Inspectors observed the resident, identified in records as R9, on September 23, 2025.
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The resident who was groped, identified in inspection records as Resident 105, was nonverbal.
Levothyroxine, a thyroid medication prescribed for a 6:00 a.m.
The physician on staff disagreed.
The resident's prescribed flow rate was 8 liters per minute, which requires a high-flow nasal cannula.
The heel injuries were being managed with heel protectors.
The inspection, completed October 1, 2025, was triggered by a complaint.
The altercation happened September 11, 2025.
Federal inspectors cited the facility for actual harm, isolated, the kind of citation that signals a real person was hurt, not a paperwork lapse.
That is how the facility learned Resident 101 was gone.
Starting May 9, 2025, she was given Lorazepam, a benzodiazepine sedative, every night for insomnia.
The resident, identified in inspection records only as Resident #10, was admitted to East Park Care Center on an undisclosed date.