| Mar 19, 2026 | F-0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and Care Deficiencies · Clinical care | G · Actual harm Isolated | Past non-compliance Feb 24, 2026 | Complaint |
| Mar 26, 2025 | K-0345 | Have approved installation, maintenance and testing program for fire alarm systems. | F · Potential harm Widespread | Corrected Jun 10, 2025 | |
| Mar 26, 2025 | K-0363 | Install corridor and hallway doors that block smoke. | F · Potential harm Widespread | Corrected Jun 10, 2025 | |
| Mar 26, 2025 | K-0712 | Have simulated fire drills held at unexpected times.Miscellaneous Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected Jun 10, 2025 | |
| Mar 26, 2025 | K-0753 | Have restrictions on the use of highly flammable decorations.Miscellaneous Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected Jun 10, 2025 | |
| Mar 26, 2025 | K-0920 | Ensure proper usage of power strips and extension cords.Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected Jun 10, 2025 | |
| Mar 26, 2025 | K-0921 | Ensure that testing and maintenance of electrical equipment is performed.Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected Jun 10, 2025 | |
| Mar 26, 2025 | F-0623 | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.Resident Rights Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Apr 23, 2025 | Complaint |
| Mar 26, 2025 | F-0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing.Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Apr 23, 2025 | Complaint |
| Mar 26, 2025 | F-0756 | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.Pharmacy Service Deficiencies · Medication management | D · Potential harm Isolated | Corrected Apr 23, 2025 | Complaint |
| Mar 26, 2025 | F-0758 | Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.Pharmacy Service Deficiencies · Medication management | D · Potential harm Isolated | Corrected Apr 23, 2025 | Complaint |
| Mar 26, 2025 | F-0761 | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.Pharmacy Service Deficiencies · Medication management | D · Potential harm Isolated | Corrected Apr 23, 2025 | Complaint |
| Mar 26, 2025 | F-0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and Dietary Deficiencies · Food, nutrition & hydration | E · Potential harm Pattern | Corrected Apr 23, 2025 | Complaint |
| Mar 26, 2025 | F-0921 | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.Environmental Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Apr 23, 2025 | Complaint |
| Jun 15, 2023 | E-0018 | Establish procedures for tracking staff and patients during an emergency.Emergency Preparedness Deficiencies · Emergency preparedness | F · Potential harm Widespread | Corrected Aug 24, 2023 | |
| Jun 15, 2023 | E-0024 | Establish policies and procedures for volunteers.Emergency Preparedness Deficiencies · Emergency preparedness | F · Potential harm Widespread | Corrected Aug 24, 2023 | |
| Jun 15, 2023 | E-0026 | Establish roles under a Waiver declared by secretary.Emergency Preparedness Deficiencies · Emergency preparedness | F · Potential harm Widespread | Corrected Aug 24, 2023 | |
| Jun 15, 2023 | E-0035 | Provide family notifications of emergency plan.Emergency Preparedness Deficiencies · Emergency preparedness | F · Potential harm Widespread | Corrected Aug 24, 2023 | |
| Jun 15, 2023 | K-0345 | Have approved installation, maintenance and testing program for fire alarm systems. | F · Potential harm Widespread | Corrected Aug 24, 2023 | |
| Jun 15, 2023 | K-0353 | Inspect, test, and maintain automatic sprinkler systems. | D · Potential harm Isolated | Corrected Aug 24, 2023 | |
| Jun 15, 2023 | K-0753 | Have restrictions on the use of highly flammable decorations.Miscellaneous Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected Aug 24, 2023 | |
| Jun 15, 2023 | K-0914 | Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety | D · Potential harm Isolated | Corrected Aug 24, 2023 | |
| Jun 15, 2023 | K-0920 | Ensure proper usage of power strips and extension cords.Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected Aug 24, 2023 | |
| Jun 15, 2023 | F-0623 | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.Resident Rights Deficiencies · Resident rights & abuse/neglect | D · Potential harm Isolated | Corrected Jul 19, 2023 | |
| Jun 15, 2023 | F-0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.Resident Assessment and Care Planning Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Jul 19, 2023 | |
| Jun 15, 2023 | F-0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing.Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Jul 19, 2023 | |
| Jun 15, 2023 | F-0688 | Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Jul 19, 2023 | |
| Jun 15, 2023 | F-0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and Care Deficiencies · Clinical care | E · Potential harm Pattern | Corrected Jul 19, 2023 | |
| Jun 15, 2023 | F-0690 | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Jul 19, 2023 | |
| Jun 15, 2023 | F-0695 | Provide safe and appropriate respiratory care for a resident when needed.Quality of Life and Care Deficiencies · Clinical care | D · Potential harm Isolated | Corrected Jul 19, 2023 | |
| Jun 15, 2023 | F-0726 | Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.Nursing and Physician Services Deficiencies · Staffing & supervision | D · Potential harm Isolated | Corrected Jul 19, 2023 | |
| Jun 15, 2023 | F-0756 | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.Pharmacy Service Deficiencies · Medication management | D · Potential harm Isolated | Corrected Jul 19, 2023 | |
| Jun 15, 2023 | F-0758 | Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.Pharmacy Service Deficiencies · Medication management | D · Potential harm Isolated | Corrected Jul 19, 2023 | |
| Jun 15, 2023 | F-0761 | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.Pharmacy Service Deficiencies · Medication management | E · Potential harm Pattern | Corrected Jul 19, 2023 | |
| Jun 15, 2023 | F-0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and Dietary Deficiencies · Food, nutrition & hydration | F · Potential harm Widespread | Corrected Jul 19, 2023 | |
| Jun 15, 2023 | F-0880 | Provide and implement an infection prevention and control program.Infection Control Deficiencies · Infection prevention | E · Potential harm Pattern | Corrected Jul 19, 2023 | |
| Jun 15, 2023 | F-0883 | Develop and implement policies and procedures for flu and pneumonia vaccinations.Infection Control Deficiencies · Infection prevention | D · Potential harm Isolated | Corrected Jul 19, 2023 | |
| Jun 15, 2023 | F-0887 | Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.Infection Control Deficiencies · Infection prevention | D · Potential harm Isolated | Corrected Jul 19, 2023 | |
| Nov 4, 2021 | K-0211 | Keep aisles, corridors, and exits free of obstruction in case of emergency. | E · Potential harm Pattern | Corrected Jan 3, 2022 | |
| Nov 4, 2021 | K-0291 | Install emergency lighting that can last at least 1 1/2 hours. | F · Potential harm Widespread | Corrected Jan 3, 2022 | |
| Nov 4, 2021 | K-0353 | Inspect, test, and maintain automatic sprinkler systems. | E · Potential harm Pattern | Corrected Jan 3, 2022 | |
| Nov 4, 2021 | K-0354 | Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours. | F · Potential harm Widespread | Corrected Jan 3, 2022 | |
| Nov 4, 2021 | K-0363 | Install corridor and hallway doors that block smoke. | E · Potential harm Pattern | Corrected Jan 3, 2022 | |
| Nov 4, 2021 | K-0374 | Install smoke barrier doors that can resist smoke for at least 20 minutes. | E · Potential harm Pattern | Corrected Jan 3, 2022 | |
| Nov 4, 2021 | K-0511 | Have properly installed electrical wiring and gas equipment. | E · Potential harm Pattern | Corrected Jan 3, 2022 | |
| Nov 4, 2021 | K-0712 | Have simulated fire drills held at unexpected times.Miscellaneous Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected Jan 3, 2022 | |
| Nov 4, 2021 | K-0761 | To conduct inspection, testing and maintenance of fire doors by qualified individuals.Miscellaneous Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected Jan 3, 2022 | |
| Nov 4, 2021 | K-0914 | Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.Gas, Vacuum, and Electrical Systems Deficiencies · Environment & life safety | F · Potential harm Widespread | Corrected Jan 3, 2022 | |
| Nov 4, 2021 | F-0756 | Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.Pharmacy Service Deficiencies · Medication management | D · Potential harm Isolated | Corrected Dec 14, 2021 | |
| Nov 4, 2021 | F-0757 | Ensure each resident’s drug regimen must be free from unnecessary drugs.Pharmacy Service Deficiencies · Medication management | D · Potential harm Isolated | Corrected Dec 14, 2021 | |
| Nov 4, 2021 | F-0761 | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.Pharmacy Service Deficiencies · Medication management | E · Potential harm Pattern | Corrected Dec 14, 2021 | |