Dyersburg Health And Rehabilitation Center
Inspection Findings
F-Tag F0686
F 0686
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Level of Harm - Minimal harm or potential for actual harm
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on facility policy review, medical record review, observation, and interview, the facility failed to ensure that residents received the necessary treatment and services consistent with professional standards of practice to promote healing when the facility failed to document wound care treatments for 1 of 3 (Resident #1) sampled residents reviewed for pressure ulcers. The findings include: 1. Review of the facility policy titled, Wound Treatment Management, dated 12/3/2024, revealed .Wound treatments will be provided in accordance with physician orders .Treatments will be documented on the Treatment Administration Record .
- 2. Review of medical record revealed Resident #1 was admitted to the facility on [DATE REDACTED], with diagnoses
including Osteomyelitis of Vertebra, Sacral and Sacrococcygeal Region, Pressure Ulcer of Sacral Stage 4, and Paraplegia. Review of the Physician's Order dated 5/11/2024, revealed .CLEAN L [left] GROIN W/ [with].SKIN PREP PERIWOUND MIX SSD [silver sulfadiazine a topical antibiotic] CREAM AND CRUSHED FLAGYL [antibiotic used to treat bacterial infections] APPLY TO WOUND BED PACK W/ DANKINS [antiseptic solution] SOAKED KERLEC [KERLEX gauze based bandage] OVER W/ ABD [abdominal] PAD AND SECURE W/TAPE ONCE DAILY AND PRN [as needed]. Review of the Treatment Administration
Record (TAR) dated May 2024, revealed that treatments were not documented on 5/16/2024, 5/22/2024, 5/24/2024, 5/27/2024, and 5/30/2024.Review of the TAR dated June 2024, revealed treatments were not documented on 6/5/2024, 6/6/2024, 6/10/2024, 6/14/2024, 6/15/2024, 6/19/2024, 6/28/2024, 6/29/2024, and 6/30/2024. Review of the quarterly Minimum Data Set (MDS) assessment dated [DATE REDACTED], revealed a Brief Interview for Mental Status (BIMS) score of 15, which indicated Resident #1 was cognitively intact.
Resident was assessed for a Stage 4 Pressure Ulcer. Review of TAR dated July 2024, revealed treatments were not documented on 7/3/2024, 7/4/2024, 7/6/2024, 7/10/2024, 7/11/2024, 7/21/2024, 7/25/2024.
During an interview on 10/6/2025 at 3:54 PM, the Director of Nursing (DON) was asked, if Resident refuses wound care, should the refusal be documented. The DON stated, Yes. The DON was asked if the TAR should have any blank days for wound care. The DON stated, No, it should be documented completed unless it was refused and then it should be documented as refused.
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:
DYERSBURG HEALTH AND REHABILITATION CENTER in DYERSBURG, TN 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 DYERSBURG, TN, (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 DYERSBURG HEALTH AND REHABILITATION CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.