Complete Care At Woodlands
Inspection Findings
F-Tag F0686
F 0686 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
Director of Nursing (DON) stated that the expectation when the resident refused the treatment was to first retry by making another attempt to do the treatment, then if not successful, document and make the doctor aware that the treatment was not done, to make sure the resident was getting optimal care.During a telephone interview with the surveyor on 10/24/25 at 1:39 PM, the Registered Nurse (RN) reported that on
the 10/22/25 and 10/23/25 evening shifts, Resident #2 refused both dressing changes. The RN stated that
she coded the wound care for both shifts wrong, and that the process when the resident refused treatment, was to document in the PNs. The RN stated that because it was coded wrong, she did not get the option to document the Resident #2's refusal note. The RN further stated that she did not make anyone, including the doctor, aware that the treatment was not done. The RN stated that for continuity of care and the incoming nurse aware that Resident #2's wound treatment was not done.In an interview on 10/24/25 at 3:15 PM, the Medical Doctor (MD) stated that she was aware that Resident #2 refused treatments at times but was not made aware of their refusals on the 10/22/25 evening shift, the 10/23/25 morning shift, or the 10/23/25 evening shift. The MD stated that the expectation was for the nurses to inform them [medical staff] and they would then reach out to the wound care specialist. The MD stated that the nurses could have also called
the wound care specialist and they reach out to them [medical staff]. The MD stated it was important for the nurses to notify the doctor in case of any change in wound status. The MD stated that there was no harm done because the area was gangrenous and a dead area but indicated that not cleaning the wound could cause discomfort to the normal area of skin. A review of the facility policy Documentation of Wound Treatments with an implementation date of 6/1/2025, revealed under Policy: The facility completes accurate documentation of wound assessments and treatments, including response to treatment, change in condition, and changes in treatment. Under Policy Explanation and Compliance Guidelines: 3. Wound treatments are documented at the time of each treatment.4. Additional documentation shall include, but is not limited to a. Date and time of wound management treatments.e. Notifications to physician and/or responsible party regarding wound or treatment changes. A review of the facility policy Charting and Documentation with a reviewed date on 1/2023, revealed under the policy statement . The medical record should facilitate communication between the interdisciplinary team regarding the resident's condition and response to care. Under Policy Interpretation and Implementation, .7. Documentation of procedures and treatments will include care-specific details, including: e. Whether the resident refused the procedure/treatment; f. Notification of family, physician or other staff. NJAC 8:39-27.1 (e)
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COMPLETE CARE AT WOODLANDS in PLAINFIELD, NJ 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 PLAINFIELD, NJ, (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 COMPLETE CARE AT WOODLANDS or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.