Dubois Nursing Home
Inspection Findings
F-Tag F0684
F 0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Level of Harm - Minimal harm or potential for actual harm
Based on review of facility policy and clinical record reviews, as well as staff interviews, it was determined that the facility failed to ensure that physician's orders for dressing changes were followed for one of three residents reviewed (Resident 2).Findings include:A facility policy regarding physician orders, dated January 1, 2025, revealed that the licensed nurse would complete the physician order how it was written regarding timing and frequency.A significant change Minimum Data Set (MDS) assessment (a mandated assessment of a resident's abilities and care needs) for Resident 2, dated August 4, 2025, indicated that the resident was severely cognitively impaired, could sometimes understand, was sometimes understood, required assistance from staff for all care needs, and had diagnoses that included dementia.A nursing note dated August 19, 2025, indicated that staff found a large skin tear. Resident 2 was assessed by a registered nurse and identified a seven centimeter (cm) by nine cm skin tear with bruising noted on the right forearm.Physician's orders for Resident 2, dated August 20, 2025, included an order for the resident to have wound care to the right forearm skin tear. The skin tear was to be cleansed with wound cleanser, patted dry, xeroform (gauze dressing with petroleum) applied, and covered with a foam dressing daily and as needed.Review of the Treatment Administration Record (TAR) for Resident 2, dated August and September 2025, revealed that on August 20, 23, 24, 27, 28, and 29, 2025, and September 2, 3, 6, and 7, 2025, the dressing was not administered as ordered. Interview with the Director of Nursing on September 9, 2025, at 2:09 p.m. confirmed that Resident 2's dressing changes were not completed as ordered for the dates listed above. 28 Pa. Code 211.12(d)(1)(5) Nursing Services.
Residents Affected - Few
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 REPRESENTATIVE'S SIGNATURE
TITLE
(X6) DATE
FORM CMS-2567 (02/99) Previous Versions Obsolete
Facility ID:
If continuation sheet
Event ID:
Dubois Nursing Home in DUBOIS, PA 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 DUBOIS, PA, (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 Dubois Nursing Home or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.