects of the resident's diuretic medication to treat the resident's heart failure. During an interview on 9/23/25 at 1:00 PM
the Director of Nursing confirmed Resident 1 was not weighed as ordered on 8/16/25 and 8/17/25.
Residents Affected - Few
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:
Adept Nursing & Rehab of South Sioux City in South Sioux City, NE 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 South Sioux City, NE, (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 Adept Nursing & Rehab of South Sioux City or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.