What inspectors found was not a complicated case.
Nursing Home News — Page 169
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Federal inspectors visited Goldwater Care Clinton on April 29, 2026, following a complaint.
The certified nursing aide, identified in inspection records as V4, looked at the daily schedule for January 27 and confirmed her own name was on it.
The resident, identified in inspection records only as Resident 2, had been waiting since December.
The facility's own internal assessment said that number should never exceed 30.
The nursing assistant, identified as NA #1, was in the resident's room when the situation became heated.
After administering insulin, the nurse set the glucometer, now carrying Resident 8's blood, on top of the cart in the hallway.
That resident, identified in federal inspection records only as R1, said so directly when inspectors arrived on April 24, 2026.
He spends the majority of his time in bed.
The resident who did the hitting, Resident 2, had been admitted in 2024 following a cerebral infarct, a form of brain tissue death caused by lack of oxygen.
The man, identified only as Resident 1 in the inspection report, was completely dependent on staff for oral hygiene.
The resident, identified in inspection records only as R24, has a colostomy bag and cleans it himself in the bathroom sink.