Nursing Home News — Page 556

The patient had undergone extensive lumbar spinal surgery on July 31, 2025, but developed complications within days.

While this represents the lower end of the federal severity scale, medical records violations carry significant implications for resident safety and privacy.

The breakdown in communication left physicians unaware when Resident #1 missed multiple doses of phenobarbital, a medication used to control seizures.

While this designation falls below the threshold of immediate jeopardy, it signals conditions that could lead to serious injury if left unaddressed.

The deficiency fell under F0689, the federal tag covering accident hazards and fall prevention.

The facility has not submitted a correction plan.

The Director of Nursing told inspectors on November 6 that she made the shower schedule for staff every day.

"It was uncomfortable," the resident said, pointing to her vagina.

The facility received a total of **four deficiencies** during the inspection.

The discrepancy involved Resident #1, who was admitted with major depressive disorder, adjustment disorder, unspecified dementia and metabolic encephalopathy.

This included shortcomings in providing treatment and daily living supports in a safe manner.

The facility's own managers confirmed it, one after another, in interviews with inspectors across two days.