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Complaint Investigation

The Waters Of Springfield Llc

February 23, 2026 · Springfield, TN · 704 5th Avenue East
Citations 1
CMS Rating 1/5
Beds 66
Provider ID 445480
Healthcare Facility
The Waters Of Springfield Llc
Springfield, TN  ·  View full profile →
Source Document
Official CMS Inspection Report (Medicare.gov)
Downloaded from CMS/Medicare.gov. Reflects what state inspectors documented and does not include the facility's plan of correction, which is submitted separately. Facilities may have taken corrective actions since this report was released.
Inspection Summary

THE WATERS OF SPRINGFIELD LLC in SPRINGFIELD, TN — inspection on February 23, 2026.

Found 1 citation. 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

FF0678
Quality of Life and Care Deficiencies

During an interview on [DATE] at 4:00 PM, the Administrator said, he implemented Mock Code Drills due to the family dynamic that was displayed at the time of death.

After review of the facility's plan of action, the Administrator was asked why he and the DON were educated.

The Administrator responded, .corporate educated us [the Administrator and the DON] due to the changes in the policy related to Lividity.only a Registered Nurse [RN] can assess for lividity.based on the company's policy, state regulations and the American Heart Association. An acceptable Removal Plan which removed the immediacy of the Jeopardy was received on [DATE] at 12:15 PM and was validated onsite by the surveyor through medical record review, in-service sign-in log review, audit/monitoring tool review, and interviews. AOC #2 Facility: Waters of [NAME] Removal of Immediacy or IJ F-678 cited [DATE] As required by state and federal law, the facility, the Waters of [NAME], is respectively submitting the following removal of immediacy in order to request removal of the Immediate Jeopardy.

Disclaimer Statement: The completion and submission of the credible allegation of compliance does not constitute an admission that the facility agrees with the allegation in the notification of Immediate Jeopardy.

The facility is completing the removal of immediacy because it is required by state and federal law.

The facility disagrees with and disputes the alleged deficiency as stated in the notification and disagrees with the accuracy of statements and other information relied upon in the support of the alleged deficiencies.

This includes but is not limited to the alleged content/summary of interviews, the chronological training sequence of events and contact with healthcare professionals, and the description of the care and supervision provided to resident(s).

The facility reserves its right to continue disputing, appealing and contesting this alleged deficiency and any action related to or arising therefrom in any other forum as needed.

Allegation---F-678-Cardio-Pulmonary Resuscitation (CPR)-Basic Life Support The facility failed to provide continuous BLS (basic life support)/Cardiopulmonary Resuscitation (CPR) to a vulnerable resident, who was found on [DATE] at 6:07 AM, in the bathroom, on his knees slumped over the commode unresponsive.

The facility failed to provide continuous CPR until local Emergency Medical services arrived, took over, and / or pronounced the resident deceased .

Resident(s) Affected- As stated prior, Resident #1 expired.

How other residents having the same potential to be affected by the same deficient practice will be identified, and what corrective action(s) will be taken- Residents who reside in the facility have the potential to be affected by this finding.

Administrator and DON educated on BLS Standards, CPR Policy, and Facility Expectations during a Code Blue Response by the Regional Nurse on [DATE] to include: GUIDELINES FOR CARDIOPULMONARY RESUSCITATION-CPR Intent: It is the intent of the facility to ensure that it is able to-and does---provide emergency basic life support immediately when needed, including cardiopulmonary resuscitation (CPR), to any resident requiring such care prior to the arrival of emergency medical personnel in accordance with related physician orders, such as DNR (Do Not Resuscitate) as well as a resident's personal Advance D

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 SPRINGFIELD, 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 THE WATERS OF SPRINGFIELD LLC or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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About This Inspection Report

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.