Carlyle Senior Care Of Fountain Inn
Inspection Findings
F-Tag F0656
F 0656 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Based on interview, record review, and facility policy review, the facility failed to implement a comprehensive person-centered care plan to maintain the resident's highest physical well-being for 1 (Resident (R)29) of 3 sampled residents reviewed for falls.Findings included:A facility policy titled, Falls - Clinical Protocol, revised 03/2018, revealed, 1. For an individual who has fallen, the staff and practitioner will begin to try to identify possible causes within 24 hours of the fall. The policy specified, 3. The staff and physician will continue to collect and evaluate information until either the cause of the falling is identified, or it is determined that the cause cannot be found or is not correctable. Treatment/Management 1. Based on the preceding assessment, the staff and physician will identify interventions to try to prevent subsequent falls and to address the risk of clinically significant consequences of falling.An admission Record revealed the facility admitted Resident R29 on 04/15/2025. According to the admission Record, the resident had a medical history that included diagnoses of senile degeneration of the brain, atrial fibrillation, and hypertension. Per the admission Record, Resident R29 discharged from the facility on 11/13/2025.An admission Minimum Data Set (MDS), with an Assessment Reference Date (ARD) of 04/22/2025, revealed Resident R29 had a Brief Interview for Mental Status (BIMS) score of 3, which indicated the resident had severe cognitive impairment. The MDS revealed
the resident required partial/moderate assistance with rolling left and right in bed and chair/bed-to-chair transfers.Resident R29's Care Plan Report included a focus area initiated 04/17/2025, that indicated the resident was at risk for falls with or without injury related to altered balance while standing and/or walking, altered mental status, antidepressant medication, antihypertensive medication, cardiovascular disease, decreased muscular coordination, history of falls, unsteady gait, and visual impairment. Interventions directed staff to conduct every-one-hour rounding (initiated 05/06/2025).Resident R29's Rehab - Status Post-Fall Screen, electronically signed by Physical Therapist #9 and dated 05/05/2025 at 5:37 PM, revealed that on 05/05/2025 at 12:00 PM, Resident R29 had an unwitnessed fall onto the floor in the resident's room and was found underneath their bed in the resident's room by a certified nursing assistant, with no signs or symptoms of skin bruising, tearing, or discoloration. The Rehab - Status Post-Fall Screen revealed the fall incident was discussed with the Interdisciplinary Team and an intervention for hourly rounds was implemented.During an
interview on 12/19/2025 at 10:25 AM, the Director of Nursing stated she was not able to find any documentation in Resident R29's medical record that indicated that one-hour rounding was being conducted in accordance with the resident's care plan.During an interview on 12/19/2025 at 12:02 PM, the Administrator stated he would expect facility staff to follow the resident's care plan.
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:
Carlyle Senior Care of Fountain Inn in Fountain Inn, SC 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 Fountain Inn, SC, (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 Carlyle Senior Care of Fountain Inn or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.