Caremeridian Llc, Dba Neurorestorative
CAREMERIDIAN LLC, DBA NEURORESTORATIVE in RENO, NV — inspection on February 21, 2025.
Found 19 citations. Severity: Standard violations.
Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.
Inspection Findings
Medicaid Services (CMS) Form 10055 Skilled Nursing Facility Advanced Beneficiary Notice of
residents discharged from a Medicare covered Part A stay with benefit days remaining within the previous six months (Resident #26).
This deficent practice had the potential to negatively impact the resident(s) ability to make informed decisions about their care.
Findings include: Resident #26 Resident #26 was admitted to the facility on [DATE], with diagnoses including essential primary hypertension and generalized muscle weakness. Resident #26's documented Medicare Part A Skilled Services Episode start date was 12/20/2024.
The documented last covered day of Part A services was 02/02/2025. Resident #26's record lacked documented evidence of having received either form CMS-10055 or form CMS-10123.
On 02/19/2025 at 12:36 PM, the Regional Support Director of Nursing (DON) confirmed Resident #26 was in the facility from 12/20/2024 to 02/02/2025, and should have received both forms CMS-10055 and CMS-10123, as the resident's stay in the facility was covered by Medicare Part A.
The Regional Support DON verbalized the facility could not locate copies of the forms provided to the resident, and the forms may not have been completed due to the facility not having had a social worker or case worker.
The Regional Support DON verbalized the facility should have provided the forms to the resident and maintained the forms in the resident's record.
On 02/21/2025 at 9:55 AM, the Regional Support DON verbalized having been unable to locate a policy on beneficiary notifications.
295103 02/21/2025
Caremeridian Llc, Dba Neurorestorative 3980 Lake Placid Drive Ste 2 Reno, NV 89511
limited to receiving treatment and supports for daily living safely.
observation, clinical record review, interview, and document review, the facility failed to ensure a
200 Hall had been closing loudly resulting in disruption in the resident's sleep for 1 of 11 residents in the 200 Hall (Resident #2).
This deficient practice had the potential to affect the resident's sleep patterns by exposing the resident to unnecessary noise disturbances, potentially leading to a less comfortable living environment.
Findings include: Resident #2 Resident #2 was admitted to the facility on [DATE], with diagnoses including circadian rhythm sleep disorder, free running type, and sleep disorder, unspecified.
On 02/19/2025 at 10:49 AM, Resident #2 verbalized having submitted a grievance in December 2024, about the exit door in the 200 Hall closing loudly when staff would exit the facility waking up the resident several times a night.
The resident verbalized the facility had yet to address the resident's grievance.
On 02/20/2025 at 3:30 PM, Resident #2 verbalized the resident was awakened every night due to the staff exiting the facility through the door just left of the resident's room.
The resident explained how difficult it had been to sleep through the night with the door slamming closed and the resident having sleep disorders.
On 02/20/2025 at 3:38 PM, the Director of Nursing confirmed staff used the door next to Resident #2's room as an exit.
On 02/20/2025 at 3:43 PM, the Administrator opened the exit door in the 200 Hall and allowed the door to close on its own.
The Administrator confirmed the door closed hard and was loud enough to wake up residents in the hall.
The Administrator verbalized it was the first time having been made aware the exit door in the 200 Hall was a noise concern with a resident.
The facility policy titled, Resident Rooms, Capacity, Furnishings, Storage, Space, Conversion, Privacy, revised 09/12/2019, lacked documented language of environmental considerations for residents related to noise levels.
On 02/20/2025 at 4:28 PM, the Administrator verbalized the policy on resident rooms was the only policy the facility had related to a homelike environment.
295103 02/21/2025
Caremeridian Llc, Dba Neurorestorative 3980 Lake Placid Drive Ste 2 Reno, NV 89511
During the Resident Council Meeting with the surveyors on the morning of 02/19/2025, one resident verbalized the facility had yet to respond to a written grievance the resident submitted in December
- On 02/20/2025 at 4:47 PM, the Administrator verbalized the facility did not have documented
complaints or grievances from residents as the binder where the grievance forms were kept could not be located.
The Administrator verbalized the binder had been missing since the Licensed Social Worker left employment with the facility several weeks previous, and the facility had not made attempts to re-create or gather the missing information.
The facility policy titled, Grievance Policy, revised 06/22/2015, documented the facility shall conduct an investigation of the complaint and a decision will be issued in written form to the resident no later than thirty (30) days after submission.
Grievance forms shall be retained for a period of one (1) year.
295103 02/21/2025
Caremeridian Llc, Dba Neurorestorative 3980 Lake Placid Drive Ste 2 Reno, NV 89511
Complaint #NV00073200.
Cross reference with F-F609.
295103 02/21/2025
Caremeridian Llc, Dba Neurorestorative 3980 Lake Placid Drive Ste 2 Reno, NV 89511
3.0 (MDS) assessment for 1 of 12 sampled residents (Resident #19).
This deficient practice had the
services relative to their current health management needs.
Findings include: Resident #19 Resident #19 was admitted to the facility on [DATE], with a primary diagnosis of hemiplegia, unspecified affecting left nondominant side.
An admission MDS assessment dated [DATE], Section K - Swallowing/Nutritional Status, documented Resident #19 had a weight loss of 5 percent (%) or more in the last month or a loss of 10% or more in the last six months without being on a physician prescribed weight-loss regimen.
A weights and vitals summary dated 02/20/2025, documented the following weights taken prior to or on the 01/02/2025 date of the MDS assessment: -152.7 pounds on 12/26/2024.
On 02/19/2025 at 5:33 PM, the MDS RN verbalized different sections of the MDS were completed by different people including the MDS RN and the Dietician and explained the Dietician completed Section K of the MDS assessment.
The MDS RN confirmed Resident #19's MDS assessment documented Resident #19 had a weight loss of 5% or more in the last month or a loss of 10% or more in the last six months without being on a physician prescribed weight-loss regimen.
The MDS RN reviewed Resident #19's weights and vitals summary and confirmed the resident did not have any weight loss by the time the MDS assessment was completed.
295103 02/21/2025
Caremeridian Llc, Dba Neurorestorative 3980 Lake Placid Drive Ste 2 Reno, NV 89511
to physician orders and the resident?s advance directives.
personnel record review, document review, and interview, the facility failed to ensure direct care staff
employees (Employee #14 and #16).
This deficient practice could result in a negative outcome for a resident requiring CPR while awaiting the arrival of emergency medical personnel.
Findings include: Employee #14 Employee #14 was hired as a Licensed Practical Nurse (LPN) with a start date of [DATE].
The LPN's personnel record documented CPR training and certification expired on 09/2024.
Employee #16 Employee #16 was hired as a Certified Nursing Assistant (CNA) with a start date of [DATE].
The CNA's personnel record documented CPR training and certification expired on 08/2024.
On [DATE] at 12:58 PM, the Office Manager verbalized CPR certification was required to be taken by all direct care staff and confirmed Employees #14 and #16 did not have a current CPR certification.
The Facility Assessment, completed on [DATE], documented all staff would be Basic Life Support certified.
295103 02/21/2025
Caremeridian Llc, Dba Neurorestorative 3980 Lake Placid Drive Ste 2 Reno, NV 89511
psychotherapeutic medications included antianxiety medications. A PRN psychotherapeutic
295103 02/21/2025
Caremeridian Llc, Dba Neurorestorative 3980 Lake Placid Drive Ste 2 Reno, NV 89511
medication should have been removed from storage with active medications and placed in the bin in
On 02/20/2025 at 10:04 AM, the Director of Nursing (DON) verbalized expired medications were to be
cabinets in the medication storage room. If expired medications were not removed from storage with active medications, the expired medications could be administered to residents by mistake.
The facility policy titled, Storage and Expiration Dating of Medications and Biologicals, revised 08/01/2024, documented the facility was to ensure medications and biologicals with an expired date on the label were stored separate from other medications until destroyed or returned to the pharmacy/supplier.
Medications with a manufacturer's expiration date expressed in month and year would expire on the last day of the month.
295103 02/21/2025
Caremeridian Llc, Dba Neurorestorative 3980 Lake Placid Drive Ste 2 Reno, NV 89511
indicated Resident #3 was to receive one hour of PT per week.
designee would provide health care when needed as regulated by the physician.
Physical Therapy
295103 02/21/2025
Caremeridian Llc, Dba Neurorestorative 3980 Lake Placid Drive Ste 2 Reno, NV 89511
Based on interview and document review, the Administrator failed to ensure the Facility Assessment
factors with the potential to affect the care provided by the facility.
This deficient practice had the potential to deprive residents of necessary care and services to meet each resident's individual needs and preferences.
Findings include: The FA, approved by the Administrator on 01/16/2025, documented the facility provided a continuum of post-acute care and rehabilitation to children.
The facility accepted infants to young adults.
The section of the FA titled resident population, type of unit, and census documented the facility was designed to provide children with a safe, home-like environment, while receiving specialized, skilled care.
The facility had created an atmosphere favorable to young patients' recovery including distinctly decorated rooms and rehabilitation equipment specifically designed for children.
The FA lacked documentation related to the facility's adult resident population, the unit where adult residents were cared for and any ethnic, cultural, or religious factors which could affect the care provided by the facility.
On 02/19/2025 at 12:42 PM, the Administrator verbalized the Administrator was responsible to complete the FA once per year.
Completing the FA included reviewing the needs and complexity of the residents in the facility, staffing and training needs.
The Administrator confirmed all resident types and all care required by the residents in the facility should have been included in the FA.
The Administrator confirmed the FA should have addressed any ethnic, cultural, or religious factors with potential to affect the care provided by the facility.
The Administrator reviewed the FA and confirmed the FA did not include the facility's adult resident population and did not address any ethnic, cultural, or religious factors with the potential to affect care provided by the facility.
On 02/19/2025 at 5:08 PM, the Administrator verbalized the facility did not have a policy related to the completion or required components of the FA.
The Administrator verbalized the facility followed state and federal regulations.
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 TITLE (X6) DATE REPRESENTATIVE'S SIGNATURE
295103 02/21/2025
Caremeridian Llc, Dba Neurorestorative 3980 Lake Placid Drive Ste 2 Reno, NV 89511
obtained a consent for Resident #9 prior to the resident having been administered Sertraline and should have obtained a consent per the facility's policy.
The facility policy titled, Medical Records Maintenance-Facility and Off-Site, revised 09/26/2018, documented the facility would maintain each resident's medical record in a complete, accurate, organized fashion, and readily accessible to those persons authorized to review the record.
Information in the record was not to be lost, destroyed, or used in an unauthorized manner.
295103 02/21/2025
Caremeridian Llc, Dba Neurorestorative 3980 Lake Placid Drive Ste 2 Reno, NV 89511
identified problems related to the lack of Enhanced Barrier Precautions (EBP) for residents with a
exposure of all residents, staff and visitors to harmful infectious agents.
Findings include: On 02/21/2025 at 10:28 AM, during the QAPI review with the Administrator, the Administrator verbalized the facility had not identified a concern related to the lack of EBP for residents with a chronic wound or indwelling medical device until the middle of January 2025.
The Administrator confirmed when the facility was made aware, no EBP was implemented and no current residents of the facility had EBP.
The job description for facility Administrator dated 11/29/2011, documented the Administrator was responsible for the Performance Improvement Program.
Cross reference with F-F880.
295103 02/21/2025
Caremeridian Llc, Dba Neurorestorative 3980 Lake Placid Drive Ste 2 Reno, NV 89511
01/13/2025, documented the goals of the infection control program included decreasing the risk of
On 02/20/2025 at 10:25 AM, during a review of the facility's Water Management Program, monitoring of control measures implemented in the facility to prevent growth and spread of legionella and other waterborne pathogens included visual inspections for debris and biofilm, checking residual chlorine/disinfectant levels, checking water temperatures at various locations in the facility, and quarterly legionella testing.
Included with the Water Management Program was a results report dated 12/30/2024.
The results report documented the facility's water was tested at six locations within the building.
All locations had ideal amounts of free and total chlorine. No bacteria strains were identified. No other test results were kept with the program.
On 02/20/2025 at 10:46 AM, the Maintenance Manager explained the facility ensured all sources of water in the facility were ran/used at least once a week and service was completed on bathtubs weekly to help prevent legionella and other waterborne pathogens in the facility's water system.
The Maintenance Manager verbalized the facility utilized an outside agency to conduct quarterly testing for legionella and was unsure why the results for the remaining three quarters of 2024 were not kept with the Water Management Program.
On 02/20/2025 at 2:05 PM, the Maintenance Manager provided a copy of a results report for water testing completed in the facility on 03/13/2024.
The Maintenance Manager explained the facility was only performing water testing two times per year and not quarterly as outlined in the Water Management Program.
The facility's Water Management Program, initiated 09/02/2020, documented the water management program team included the Administrator, the Director of Nursing, and the Maintenance Manager.
Monitoring of the facility's control measures included quarterly legionella testing.
Test results would be kept with the water management program.
Cross reference to F-F865.
295103 02/21/2025
Caremeridian Llc, Dba Neurorestorative 3980 Lake Placid Drive Ste 2 Reno, NV 89511
RSDON/IP reviewed the Monthly Line Listing of Resident Infections for November and December 2024
documented it was the policy of the facility to implement an antimicrobial stewardship program to promote appropriate use of antibiotics while optimizing the treatment of infections and reducing possible adverse events associated with antibiotic use.
The core elements of stewardship included leadership, accountability, action to implement recommended policies or practices, tracking measures, and education for staff about antibiotic resistance. If staff suspected a resident had an infection, the nurse was to perform and document a complete assessment of the resident using established and accepted assessment protocols to determine if the resident's status met minimum criteria for initiating antibiotics.
The facility used McGeer criteria to determine if minimum criteria for initiating antibiotics had been met.
Assessment of the facility's antimicrobial stewardship program could include reviewing for completeness of assessment and documentation of the assessment at the time the antimicrobial was ordered, laboratory findings, rationale for use of the antimicrobial, completeness of antimicrobial orders, and assuring antimicrobial selection was consistent with recommended agents for specific indications.
295103 02/21/2025
Caremeridian Llc, Dba Neurorestorative 3980 Lake Placid Drive Ste 2 Reno, NV 89511
the first orientation, and annually thereafter.
Staff were not permitted to work on the floor prior to the
abuse training must be completed prior to the employee starting floor training.
All healthcare workers during orientation, annually and as needed receive education and training on abuse.
295103 02/21/2025
Caremeridian Llc, Dba Neurorestorative 3980 Lake Placid Drive Ste 2 Reno, NV 89511
dementia care and abuse prevention.
training as a result of performance evaluations for 2 of 2 sampled Certified Nursing Assistants (CNA)
place all residents at risk of receiving care from staff without the required knowledge and competency to perform their duties.
Findings include: Employee #6 Employee #6 was hired on 09/20/2023, as a CNA.
The employee's personnel record lacked documented evidence an annual performance review had been conducted by the employee's anniversary date of 09/20/2024.
Employee #7 Employee #7 was hired on 02/17/2023, as a CNA.
The employee's personnel record documented an annual performance review had been conducted on 07/11/2024, 145 days after the employee's anniversary date of 02/17/2024.
Employee #7's personnel record lacked documented evidence an annual performance review had been conducted by the employees anniversary date of 02/17/2025.
On 02/20/2025 at 1:30 PM, the Office Manager confirmed Employee #6 did not have an annual performance evaluation for 2024 and the employee lacked the required 12-hour in-service training.
Employee #7's annual performance evaluation for 2024 was completed late.
Employee #7's annual performance evaluation had not been completed for 2025 and the employee lacked the required 12-hour in-service training.
The Office Manager verbalized all CNAs were required to have an evaluation every year by the hire date and they were to be completed by the Director of Nursing.
F-F609.
295103
Form Approved OMB
STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.
Building 295103 B.
Wing 02/21/2025
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Caremeridian Llc, Dba Neurorestorative 3980 Lake Placid Drive Ste 2 Reno, NV 89511
F-F865.
potential for actual harm
295103
Form Approved OMB
STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.
Building 295103 B.
Wing 02/21/2025
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Caremeridian Llc, Dba Neurorestorative 3980 Lake Placid Drive Ste 2 Reno, NV 89511
F-F880.
295103
Form Approved OMB
STATEMENT OF DEFICIENCIES (X1) PROVIDER/SUPPLIER/CLIA (X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY AND PLAN OF CORRECTION IDENTIFICATION NUMBER: COMPLETED A.
Building 295103 B.
Wing 02/21/2025
NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE
Caremeridian Llc, Dba Neurorestorative 3980 Lake Placid Drive Ste 2 Reno, NV 89511
Frequently Asked Questions
More Reports
Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.
Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.
Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.