REGINALD P WHITE NURSING FACILITY
Government - State
70 Beds
Independent
Data: November 2025
4 Immediate Jeopardy citations
Trust Grade
0/100
#83 of 200 in MS
Last Inspection: May 2025
Inspected within the last 6 months. Data reflects current conditions.
Overview
Reginald P White Nursing Facility in Meridian, Mississippi has received a Trust Grade of F, indicating significant concerns about the quality of care provided. It ranks #83 out of 200 facilities in the state, placing it in the top half, but its overall score is troubling. The facility is worsening, with issues increasing from 3 in 2024 to 7 in 2025, including critical incidents of physical abuse where a resident was dragged by a staff member, and staff failed to report this abuse. Staffing is a strength, with a 5/5 rating and good RN coverage, meaning there is more RN availability than 94% of state facilities, which helps identify issues early. However, the facility has accumulated $10,364 in fines, which is average, but the concerning incidents raise red flags about resident safety and care.
- Trust Score
- F
- In Mississippi
- #83/200
- Safety Record
- High Risk
- Inspections
- Getting Worse
- Staff Stability ⚠ Watch
- 55% turnover. Above average. Higher turnover means staff may not know residents' routines.
- Penalties ⚠ Watch
- $10,364 in fines. Higher than 92% of Mississippi facilities. Major compliance failures.
- Skilled Nurses ✓ Good
- Each resident gets 73 minutes of Registered Nurse (RN) attention daily — more than 97% of Mississippi nursing homes. RNs are the most trained staff who catch health problems before they become serious.
- Violations ⚠ Watch
- 13 deficiencies on record. Higher than average. Multiple issues found across inspections.
0/100
Top 41%
Review needed
3 → 7 violations
★★★☆☆
3.0
Overall Rating
★★★★★
5.0
Staff Levels
★★☆☆☆
2.0
Care Quality
★★☆☆☆
2.0
Inspection Score
↔
Stable
2024: 3 issues
2025: 7 issues
The Good
-
5-Star Staffing Rating · Excellent nurse staffing levels
-
Full Sprinkler Coverage · Fire safety systems throughout facility
-
No fines on record
Facility shows strength in staffing levels, fire safety.
The Bad
3-Star Overall Rating
Near Mississippi average (2.6)
Meets federal standards, typical of most facilities
Staff Turnover: 55%
Near Mississippi avg (46%)
Higher turnover may affect care consistency
Federal Fines: $10,364
Below median ($33,413)
Minor penalties assessed
The Ugly 13 deficiencies on record
4 life-threatening
May 2025
3 deficiencies
CONCERN
(D)
Potential for Harm - no one hurt, but risky conditions existed
Deficiency F0658
(Tag F0658)
Could have caused harm · This affected 1 resident
Based on observation, staff interview, record review, and policy review, the facility failed to ensure nursing services were provided in accordance with professional standards of practice by not verif...
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Based on observation, staff interview, record review, and policy review, the facility failed to ensure nursing services were provided in accordance with professional standards of practice by not verifying Percutaneous Endoscopic Gastrostomy (PEG) placement prior to administering medications for one (1) of four (4) residents observed for medication administration. Resident #13.
Findings included:
A review of the facility's policy titled Tube Enteral Nutrition, revised 10/24, revealed, The purpose of this protocol is to establish general guidelines for the use of tube enteral feedings for residents/Individuals Receiving Services (IRS) with a functioning Gastrointestinal Tract .
On 5/29/25 at 9:23 AM, during an observation of medication administration via PEG tube, Registered Nurse (RN) #2 administered MiraLAX, potassium chloride, and ibuprofen to Resident #13 without verifying PEG tube placement prior to administration.
On 5/29/25 at 10:40 AM, during an interview, RN #2 confirmed she had not verified PEG tube placement before administering medications. RN #2 acknowledged that placement verification is necessary to ensure the tube is in the correct position and stated that medications delivered into the body cavity could lead to complications.
On 5/29/25 at 1:40 PM, during an interview with the acting Director of Nursing (DON), she stated that RN #2 should have verified PEG tube placement prior to medication administration. The DON confirmed that failure to verify placement could result in complications
A record review of the Face Sheet revealed the facility admitted Resident #13 on 8/5/24.
A record review of the Physician Order Report revealed Resident #13 had diagnoses including Gastrostomy Status. Further review revealed Resident #13 had Physician Orders for Pro-Stat via PEG tube two (2) times daily (start date of 8/15/24); Potassium Chloride liquid 20 milliequivalent (mEq)/15 milliliter (mL), 15 mL via PEG tube daily (start date of 1/23/25); Ibuprofen suspension 100 milligrams (mg)/5 mL, 30 mL per tube; oral tube twice daily (start date of 9/18/24); MiraLAX powder 17 grams per PEG tube (start date of 8/9/24).
A record review of the Minimum Data Set (MDS) with an Assessment Reference Date (ARD) of 5/2/25 revealed Resident #13 had a Brief Interview for Mental Status (BIMS) score of eleven (11), which indicated the resident's cognition was moderately impaired.
CONCERN
(E)
Potential for Harm - no one hurt, but risky conditions existed
QAPI Program
(Tag F0867)
Could have caused harm · This affected multiple residents
Based on record review, staff interview, and facility policy review, the facility's Quality Assurance and Performance Improvement (QAPI) Committee failed to sustain corrective actions to prevent recur...
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Based on record review, staff interview, and facility policy review, the facility's Quality Assurance and Performance Improvement (QAPI) Committee failed to sustain corrective actions to prevent recurrence of previously cited deficiencies, specifically, the facility was cited for failing to maintain infection control practices during an annual recertification survey on 1/11/2024 and was cited again for the same deficiency during the current survey, demonstrating that QAPI failed to sustain ongoing monitoring and oversight to prevent recurrence for one (1) of three (3) deficiencies cited. (F880)
Findings Include:
A review of the facility's Quality Assurance document (undated) revealed, .The Outcome Services Division will .Periodically assess information based on established indicators, taking action to solve problems and pursue opportunities to improve quality .
Record review of the Provider History Profile revealed the facility received a citation for F880-Infection Prevention & Control for the survey date of 1/11/2024.
Record review of the CMS-2567 (a record that identifies the federal regulation in violation and describes the findings of noncompliance and the facility's plan of correction), with a survey date of 1/11/2024, revealed the facility received a citation for F880, .Based on observation, staff interviews, record review, and facility policy review, the facility failed to prevent the possibility of the spread of infection . during wound care for one (1) of five (5) wounds observed .
During the current recertification survey, the facility failed to ensure staff followed appropriate infection prevention and control practices for two (2) of 18 sampled residents, Resident #13 and Resident #45. Specifically, the facility failed to ensure Registered Nurse (RN) #2 performed hand hygiene and donned appropriate personal protective equipment (PPE) while administering medications through a Percutaneous Endoscopic Gastrostomy (PEG) tube for Resident #13 who required enhanced barrier precautions (EBP) and failed to ensure Licensed Practical Nurse (LPN) # 1 followed EBP and glove-changing protocols during wound care for Resident #45.
On 05/29/25 at 2:43 PM, in an interview, the Nursing Home Administrator (NHA) confirmed he was aware that during the prior annual survey, a Licensed Practical Nurse (LPN) was cited for failure to perform hand hygiene during wound care. He stated that since the prior citation, nurses had been retrained, and QAPI had focused on correcting the issue. He stated that QAPI meets monthly and that after three months of focused wound policy correction and achieving what they considered 100% compliance, the QAPI committee shifted focus to other issues. He further stated that follow-up may now occur only one to two times per year. He acknowledged that recent in-services focused on infection control had been conducted in the past few months.
CONCERN
(E)
Potential for Harm - no one hurt, but risky conditions existed
Infection Control
(Tag F0880)
Could have caused harm · This affected multiple residents
Based on observation, interview, record review, and facility policy review, the facility failed to ensure staff followed appropriate infection prevention and control practices for two (2) of 18 sample...
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Based on observation, interview, record review, and facility policy review, the facility failed to ensure staff followed appropriate infection prevention and control practices for two (2) of 18 sampled residents, Resident #13 and Resident #45. Specifically, the facility failed to ensure Registered Nurse (RN) #2 performed hand hygiene and donned appropriate personal protective equipment (PPE) while administering medications through a Percutaneous Endoscopic Gastrostomy (PEG) tube for Resident #13 who required enhanced barrier precautions (EBP) and failed to ensure Licensed Practical Nurse (LPN) # 1 followed EBP and glove-changing protocols during wound care for Resident #45.
The scope/severity for F880 was increased to E due to previous citation on the annual recertification survey on 1/11/24.
Findings included:
A review of the facility's Enhanced Barrier Precautions Protocol (undated), revealed, 1. Enhanced Barrier Precautions (EBP) are required for certain resident categories .3. For residents for whom EBP is indicated, EBP is employed when performing the following high-contact resident care activities .Device care or use .feeding tube .Wound care: any skin opening requiring a dressing .
A review of the facility's policy, Hand Hygiene, revised 9/23, revealed: It is the policy .that employees will use proper hand hygiene techniques to prevent the spread of infectious diseases . Procedure .C. Employees must always wash hands .(4) Before performing invasive procedures .(7) Before and after touching wounds. (8) After removing gloves .
Resident #13
On 5/29/25 at 9:23 AM, during an observation of a medication pass for Resident #13, RN #2 administered medications via a PEG tube. RN #2 wiped down the bedside table with an antibacterial wipe while wearing gloves, then removed her gloves without performing hand hygiene. She applied a new set of gloves, placed a barrier on the bedside table, removed her gloves again, and applied a second clean pair without hand hygiene. She failed to don a gown at any point during the procedure, despite the resident requiring EBP.
On 5/29/25 at 10:40 AM, during an interview, RN #2 stated she should have performed hand hygiene initially and between glove changes. She also stated she should have worn a gown to protect the resident from potential contamination. She acknowledged these failures put the resident at risk for infection and noted she had received prior training on hand hygiene and EBP but forgot to follow protocol.
On 5/29/25 at 11:05 AM, during an interview, RN #3, the Infection Preventionist stated nurses are expected to perform hand hygiene before starting care and between glove changes. She stated that gowns should be worn before initiating care under EBP protocols and confirmed that failure to do so could lead to infection. She stated staff received recent training on hand hygiene and EBP.
On 5/29/25 at 1:40 PM, during an interview, the Acting Director of Nursing (DON) confirmed that RN #2 should have worn a gown before starting care and performed hand hygiene between glove changes. She stated the nurse could have used hand sanitizer or washed her hands, and that failing to do so risked transmitting germs or bacteria to the resident.
A record review of the Face Sheet revealed the facility admitted Resident #13 on 8/5/24.
A record review of the Quarterly Minimum Data Set (MDS) with an Assessment Reference Date (ARD) of 5/2/25 revealed Resident #13 had a Brief Interview for Mental Status (BIMS) score of 11, which indicated her cognition was moderately impaired.
A record review of the Physician Order Report for 5/1/25 through 5/31/25 revealed Resident #13 had diagnoses including Gastrostomy status and had medications required to be administered via a PEG tube.
Resident #45
On 5/28/25 at 12:58 PM, LPN #1 was observed performing wound care for Resident #45. Prior to initiating care, she failed to don a gown, despite the resident being on EBP. During the procedure, she cleansed a dirty wound bed and then applied a new dressing without removing or changing her gloves, thereby applying the clean dressing with contaminated gloves.
On 5/28/25 at 1:35 PM, during an interview, LPN #1 acknowledged that she should have worn a gown and changed gloves during the wound care procedure to prevent infection. She confirmed that the resident was on EBP, and her actions did not follow protocol.
On 5/28/25 at 1:38 PM, during an interview, the DON confirmed that LPN #1 should have worn a gown before entering the room and should have changed gloves during the procedure. She stated gowns were available in the room and that failure to change gloves risked spreading infection.
A record review of the Nurse Competency Skill Assessment for Wound Care revealed that gloves should be removed, and clean gloves donned four times during wound care-specifically after cleansing a dirty wound and before applying a new dressing, in accordance with physician orders and manufacturer instructions.
On 5/29/25 at 1:08 PM, during an interview, the facility's Infection Preventionist (IP Nurse) stated that LPN #1 should have worn a gown and changed gloves prior to applying the new dressing. She stated failure to do so contaminated the dressing and placed the resident at risk of infection.
A record review of the Face Sheet revealed the facility admitted Resident #45 on 12/21/22.
A record review of the Physician Order Report revealed Resident #45 had diagnoses including Venous Insufficiency and had a treatment with a start date of 4/25/25 to .Venous wound left anterior superior lower leg: Clean with normal saline, pat dry, apply Xeroform gauze and cover with dry dressing daily and PRN (as needed) .
A record review of the Quarterly MDS with an ARD of 4/11/25 revealed Resident #45 had a BIMS score of three (3), which indicated his cognition was severely impaired.
Feb 2025
4 deficiencies
4 IJ
CRITICAL
(J)
📢 Someone Reported This
A family member, employee, or ombudsman was alarmed enough to file a formal complaint
Immediate Jeopardy (IJ) - the most serious Medicare violation
Free from Abuse/Neglect
(Tag F0600)
Someone could have died · This affected 1 resident
Based on observation, interviews, record review, and facility policy review, the facility failed to ensure a resident's right to be free from physical abuse by a staff member for one (1) of three (3) ...
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Based on observation, interviews, record review, and facility policy review, the facility failed to ensure a resident's right to be free from physical abuse by a staff member for one (1) of three (3) sampled residents. Resident #1.
Resident #1 was physically abused on 12/31/24 when a Certified Nurse Assistant (CNA) #1 dragged him by his shirt, the collar, and the shoulders of his jacket up the hallway into Resident #1's room. One nurse observed the abuse and failed to intervene, allowing the abuse to escalate.
The facility's failure to protect Resident #1 from abuse placed this resident and all residents in a situation that was likely to cause serious injury, harm, impairment, or death.
The situation was determined to be Immediate Jeopardy and Substandard Quality of Care (SQC) that began on 12/31/24. The State Agency (SA) notified the Administrator of the IJ and SQC on 2/11/25 at 4:45 PM and provided an IJ Template.
Based on the facility's implementation of corrective actions on 1/7/25, the SA determined the IJ and SQC to be Past-Non-Compliance (PNC) and the IJ was removed on 1/8/25.
Findings include:
A review of the facility policy titled Suspicion of Abuse, Neglect, Exploitation, Injuries of Unknown Origin, And/or Misappropriation of Funds/Property To Individuals Receiving Services/Residents, revised January 2024, revealed, .It is the policy .to affirm that all Individuals Receiving Services (IRS)/Residents have a right to be free from abuse .Definitions .Abuse: The willful infliction of physical pain, injury, or mental anguish, unreasonable confinement or the willful deprivation of services necessary to maintain physical and mental health .Mental Abuse: includes .humiliation, harassment .Prevention .(4) .will review, correct, and intervene in situations in which allegations of abuse, neglect .have potentially occurred .D. Reporting: (1) All employees .will immediately report any of the following (a) Witness of or discovery of any situation in which suspicion exits that an IRS/Resident has been the victim of abuse .
A record review of the Investigative Summary Report, dated 1/7/25, revealed that on 12/31/24 at 2:21 PM, Resident #1 was dragged on the floor by CNA #1. The resident was assessed on 1/3/25 when the allegation was submitted, and the Director of Nurses (DON) was notified. It was reported on 1/3/25 that on 12/31/24, CNA #1 dragged Resident #1 on the floor by the neck of his shirt to his room because the resident positioned himself on the floor in the hallway near the nurse's station. The resident was observed lying on the floor, hitting his head, and refusing to keep his protective helmet on. The investigation into the allegation yielded evidence that CNA #1 did drag the resident by the neck and shoulder sections of his jacket up the hallway into his room. Staff were placed on administrative leave pending the investigation and following the investigation, CNA #1 and License Practical Nurse (LPN) #1 were terminated on 1/7/25.
A record review of LPN #1's written statement, dated 1/6/25, revealed that on 12/31/24 between 2:00 PM and 2:30 PM, Resident #1 was banging his head against the wall. CNA #1 proceeded to grab the resident by his neck and sweatshirt and drag him to his room. She felt like she was choking him, and she felt like this was abuse. She reported to the security officer and attempted to notify her DON, but she was not in her office.
On 2/10/25 at 2:00 PM, during an observation and interview, Resident #1 was lying in his bed and sat up to speak during the interview. He confirmed that he remembered the CNA who dragged him down the hall. He stated that she did not hurt him but commented that she didn't have to drag him like an old rag. Resident #1 explained that he was embarrassed by the CNA's actions. He reported that he often hits his head on the wall or the floor because he normally wants something and that is his way of getting attention from the staff, but on this day (12/31/24), he was dragged to his room by the CNA.
On 2/10/25 at 2:35 PM, in an interview with the Campus Safety Officer, he confirmed he was working on 12/31/24, but stated he did not witness the event. He explained that an LPN approached him on 12/31/24 and asked him generalized questions about physical abuse, but she did not inform him of the incident that had occurred. He advised her to inform her immediate supervisor if she had questions on the definition of physical abuse. He reported he was not aware of the incident until the investigation began on 1/3/25.
On 2/10/25 at 2:43 PM, during an interview with the Housekeeper, he confirmed that he witnessed Resident #1 being pulled by his clothing down the hall approximately 20 feet by a staff member. He stated he did not report the episode to his manager because he assumed the other staff would have reported it. Still, he was placed on administrative leave following the episode and attended many in-services on reporting following the episode.
On 2/10/25 at 3:00 PM, during an observation of the surveillance video with the Administrator present, on 12/31/24 at 2:07 PM, CNA #1 was observed dragging/pulling Resident #1 by his arm/sleeve of his clothes, right side, approximately 16 feet to his room, and LPN #1 was observed walking beside the resident and the CNA.
On 2/11/25 at 12:01 PM, during an interview with Registered Nurse (RN) #1, she confirmed that on 1/3/25, LPN #1 informed her that CNA #1 pulled Resident #1 down the hallway on the floor by his clothes because he was banging his head on the floor. LPN #1 stated that she attempted to re-direct him and place his helmet on, but he refused the helmet. LPN #1 revealed she attempted to notify security and the DON of the incident, but the DON wasn't available, so she didn't report it until her next shift on 1/3/25. RN #1 confirmed that the facility's policy is to report any abuse to a supervisor, DON, or Administrator. RN #1 stated that LPN #1 and CNA #1 did not treat Resident #1 with respect or dignity.
On 2/11/25 at 12:30 PM, during an interview with CNA #2, she confirmed Resident #1 was her assigned resident on 12/31/24. She revealed that she witnessed CNA #1 drag the resident down the hallway but stated that she did not have time to intervene. She reported the event was over in just a few seconds. LPN #1 advised her that she was going to report the episode to security campus, so CNA #2 did not report the episode to any supervisor.
On 2/11/25 at 1:00 PM, during a phone interview with CNA #1, she confirmed that she dragged Resident #1 down the hallway by his clothing. She said that Resident #1 was not her assigned resident, but he was sitting on the floor between two doors, and it was difficult for residents to get through the doorways. CNA #1 explained Resident #1 had had this behavior in the past to get attention, so she grabbed his clothes and pulled him about 20 feet to his room. She was not trying to do anything intentional to hurt him and she was not being vindictive, but he was hitting his head on the floor and the wall. CNA #1 confirmed that Resident #1 was not her assigned resident and she did not attempt to redirect him, nor offer him food or water. She explained that she just responded, and she did not think of the outcome. CNA #1 expressed remorse and commented that she has been very upset since the incident.
In an interview with the Administrator on 2/11/25 at 3:40 PM, he confirmed that upon reviewing the video surveillance, CNA #1 dragged Resident #1 by his shirt/jacket to his room. He stated that this incident was a form of physical abuse and that LPN #1, who was present, should have intervened to stop the situation.
During an interview with the DON on 2/11/25 at 4:00 PM, confirmed that following a review of the video surveillance, CNA #1 did drag Resident #1 on the floor by his clothing down the hall and placed him in his room.
A record review of the Face Sheet, revealed the facility admitted Resident #1 on 8/7/24 with current diagnoses including Epilepsy, Bipolar Disorder, and Mild Intellectual Disabilities.
A record review of the Minimum Data Set (MDS) with an Assessment Reference Date (ARD) of 11/5/24, revealed Resident #1 had a Brief Interview for Mental Status (BIMS) score of 12, which indicated his cognition was moderately impaired. Further review revealed his vision was severely impaired.
The facility implemented the following Corrective Action Plan prior to the State Agency's entrance on 2/10/25:
The Quality Assurance (Quality Assurance) Committee held an Emergency QA Meeting on 1/7/2025. The Quality Assurance Committee discussed the description of the incident. The QA committee discussed and approved training that was provided beginning on 1/3/25 at the beginning of the shift to all staff on Resident Rights, Suspicion of Abuse, Neglect, Exploitation, Injuries of Unknown Origin, and misappropriation of funds/Property to Individuals Receiving Services/Residents and Resident # 1 behavior Intervention protocol.
The additional will be monitored per staff for continued effectiveness as follows:
Abuse/Neglect Policy & Adherence to Care Plan.
Quality of correction will also be monitored by observing interventions and interactions with patients 5 (five) days a week for 8 (eight) weeks by Nurse Manager and four Nurse Supervisor, beginning on 1/21/25.
Findings will be reported to QAPI (Quality Assurance Performance Improvement), beginning 2/13/25 times two months.
On 1/3/25, all supervisors began training all the oncoming staff before the start of their shift on Resident Rights, Suspicion of Abuse, Neglect, Exploitation, Injuries of Unknown Origin, or Misappropriation of Funds/Property to Individuals Receiving Services/Residents, and Resident #1 Behavioral Intervention Protocol. No employee was allowed to work until there was in-service.
On 1/3/2025 CNA #1 and License Practical Nurse (LPN)#1 were placed on administrative leave pending completion of the investigation. LPN #1 was terminated from employment on 1/7/25 for observing physical abuse and failing to report it in a timely manner. CNA #1 was terminated from employment effective 1/7/25 for physically abusing Resident #1.
The Investigator notified the State Agency by telephone on 1/3/25, the Attorney General's Office in writing of the incident on 1/3/25.
Supervisors began In-servicing all employees on 1/3/25 prior to the beginning their shift. The in-services were completed on 1/7/25.
The facility alleges all corrective actions were completed on 1/7/25 and the IJ removed on 1/8/25 prior to the State Agency's entrance on 2/10/25.
Validation:
The SA validated on 2/12/25, through interview and record review, that all corrective actions had been implemented as of 1/7/25, and the facility was in compliance as of 1/8/25, prior to the SA's entrance on 2/10/25.
CRITICAL
(J)
📢 Someone Reported This
A family member, employee, or ombudsman was alarmed enough to file a formal complaint
Immediate Jeopardy (IJ) - the most serious Medicare violation
Abuse Prevention Policies
(Tag F0607)
Someone could have died · This affected 1 resident
Based on observation, interviews, record review, and facility policy review, the facility failed to implement its abuse policy, allowing an abusive act to occur without staff intervening or prompt rep...
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Based on observation, interviews, record review, and facility policy review, the facility failed to implement its abuse policy, allowing an abusive act to occur without staff intervening or prompt reporting for one (1) of three (3) sampled residents. Resident #1.
Resident #1 was physically abused on 12/31/24 when Certified Nurse Assistant (CNA) #1 dragged him by his shirt, the collar, and the shoulders of his jacket up the hallway into Resident #1 room. One nurse observed the abuse and failed to intervene, allowing the abuse to escalate.
The facility's failure to implement abuse policies and protect Resident #1 from physical abuse and the facility's failure to intervene placed this resident and all residents in a situation that was likely to cause serious injury, harm, impairment, or death.
The situation was determined to be Immediate Jeopardy and Substandard Quality of Care (SQC). The State Agency (SA) notified the Administrator of the IJ and SQC on 2/11/25 at 4:45 PM and provided an IJ Template.
Based on the facility's implementation of corrective actions on 1/7/25, the SA determined the IJ and SQC to be Past-Non-Compliance (PNC) and the IJ was removed on 1/8/25.
Findings include:
A review of the facility policy titled Suspicion of Abuse, Neglect, Exploitation, Injuries of Unknown Origin, And/or Misappropriation of Funds/Property To Individuals Receiving Services/Residents, revised January 2024, revealed, .It is the policy .to affirm that all Individuals Receiving Services (IRS)/Residents have a right to be free from abuse .Definitions .Abuse: The willful infliction of physical pain, injury, or mental anguish, unreasonable confinement or the willful deprivation of services necessary to maintain physical and mental health .Mental Abuse: includes .humiliation, harassment .Prevention .(4) .will review, correct, and intervene in situations in which allegations of abuse, neglect .have potentially occurred .D. Reporting: (1) All employees .will immediately report any of the following (a) Witness of or discovery of any situation in which suspicion exits that an IRS/Resident has been the victim of abuse .
A record review of the Investigative Summary Report, dated 1/7/25, revealed that on 12/31/24 at 2:21 PM, Resident #1 was dragged on the floor by CNA #1. The resident was assessed on 1/3/25 when the allegation was submitted, and the Director of Nurses (DON) was notified. It was reported on 1/3/25 that on 12/31/24, CNA #1 dragged Resident #1 on the floor by the neck of his shirt to his room because the resident positioned himself on the floor in the hallway near the nurse's station. The resident was observed lying on the floor, hitting his head, and refusing to keep his protective helmet on. The investigation into the allegation yielded evidence that CNA #1 did drag the resident by the neck and shoulder sections of his jacket up the hallway into his room. Staff were placed on administrative leave pending the investigation and following the investigation, CNA #1 and License Practical Nurse (LPN) #1 were terminated on 1/7/25.
A record review of LPN #1's written statement, dated 1/6/25, revealed that on 12/31/24 between 2:00 PM and 2:30 PM, Resident #1 was banging his head against the wall. CNA #1 proceeded to grab the resident by his neck and sweatshirt and drag him to his room. She felt like she was choking him, and she felt like this was abuse. She reported to the security officer and attempted to notify the Director of Nursing (DON), but she was not in her office.
During an observation and interview, on 2/10/25 at 2:00 PM, Resident #1 was lying in his bed. He confirmed that a CNA dragged him down the hall. He stated that it did not hurt but commented that she didn't have to drag him like an old rag. Resident #1 explained that he was embarrassed by the CNA's actions. He reported that he often hits his head on the wall or the floor because he normally wants something and that is his way of getting attention from the staff, but on this day (12/31/24), he was dragged to his room by the CNA.
During an interview on 2/10/25 at 2:35 PM, the Campus Safety Officer, confirmed he was working on 12/31/24, but stated he did not witness the event. He explained that an LPN approached him on 12/31/24 and asked him generalized questions about physical abuse, but she did not inform him of the incident that had occurred. He advised her to inform her immediate supervisor if she had questions on the definition of physical abuse. He reported he was not aware of the incident until the investigation began on 1/3/25.
During an interview on 2/10/25 at 2:43 PM, the Housekeeper confirmed that he witnessed Resident #1 being pulled by his clothing down the hall by a staff member. He stated he did not stop the situation because he felt it was not his place because there was a CNA and LPN present during the situation.
During an observation of the video surveillance with the Administrator on 2/10/25 at 3:00 PM, on 12/31/24 at 2:07 PM, CNA #1 was observed dragging/pulling Resident #1 by his arm/sleeve of his clothes, right side, approximately 16 feet to his room, and LPN #1 was observed walking beside the resident and CNA.
During an interview on 2/11/25 at 12:30 PM, CNA #2 confirmed Resident #1 was her assigned resident on 12/31/24. She revealed that she witnessed CNA #1 drag the resident down the hallway but stated that she did not have time to intervene. She reported the event was over in just a few seconds. LPN #1 advised CNA #2 that she was going to report the episode to security campus, so CNA #2 did not report the episode to any supervisor.
During a phone interview on 2/11/25 at 1:00 PM, CNA #1 confirmed that she dragged Resident #1 down the hallway by his clothing. She said that Resident #1 was not her assigned resident, but he was sitting on the floor between two doors, and it was difficult for residents to get through the doorways. CNA #1 explained Resident #1 had this behavior in the past to get attention, so she grabbed his clothes and pulled him about 20 feet to his room. She was not trying to do anything intentional to hurt him and she was not being vindictive, but he was hitting his head on the floor and the wall. CNA #1 confirmed that Resident #1 was not her assigned resident and she did not attempt to redirect him, nor offer him food or water. She explained that she just responded, and she did not think of the outcome. CNA #1 expressed remorse and commented that she has been very upset since the incident.
During an interview with the Administrator on 2/11/25 at 3:40 PM, he confirmed that upon reviewing the video surveillance, CNA #1 dragged Resident #1 by his shirt/jacket to his room. He stated that this incident was a form of physical abuse and that LPN #1, who was present, should have intervened to stop the situation, they were both educated on abuse prior to the incident.
During an interview with the DON on 2/11/25 at 4:00 PM, confirmed that following a review of the video surveillance, CNA #1 did drag Resident #1 on the floor by his clothing down the hall and placed him in his room. LPN #1 should have stopped the physical abuse.
A record review of the Face Sheet, revealed the facility admitted Resident #1 on 8/7/24 with current diagnoses including Epilepsy, Bipolar Disorder, and Mild Intellectual Disabilities.
A record review of the Minimum Data Set (MDS) with an Assessment Reference Date (ARD) of 11/5/24, revealed Resident #1 had a Brief Interview for Mental Status (BIMS) score of 12, which indicated his cognition was moderately impaired. Further review revealed his vision was severely impaired.
The facility implemented the following Corrective Action Plan prior to the State Agency's entrance on 2/10/25:
The Quality Assurance (Quality Assurance) Committee held an Emergency QA Meeting on 1/7/2025. The Quality Assurance Committee discussed the description of the incident. The QA committee discussed and approved training that was provided beginning on 1/3/25 at the beginning of the shift to all staff on Resident Rights, Suspicion of Abuse, Neglect, Exploitation, Injuries of Unknown Origin, and misappropriation of funds/Property to Individuals Receiving Services/Residents and Resident # 1 behavior Intervention protocol.
The additional will be monitored per staff for continued effectiveness as it follows:
Abuse/Neglect Policy & Adherence to Care Plan.
Quality of corrections will be monitored daily by using a minimum of 5 (five) staff interviews per day 5 (five) days a week for 8 (eight) weeks by Nurse Manager and four Nurse Supervisors, beginning on 1/21/25.
Quality of correction will also be monitored by observing interventions and interactions with patients 5 (five) days a week for 8 (eight) weeks by Nurse Manager and four Nurse Supervisosr, beginning on 1/21/25.
Findings will be reported to QAPI (Quality Assurance Performance Improvement), beginning 2/13/25 times two months.
On 1/3/25, all supervisors began training all the oncoming staff before the start of their shift on Resident Rights, Suspicion of Abuse, Neglect, Exploitation, Injuries of Unknown Origin, or Misappropriation of Funds/Property to Individuals Receiving Services/Residents, and Resident #1 Behavioral Intervention Protocol. No employee was allowed to work until there was in-service.
On 1/3/2025 CNAs #1 and License Practical Nurse (LPN)#1 were placed on administrative leave pending completion of the investigation. LPN #1 was terminated from employment on 1/7/25 for observing physical abuse and failing to report it in a timely manner. CNA #1 was terminated from employment effective 1/7/25 for physically abusing Resident #1.
The Investigator notified the State Agency by telephone on 1/3/25, the Attorney General's Office in writing of the incident on 1/3/25.
Supervisors began In-servicing all employees on 1/3/25 prior to the beginning their shift. The in-services were completed on 1/7/25. The Immediate Jeopardy was removed on 1/8/25. The facility alleges all corrective actions were completed on 1/7/25 and the Immediate Jeopardy was removed on 1/8/25 prior to the state department of health entrance on 2/10/25.
The facility alleges all corrective actions were completed on 1/7/25 and the IJ removed on 1/8/25 prior to the state agency's entrance on 2/10/25.
Validation:
The SA validated on 2/12/25, through interview and record review, that all corrective actions had been implemented as of 1/7/25, and the facility was in compliance as of 1/8/25, prior to the SA's entrance on 2/10/25.
CRITICAL
(J)
📢 Someone Reported This
A family member, employee, or ombudsman was alarmed enough to file a formal complaint
Immediate Jeopardy (IJ) - the most serious Medicare violation
Report Alleged Abuse
(Tag F0609)
Someone could have died · This affected 1 resident
Based on observation, interviews, record review, and facility policy review, the facility failed to report abuse in a timely manner for one (1) of three (3) sampled residents. Resident #1.
Resident #...
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Based on observation, interviews, record review, and facility policy review, the facility failed to report abuse in a timely manner for one (1) of three (3) sampled residents. Resident #1.
Resident #1 was physically abused on 12/31/24 when a Certified Nurse Assistant (CNA) #1 dragged him by his shirt, the collar, and the shoulders of his jacket up the hallway into Resident #1 room. One nurse observed the abuse and failed to report it to the Director of Nursing (DON) or other staff.
The facility's failure to report Resident #1's abuse placed this resident and all residents in a situation that was likely to cause serious injury, harm, impairment, or death.
The situation was determined to be Immediate Jeopardy and Substandard Quality of Care (SQC) which began on 12/31/24. The State Agency (SA) notified the Administrator of the IJ and SQC on 2/11/25 at 4:45 PM and provided an IJ Template.
Based on the facility's implementation of corrective actions on 1/7/25, the SA determined the IJ and SQC to be Past-Non-Compliance (PNC) and the IJ was removed on 1/8/25.
Findings include:
A review of the facility policy titled Suspicion of Abuse, Neglect, Exploitation, Injuries of Unknown Origin, And/or Misappropriation of Funds/Property To Individuals Receiving Services/Residents, revised January 2024, revealed, .It is the policy .to affirm that all Individuals Receiving Services (IRS)/Residents have a right to be free from abuse .Definitions .Abuse: The willful infliction of physical pain, injury, or mental anguish, unreasonable confinement or the willful deprivation of services necessary to maintain physical and mental health .Mental Abuse: includes .humiliation, harassment .Prevention .(4) .will review, correct, and intervene in situations in which allegations of abuse, neglect .have potentially occurred .D. Reporting: (1) All employees .will immediately report any of the following (a) Witness of or discovery of any situation in which suspicion exits that an IRS/Resident has been the victim of abuse .
A record review of LPN #1's written statement, dated 1/6/25, revealed that on 12/31/24 between 2:00 PM and 2:30 PM, Resident #1 was banging his head against the wall. CNA #1 proceeded to grab the resident by his neck and sweatshirt and drag him to his room. She felt like she was choking him, and she felt like this was abuse. She reported to the security officer and attempted to notify her DON, but she was not in her office.
A record review of the Investigative Summary Report revealed that on 12/31/24 at 2:21 PM, Resident #1 was dragged on the floor by CNA #1. The resident was assessed on 1/3/25 when the allegation was submitted, and the Director of Nurses (DON) was notified. It was reported on 1/3/25 that on 12/31/24, CNA #1 dragged Resident #1 on the floor by the neck of his shirt to his room because the resident positioned himself on the floor in the hallway near the nurse's station. The resident was observed lying on the floor, hitting his head, and refusing to keep his protective helmet on. The investigation into the allegation yielded evidence that CNA #1 did drag the resident by the neck and shoulder sections of his jacket up the hallway into his room. Staff were placed on administrative leave pending investigation. Following the investigation, CNA #1 and License Practical Nurse (LPN) #1 were terminated on 1/7/25.
At 2:43 PM on 2/10/25, during an interview with the Housekeeper, he confirmed that he did not report the abuse he witnessed to his manager because he assumed the other staff would have reported it.
At 3:00 PM on 2/10/25, the SA observed surveillance video with the Administrator present. On 12/31/24 at 2:07 PM, CNA #1 was observed dragging/pulling Resident #1 by his arm/sleeve of his clothes, right side, approximately 16 feet to his room, and LPN #1 was observed walking beside the Resident #1 and CNA #1.
At 12:01 PM on 2/11/25, during an interview with Registered Nurse (RN) #1, she confirmed that LPN #1 did not report that she had witnessed abuse of Resident #1 on 12/31/24 until 1/3/25, which was her next scheduled shift. RN #1 confirmed that the facility's policy is to immediately report any abuse to a supervisor, DON, or Administrator.
At 12:30 PM on 2/11/25, during an interview with CNA #2, she confirmed Resident #1 was her assigned resident on 12/31/24. She revealed that she witnessed CNA #1 drag the resident down the hallway but stated that she did not have time to intervene. She reported the event was over in just a few seconds. LPN #1 advised her that she was going to report the episode to security campus, so CNA #2 did not report the episode to any supervisor.
At 1:00 PM on 2/11/25, during a phone interview CNA #1, she confirmed she had dragged Resident #1 down the hallway by his clothing. CNA #1 stated that she did not report what had occurred on 12/31/24.
At 3:40 PM on 2/11/25, in an interview with the Administrator , he confirmed that staff should have reported the abuse of Resident #1 immediately when it occurred on 12/31/24.
At 4:00 PM on 2/11/25 during an interview with the DON, she confirmed the facility staff did not report the abuse of Resident #1 immediately and that it was not reported until 1/3/25. Following a review of the video surveillance, CNA #1 did drag Resident #1 on the floor by his clothing down the hall and placed him in his room. She stated that facility staff should have reported it to administrative staff when it happened.
A record review of the Face Sheet, revealed the facility admitted Resident #1 on 8/7/24 with current diagnoses including Epilepsy, Bipolar Disorder, and Mild Intellectual Disabilities.
A record review of the Minimum Data Set (MDS) with an Assessment Reference Date (ARD) of 11/5/24, revealed Resident #1 had a Brief Interview for Mental Status (BIMS) score of 12, which indicated his cognition was moderately impaired.
The facility implemented the following Corrective Action Plan prior to the State Agency's entrance on 2/10/25:
The Quality Assurance (Quality Assurance) Committee held an Emergency QA Meeting on 1/7/2025. The Quality Assurance Committee discussed the description of the incident. The QA committee discussed and approved training that was provided beginning on 1/3/25 at the beginning of the shift to all staff on Resident Rights, Suspicion of Abuse, Neglect, Exploitation, Injuries of Unknown Origin, and misappropriation of funds/Property to Individuals Receiving Services/Residents and Resident # 1 behavior Intervention protocol.
The additional will be monitored per staff for continued effectiveness as it follows:
Abuse/Neglect Policy & Adherence to Care Plan.
Quality of corrections will be monitored daily by using a minimum of 5 (five) staff interviews per day 5 (five) days a week for 8 (eight) weeks by Nurse Manager and four Nurse Supervisors, beginning on 1/21/25.
Quality of correction will also be monitored by observing interventions and interactions with patients 5 (five) days a week for 8 (eight) weeks by Nurse Manager and four Nurse Supervisor, beginning on 1/21/25.
Findings will be reported to QAPI (Quality Assurance Performance Improvement), beginning 2/13/25 times two months.
On 1/3/25, all supervisors began training all the oncoming staff before the start of their shift on Resident Rights, Suspicion of Abuse, Neglect, Exploitation, Injuries of Unknown Origin, or Misappropriation of Funds/Property to Individuals Receiving Services/Residents, and Resident #1 Behavioral Intervention Protocol. No employee was allowed to work until there was in-service.
On 1/3/2025 CNAs #1 and License Practical Nurse (LPN)#1 were placed on administrative leave pending completion of the investigation. LPN #1 was terminated from employment on 1/7/25 for observing physical abuse and failing to report it in a timely manner. CNA #1 was terminated from employment effective 1/7/25 for physically abusing Resident #1.
The Investigator notified the State Agency by telephone on 1/3/25, the Attorney General's Office in writing of the incident on 1/3/25.
Supervisors began In-servicing all employees on 1/3/25 prior to the beginning their shift. The in-services were completed on 1/7/25. The Immediate Jeopardy was removed on 1/8/25. The facility alleges all corrective actions were completed on 1/7/25 and the Immediate Jeopardy was removed on 1/8/25 prior to the state department of health entrance on 2/10/25.
The facility alleges all corrective actions were completed on 1/7/25 and the IJ removed on 1/8/25 prior to the state agency's entrance on 2/10/25.
Validation:
The SA validated on 2/12/25, through interview and record review, that all corrective actions had been implemented as of 1/7/25, and the facility was in compliance as of 1/8/25, prior to the SA's entrance on 2/10/25.
CRITICAL
(J)
📢 Someone Reported This
A family member, employee, or ombudsman was alarmed enough to file a formal complaint
Immediate Jeopardy (IJ) - the most serious Medicare violation
Comprehensive Care Plan
(Tag F0656)
Someone could have died · This affected 1 resident
Based on interviews, record review, and facility policy review, the facility failed to implement comprehensive care plan interventions for a resident with behaviors for one (1) of three (3) sampled re...
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Based on interviews, record review, and facility policy review, the facility failed to implement comprehensive care plan interventions for a resident with behaviors for one (1) of three (3) sampled residents. Resident #1.
Resident #1 was physically abused on 12/31/24 when Certified Nurse Assistant (CNA) #1 dragged him by his shirt, the collar, and the shoulders of his jacket up the hallway into Resident #1 room. One nurse observed the abuse and failed to intervene, allowing the abuse to escalate.
The facility's failure to implement the care plan interventions placed this resident and all residents in a situation that was likely to cause serious injury, harm, impairment, or death.
The situation was determined to be an Immediate Jeopardy (IJ) that began on 12/31/24. The State Agency (SA) notified the Administrator of the IJ on 2/11/25 at 4:45 PM and provided an IJ Template.
Based on the facility's implementation of corrective actions on 1/7/25, the SA determined the IJ to be Past-Non-Compliance (PNC) and the IJ was removed on 1/8/25, prior to the SA's entrance on 2/10/25.
Findings include:
A review of the facility policy titled Interdisciplinary Care Plan Team, with a reauthorized date of August 2024, revealed, .The purpose of the team is to define and coordinate the treatment for each resident .
A record review of the Care Plan revealed, .Problem Onset 8/31/24: Potential For Mood and Behavioral Problem . with a goal of Resident will not have increased and mood behavior problem during the quarter, 5/3/25.Approaches: Resident to wear helmet at all times when out of bed for safety (D/T) due to hitting head on floors/walls. Redirect resident if he has inappropriate behaviors and involve him in activities .
A record review of the Investigative Summary Report, dated 1/7/25, revealed that on 12/31/24 at 2:21 PM, Resident #1 was dragged on the floor by CNA #1. The resident was assessed on 1/3/25 when the allegation was submitted, and the Director of Nurses (DON) was notified. It was reported on 1/3/25 that on 12/31/24, CNA #1 dragged Resident #1 on the floor by the neck of his shirt to his room because the resident positioned himself on the floor in the hallway near the nurse's station. The resident was observed lying on the floor, hitting his head, and refusing to keep his protective helmet on. The investigation into the allegation yielded evidence that CNA #1 did drag the resident by the neck and shoulder sections of his jacket up the hallway into his room. Staff were placed on administrative leave pending the investigation and following the investigation, CNA #1 and License Practical Nurse (LPN) #1 were terminated on 1/7/25.
On 2/11/25 at 10:09 AM, during an interview Registered Nurse (RN)/Minimum Data Set (MDS), she confirmed that she expects all staff to follow the Comprehensive Care Plans' interventions for residents. The care plans are person-centered and address residents' needs and safety. She explained that care plans are accessible to staff through care plan books at each nursing area and are reviewed periodically. The MDS nurse reported that in-service training is provided to the staff regarding following care plans, but acknowledged that some staff may not consistently follow them and disciplinary action is taken when necessary.
During an interview with the Director of Nursing on 2/11/25 at 4:00 PM, it was revealed that the unit staff should have followed the care plan interventions for the safety of Resident #1. She expected all staff to follow the residents' care plans, which are designed to provide each resident with care based on their individual needs. The DON acknowledged that Resident #1 has a documented history of self-injurious behavior (hitting his head on walls and floors), which is why he wears a helmet for protection. She confirmed that the resident's care plan includes redirection techniques, such as offering snacks, drinks, or engaging him in activities when he exhibits such behavior. She agreed that if these interventions had been implemented, the incident may have been prevented.
On 2/11/25 at 1:00 PM, during a phone interview with CNA #1, she reported that Resident #1 was not her assigned resident, so she did not follow the care plan on re-directing him, she just responded by dragging him to his room.
A record review of the Face Sheet, revealed the facility admitted Resident #1 on 8/7/24 with current diagnoses including Epilepsy, Bipolar Disorder, and Mild Intellectual Disabilities.
A record review of the MDS with an Assessment Reference Date (ARD) of 11/5/24, revealed Resident #1 had a Brief Interview for Mental Status (BIMS) score of 12, which indicated his cognition was moderately impaired.
The facility implemented the following Corrective Action Plan prior to the State Agency's entrance on 2/10/25:
The Quality Assurance (Quality Assurance) Committee held an Emergency QA Meeting on 1/7/2025. The Quality Assurance Committee discussed the description of the incident. The QA committee discussed and approved training that was provided beginning on 1/3/25 at the beginning of the shift to all staff on Resident Rights, Suspicion of Abuse, Neglect, Exploitation, Injuries of Unknown Origin, and misappropriation of funds/Property to Individuals Receiving Services/Residents and Resident # 1 behavior Intervention protocol.
The additional will be monitored per staff for continued effectiveness as it follows:
Abuse/Neglect Policy & Adherence to Care Plan.
Quality of corrections will be monitored daily by using a minimum of 5 (five) staff interviews per day 5 (five) days a week for 8 (eight) weeks by Nurse Manager and four Nurse Supervisors, beginning on 1/21/25.
Quality of correction will also be monitored by observing interventions and interactions with patients 5 (five) days a week for 8 (eight) weeks by Nurse Manager and four Nurse Supervisor, beginning on 1/21/25.
Findings will be reported to QAPI (Quality Assurance Performance Improvement), beginning 2/13/25 times two months.
On 1/3/25, all supervisors began training all the oncoming staff before the start of their shift on Resident Rights, Suspicion of Abuse, Neglect, Exploitation, Injuries of Unknown Origin, or Misappropriation of Funds/Property to Individuals Receiving Services/Residents, and Resident #1 Behavioral Intervention Protocol. No employee was allowed to work until there was in-service.
On 1/3/2025 CNAs #1 and License Practical Nurse (LPN)#1 were placed on administrative leave pending completion of the investigation. LPN #1 was terminated from employment on 1/7/25 for observing physical abuse and failing to report it in a timely manner. CNA #1 was terminated from employment effective 1/7/25 for physically abusing Resident #1.
The Investigator notified the State Agency by telephone on 1/3/25, the Attorney General's Office in writing of the incident on 1/3/25.
Supervisors began In-servicing all employees on 1/3/25 prior to the beginning their shift. The in-services were completed on 1/7/25. The Immediate Jeopardy was removed on 1/8/25. The facility alleges all corrective actions were completed on 1/7/25 and the Immediate Jeopardy was removed on 1/8/25 prior to the state department of health entrance on 2/10/25.
The facility alleges all corrective actions were completed on 1/7/25 and the IJ removed on 1/8/25 prior to the state agency's entrance on 2/10/25.
Validation:
The SA validated on 2/12/25, through interview and record review, that all corrective actions had been implemented as of 1/7/25, and the facility was in compliance as of 1/8/25, prior to the SA's entrance on 2/10/25.
Jan 2024
3 deficiencies
CONCERN
(D)
Potential for Harm - no one hurt, but risky conditions existed
Resident Rights
(Tag F0550)
Could have caused harm · This affected 1 resident
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interviews, record review, and facility policy review, the facility failed to ensure a resident had a dign...
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**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interviews, record review, and facility policy review, the facility failed to ensure a resident had a dignified dining experience for (1) one of seven (7) resident dining observations. (Resident #160)
Findings include:
Review of the facility's policy, Rights and Responsibilities of Residents, revised October 2023, revealed, .It is the policy of (Proper Name) to protect and support the fundamental human, civil, and constitutional rights of each resident .Procedure . (10) Treated with respect and full recognition of their dignity and individuality .
During an interview and observation on 1/8/24 at 12:05 PM, Resident #160 was in her room and had not received her meal tray. She stated that her roommate had received her meal tray and had already finished eating lunch. Resident #160 said that for the last week, her tray has been served about an hour later than her roommate, and she was unsure as to why this has occurred. She expressed that she did not believe it was right that she had to watch her roommate eat and had to wait for her food to be served.
In an interview with Certified Nurse Aide (CNA) #2, on 1/8/24 at 12:10 PM, she revealed that a CNA had recognized that Resident #160's meal tray was not on the meal cart and was currently at the Dietary Department to get her meal tray. She confirmed that Resident #160's meal tray should have been on the meal cart that was delivered to the hall at 11:15 AM and the roommate should not have been served until both meal trays were available. CNA #2 also confirmed that it was possible that Resident #160 would be bothered by not having food to eat while watching her roommate enjoy her meal.
During an observation and interview on 1/8/24 at 12:15 PM, CNA #1 delivered and set up the lunch meal tray for Resident #160. She confirmed that she had delivered the roommate's meal tray earlier and that Resident #160 did not get a tray when the roommate's tray was delivered. CNA #1 explained that she did not check the cart for Resident #160's meal tray after serving the roommate because she passed the trays in the order they were set up on the cart. CNA #1 did not respond when asked how this practice affected Resident #160.
An interview with the Director of Nursing (DON) on 1/08/24 at 12:50 PM, she revealed Resident #160 should not have had to wait an hour for her meal tray, confirming the staff that delivered the roommates tray should have delivered Resident #160's tray next and if it was not on the cart the staff should have gone to dietary and requested it then. The DON also confirmed that Resident #160 could have been bothered by having to watch her roommate eat.
An interview with Dietary Manager #1 and Dietary Account Manager #2 on 1/09/24 at 2:33 PM, they both revealed they were not aware that Resident #160 had been receiving her meal trays late and confirmed Resident #160 should not have had to wait for an hour for her meal tray to be served, stating if staff would have come to dietary sooner the dietary staff would have fixed the resident a tray.
Record review of the Face Sheet revealed the facility admitted Resident #160 to the facility on [DATE] with diagnoses of Chronic Obstructive Pulmonary Disease and Anxiety.
Record review of the admission Minimum Data Set (MDS) Section C with an Assessment Reference Date (ARD) of 11/2/23, revealed that Resident #160 had a Brief Interview for Mental Status (BIMS) score of 15 which indicated that she was cognitively intact.
CONCERN
(D)
Potential for Harm - no one hurt, but risky conditions existed
Infection Control
(Tag F0880)
Could have caused harm · This affected 1 resident
Resident #57
A review of the facility's policy Standard Precautions, revised September 2023, revealed Policy .Employees will utilize Standard Precautions on all residents .Procedure .C. 1. Gloves .(c)...
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Resident #57
A review of the facility's policy Standard Precautions, revised September 2023, revealed Policy .Employees will utilize Standard Precautions on all residents .Procedure .C. 1. Gloves .(c) Gloves will . (iv) Be removed and hands will be washed immediately upon glove removal .
Record review of the Face Sheet for Resident #57 revealed he was admitted by the facility on 7/13/23 with a diagnosis of Diffuse Traumatic Brain Injury (TBI).
A Record review the Physician Orders for the month of January 2024 revealed Resident #57 had a physician's order, dated 12/21/23 to Clean wound to left heel pressure ulcer with normal saline, pat dry, paint with betadine, cover with kerlix change daily .
On 1/10/24 at 11:55 AM, during an observation of wound care by Licensed Practical Nurse (LPN) #1, she cleaned the wound on Resident #57's left heel. She then removed her gloves and applied clean gloves without washing or sanitizing her hands. LPN #1 swabbed the wound with a betadine swab and covered it with a gauze dressing.
Upon interview with LPN #1 on 1/10/24 at 12:00 PM, she agreed that she should have sanitized her hands before applying clean gloves and continued with wound care. She stated failure to sanitize her hands could put the resident at risk of acquiring an infection.
Upon interview with the Director of Nursing (DON) on 1/10/24 at 12:10 PM, she agreed that LPN #1 should have sanitized her hands prior to applying clean gloves. She verified that failure to sanitize hands could place the resident at risk for infection.
Based on observation, staff interviews, record review, and facility policy review, the facility failed to prevent the possibility of the spread of infection as evidenced by staff failing to correctly wear a face mask on one (1) of four (4) days of survey and failed to perform hand hygiene during wound care for one (1) of five (5) wounds observed. (Resident # 57)
Findings include:
A review of the facility's policy Pandemic Influenza/Coronavirus Disease 2019- Infection Control Practices, revised September 2023, revealed .It is the policy of (Proper Name) to control and prevent pandemic influenza/coronavirus disease 2019 (COVID-19) in Individuals Receiving Services (IRS)/residents, employees, and visitors by providing guidelines for infection control practices.Procedure: A.) The primary strategies for preventing COVID-19 are: (2) Use of infection control measures to prevent transmission .
An interview with the Director of Nursing (DON) upon entrance to the facility on 1/08/24 at 11:05 AM, she revealed the facility was in an active COVID-19 outbreak with one positive resident on the Dogwood Hall rooms 101-131 and all staff were using extra precautions and wearing masks.
During an observation and interview on 1/08/24 at 12:15 PM, Certified Nurse Aide (CNA) #1 exited a resident's room on the Dogwood Hall and was wearing a face mask that did not cover her nose. CNA #1 revealed that there was one resident with COVID-19 on the hall and confirmed the staff working on that hall were required to wear face masks. She also confirmed her mask was not covering her nose because it made it hard for her to breathe. She stated that she was aware that the proper way to wear a face mask was to cover the mouth and the nose to prevent the spread of infection.
An observation on 1/8/24 at 12:30 PM, revealed CNA #1 exited a resident's room, walking down the Dogwood Hall, and the top of the face mask was resting on her upper lip, only covering her mouth, leaving her nose exposed.
During an observation and interview on 1/08/24 at 12:38 PM, CNA #1 exited another resident's room with her face mask covering her mouth, and her nose was not covered. CNA #1 confirmed she was not wearing her mask correctly and stated, well it just keeps sliding down, I can't help it.
An interview with the DON on 1/08/24 at 12:45 PM, she confirmed all staff should wear a face mask that covered the mouth and nose to reduce the possible transmission of infections.
An interview with the Infection Preventionist (IP) on 1/09/24 at 2:11 PM, she confirmed the facility was in active outbreak status and staff are wearing masks. The IP revealed the purpose of adhering to infection control prevention measures such as masks is to protect residents and staff from infection and failing to wear a mask correctly could place residents and staff at risk of acquiring an infection.
CONCERN
(F)
Potential for Harm - no one hurt, but risky conditions existed
Food Safety
(Tag F0812)
Could have caused harm · This affected most or all residents
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**
Based on observation, staff interview, record review, and facility policy review, the facility failed to record daily temperatu...
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**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY**
Based on observation, staff interview, record review, and facility policy review, the facility failed to record daily temperatures for refrigerators and a freezer for the last six (6) days prior to survey entrance on 01/08/24 and failed to date and label stored food in the facility refrigerator for one (1) of two (2) kitchen observations. The deficient practice had the potential to affect 50 of 59 residents in the facility.
Findings include:
A review of the facility's policy, Food and Nutrition Services, dated January 2023, revealed, .The purpose of this policy is to provide guidelines for the creation and maintenance of an environment that is physically and bacteriologically safe for the storage, preparation, serving, and disposal of food .Procedure . (1) Food is stored in the original packaging and is properly labeled .B. Food Handling and Storage (1) Food will be held at the appropriate temperature to maintain quality and prevent the growth of harmful bacteria. (a) Immediately upon receipt, cold foods will be placed in the refrigerator or on ice to maintain 41 degrees Fahrenhiet or colder during holding . (2) Refrigerator and freezer thermometers will be monitored once daily and documented on the Refrigerator Temperature Record Form .and the Freezer Temperature Record Form .(7) Opened containers will be labeled with the date the item was opened and the date of expiration .
An observation and interview, on 01/08/24 at 11:15 AM, revealed a refrigerator in the front room of the kitchen was registering at 54 degrees on the thermometer located outside of the refrigerator, which was more than 40 degrees. The rubber gasket around the refrigerator door did not properly seal the refrigerator door when closed. Dietary Aide (DA) #3 confirmed that the gasket has not sealed in a long time and maintenance was aware.
Record review of the Freezer Temperature Log for Jan (January) 2024 revealed there were no temperatures recorded on the 5th, 6th, or 7th.
Record review of the Refrigerator Temperature Log for [DATE], for the refrigerator located on the Front revealed there were no temperatures recorded for the 3rd, 4th, 5th, 6th, or 7th.
Record review of the Refrigerator Temperature Log for [DATE], for the refrigerator located on the Back revealed there were no temperatures recorded for the 5th, 6th, or 7th.
On 1/8/24 at 11:18 AM, in an interview with DA #3, she confirmed that freezer and refrigerator temperature should be logged daily and if the food was not stored at a certain temperature, it could make the residents sick.
An observation on 1/08/24 at 11:18 AM, revealed the food warmer in the front room in the kitchen contained bacon and toast that was wrapped in aluminum foil. There was no identifying label or date on the container.
Upon observation of the back there was a an eight (8) ounce Gatorade drink with a straw inside it on the top shelf of the refrigerator, with no label indicating the date it was opened. There was a serving tray with individual prepared bowls of soup that did not have an identifying label and was not dated.
An interview, on 01/08/24 at 2:00 PM, with the Dietary Account Manager confirmed that the refrigerator and freezer temperatures logs had omissions and should be documented daily to ensure food items remain at the correct temperature and does not make anyone sick.
An interview on 01/09/24 at 09:30 AM, with the Maintenance Director confirmed that he was aware of the gasket not sealing on the refrigerator in the kitchen and that one had been ordered but not received at this time. The Maintenance Director confirmed that without the proper gasket in the refrigerator the temperature would not be 40 degrees or below and that food could be ruined.
An interview on 01/11/23 at 08:30 AM, with Dietary Account Manager confirmed that she was aware of the issue with the gasket not working properly on the refrigerator and that it would not remain at a temperature of 40 degrees or below. The Dietary Account Manager confirmed that food could ruin and make someone sick if the refrigerator did not remain at the correct temperature. She stated that food must be labeled and dated and no personal food or drinks should be in the refrigerator.
Oct 2022
3 deficiencies
CONCERN
(D)
Potential for Harm - no one hurt, but risky conditions existed
Deficiency F0567
(Tag F0567)
Could have caused harm · This affected 1 resident
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interviews, record review, and facility policy review, the facility failed to ensure residents had readily available an...
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**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interviews, record review, and facility policy review, the facility failed to ensure residents had readily available and reasonable access to their personal funds, seven (7) days a week, for four (4) of 15 residents sampled. Resident #8, Resident #10, Resident #34, and Resident #45
Findings Included:
A review of the facility's Money Policy for Individuals Receiving Services/Residents, revised March 2020, revealed, . F. Money Call is the time established by the Division Director or Fiscal Services Director, during which, an IRS (Individual Receiving Service)/resident is distributed money from his/her RFMS (Resident Fund Management Service) account, held by their designated money custodian .G. Money day is one of the scheduled days when Patient Accounts issues cash and checks from the (Proper Name of Facility) Resident Trustee Account to the money custodians .
Resident #8
On 10/17/22 at 12:53 PM, during an interview with Resident #8, he stated that they can only get their personal money on Tuesdays because the person who deals with the money is not there on the weekends.
A record review of the Face Sheet of Resident #8 revealed he was admitted on [DATE], with diagnoses including End State Renal Disease and Essential Hypertension.
Record review of the Significant Change in Status Minimum Data Set (MDS), with an Assessment Reference Date (ARD) of 10/14/22 revealed Resident #8 had a Brief Interview of Mental Status (BIMS) score of 13, indicating he had no cognitive impairment.
Resident #10
On 10/17/22 at 12:19 PM, in an interview with Resident #10, she stated she can only get money on Tuesday. She stated Tuesday is Money Call Day. She explained that no one is here to give money on weekends.
Record review of the Face Sheet of Resident #10 revealed the facility admitted her on 5/3/22, with diagnoses including Bipolar Disorder and Epilepsy.
Record review of the Quarterly MDS with an ARD of 7/26/22 for Resident #10 revealed she had a BIMS score of 15, which indicated she was cognitively intact.
Resident #34
On 10/17/22 at 12:00 PM, during an interview with Resident #34, he stated that they get their money every Tuesday morning.
A record review of the Face Sheet revealed the facility admitted Resident #34 on 5/08/19 with diagnoses including Essential Hypertension, Schizophrenia, and Type 2 Diabetes Mellitus.
A record review of Resident #34's Annual MDS with an ARD of 9/02/22 revealed that the resident has a BIMS of 9, which indicated he had moderate cognitive impairment.
Resident #45
On 10/17/22 at 12:11 PM, Resident #45 stated she can only get money out of her account on Tuesday. She stated they call it Money Call and it is on Tuesday only. She stated they cannot get money on weekends.
Record review of the Face Sheet revealed the facility admitted Resident #45 on 2/16/05 with diagnoses including Bipolar Disorder and Schizoaffective Disorder.
Record review of the Quarterly MDS with an ARD of 9/16/22 revealed a BIMS score of 15, which indicated Resident #45 was cognitively intact.
On 10/17/22 at 3:35 PM, during an interview with Licensed Practical Nurse (LPN) #1, she stated that the Money Custodian does a Money Call every Tuesday at 9:00 AM.
On 10/18/22 at 8:50 AM, the SA heard an announcement on the facility's intercom system for Money Call in which the residents were to come to the dayroom to receive their money.
On 10/18/22 at 9:03 AM, during an interview with the Money Custodian, she stated that if she knows that residents are going out on the weekend, the Social Worker will send her an email letting her know who wants what amount of money. She stated that she always makes sure that the residents receive it. She stated that the residents are used to coming to receive funds on Tuesdays, so they make it available every Tuesday. She confirmed that she is only at the facility Monday through Friday, so she gives them what they ask for during those days.
On 10/18/22 at 9:13 AM, during an interview with the Director of Nursing (DON), he stated that Money Call is a designated day that the residents come get their money. He revealed it could be for an outing, or for some, they just like to have some money on them. He stated that the person that handles the money gives it to them anytime of the week, Monday through Friday.
On 10/18/22 at 09:18 AM, during an interview with the Administrator, he stated that Money Call is when the money custodian comes, and the residents come pick up their spending money for trips or when they go out on pass. He stated that the residents can receive their money from her anytime Monday through Friday.
On 10/18/22 at 09:20 AM, during an interview with the Head Administrator, he stated that if the residents request money ahead of time by Friday, they will be able to get it for the weekend.
A record review of the Trial Balance with Balances as of 10/22/22 revealed Resident #8, Resident #10, Resident #34, and Resident #45 were listed as having a personal fund account with the facility
CONCERN
(D)
Potential for Harm - no one hurt, but risky conditions existed
Assessment Accuracy
(Tag F0641)
Could have caused harm · This affected 1 resident
Based on interviews, record review, and facility policy review, the facility failed to accurately code the admission Minimum Data Set (MDS) related to a resident's reentry into the facility from an ac...
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Based on interviews, record review, and facility policy review, the facility failed to accurately code the admission Minimum Data Set (MDS) related to a resident's reentry into the facility from an acute care hospital for one (1) of 17 residents reviewed for MDS accuracy. Resident #46.
Findings Included:
A review of the facility's Minimum Data Set (MDS) policy, revised August 2022, revealed, .2. Purpose: The purpose of this policy is to .establish the framework for organizing an individual plan of care .
A record review of the CMS's (Centers for Medicare and Medicaid Services) RAI (Resident Assessment Instrument) Version 3.0 Manual, dated October 2019, revealed, .A1800: Entered From .Item Rational .Understanding the setting that the individual was in immediately prior to facility .reentry informs care planning and may also inform discharge planning and discussions .
A record review of the Face Sheet revealed the facility admitted Resident #46 on 9/29/21 with diagnoses including Type 2 Diabetes Mellitus and Unspecified Convulsions.
A record review of the facility's document, Notice of Bed Hold and Readmission, dated 6/13/22, revealed Resident #46 was transferred to a local acute care hospital.
A record of the Discharge MDS with an Assessment Reference Date (ARD) of 6/13/22 revealed A2100 was coded as 3. Acute Hospital which indicated Resident #46 had been transferred to an acute care hospital.
A record review of the Admissions MDS with an ARD of 6/27/22 revealed the assessment was coded as a Reentry from Another nursing home or swing bed, which was not consistent with the discharge assessment or the Notice of Bed Hold and Readmission document which indicated Resident #46 was transferred to an acute hospital on 6/13/22.
A record review of the facility's document, Notice of Bed Hold and Readmission, dated 8/24/22 revealed Resident #46 was transferred to a local acute care hospital.
A record review of the Discharge MDS with an ARD of 8/24/22 revealed A2100 was coded as 3. Acute Hospital which indicated Resident #46 had been transferred to an acute care hospital.
A record review of the Admissions MDS with an ARD date of 8/27/22 revealed the assessment was coded as a Reentry from Another nursing home or swing bed, which was not consistent with the discharge assessment or the Notice of Bed Hold and Readmission document which indicated Resident #46 was transferred to an acute hospital on 8/24/22.
On 10/20/22 at 1:50 PM, during an interview with Registered Nurse (RN) #1/MDS Nurse, she stated Resident #46 returned to the facility on 6/27/22 and 8/27/22 from an acute care hospital. She confirmed that the admission Assessments should have been coded for the resident as entering from an acute hospital instead of from another nursing home or swing bed.
On 10/20/22 at 2:45 PM, during an interview with the Administrator, he stated the MDS should have been coded correctly, and it is very important.
On 10/20/22 at 2:54 PM, during an interview with the Director of Nursing (DON), he confirmed the MDS should have been coded correctly and that it is important.
MINOR
(C)
Minor Issue - procedural, no safety impact
Deficiency F0576
(Tag F0576)
Minor procedural issue · This affected most or all residents
Based on interviews, record review, and facility policy review, the facility failed to provide mail delivery on Saturdays for three (3) of 15 sampled residents and had the potential to affect 57 of 57...
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Based on interviews, record review, and facility policy review, the facility failed to provide mail delivery on Saturdays for three (3) of 15 sampled residents and had the potential to affect 57 of 57 residents residing in the facility. Resident #10, Resident #45, and Resident #46
Findings Included:
Review of the facility's policy Mail Distribution, with a revision date of May 2021, revealed, 1. Policy It is the policy of (Proper Name of Facility) that Mail Room staff will distribute and process all internal, external, and accountable mail that is delivered to the .Nursing Home Division (NHD) .9. USPS (United State Postal Service) delivers all NHD residents incoming mail to the facility mailbox on Saturday to ensure residents receive mail six days a week. Mail will be sorted and disturbed to the residents and or the residents Social Worker .
Resident #10
Record review of the Face Sheet revealed Resident #10 was admitted by the facility on 5/3/22 with diagnoses including Epilepsy and Bipolar Disorder.
Record review of the Quarterly Minimum Data Set (MDS), with an Assessment Reference Date (ARD) of 7/26/22, revealed Resident #10 had a Brief Interview of Mental Status (BIMS) score of 15, which indicated she was cognitively Intact.
On 10/20/22 at 1:00 PM, in an interview with Resident #10, she stated she has never received mail on Saturday.
Resident #45
Record review of the Face Sheet revealed Resident #45 was admitted by the facility on 2/16/05 with diagnoses including Schizoaffective Disorder and Bipolar Disorder.
Record review of the Quarterly MDS, with an ARD of 9/16/22, revealed Resident #45 had a BIMS score of 15, which indicated she was cognitively intact.
On 10/20/22 at 11:32 AM, in an interview with Resident #45, she stated she does not get mail on Saturdays and that she has never received mailed on Saturdays since she was admitted to the facility.
Resident #46
On 10/18/22 at 3:50 PM, Resident #46 stated that he does not receive his mail on the weekends because social services are not here. He stated that they usually get it on the following Monday when Social Services come back to work.
Record review of the Face Sheet revealed Resident #46 was admitted by the facility on 9/29/21, with diagnoses including Type 2 Diabetes Mellitus and Unspecified Convulsions.
Record review of the Quarterly MDS, with an ARD of 09/20/22, revealed Resident #46 had a BIMS score of 11, which indicated he had moderate cognitive impairment.
On 10/20/22 at 1:31 PM, in an interview with the Social Worker (SW), she explained the facility has a Post Office Box. Also, some of the facility's mail will go to the mailroom on the Main Campus and that transportation will bring it over to the facility. She stated the mail is received at the front office and is sorted by the Administrative Assistant, who brings the mail to the SW office to be passed out to the residents. She confirmed that this is done Monday through Friday and the mail that comes in on weekends is not given to the residents until Monday.
On 10/20/2022 at 3:35 PM, in an interview with the Administrator, he stated the mail should be issued on Saturdays because receiving mail makes the residents happy and it is good for their psychosocial health. He commented that the facility will work to ensure that residents can get their mail on Saturdays.
Understanding Severity Codes (click to expand)
Life-Threatening (Immediate Jeopardy)
J - Isolated
K - Pattern
L - Widespread
Actual Harm
G - Isolated
H - Pattern
I - Widespread
Potential for Harm
D - Isolated
E - Pattern
F - Widespread
No Harm (Minor)
A - Isolated
B - Pattern
C - Widespread
Questions to Ask on Your Visit
- "What changes have you made since the serious inspection findings?"
- "What safeguards are in place to prevent abuse and neglect?"
- "Can I speak with families of current residents?"
- "What's your RN coverage like on weekends and overnight?"
Our Honest Assessment
Strengths
- • Licensed and certified facility. Meets minimum state requirements.
Concerns
- • Multiple safety concerns identified: Federal abuse finding, 4 life-threatening violation(s). Review inspection reports carefully.
- • 13 deficiencies on record, including 4 critical (life-threatening) violations. These warrant careful review before choosing this facility.
- • $10,364 in fines. Above average for Mississippi. Some compliance problems on record.
- • Grade F (0/100). Below average facility with significant concerns.
Bottom line: This facility has a substantiated abuse finding. Extreme caution advised. Explore alternatives.
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About This Facility
What is Reginald P White Nursing Facility's CMS Rating?
CMS assigns REGINALD P WHITE NURSING FACILITY an overall rating of 3 out of 5 stars, which is considered average nationally. Within Mississippi, this rating places the facility higher than 99% of the state's 100 nursing homes. This mid-range rating indicates the facility meets federal standards but may have areas for improvement.
How is Reginald P White Nursing Facility Staffed?
CMS rates REGINALD P WHITE NURSING FACILITY's staffing level at 5 out of 5 stars, which is much above average compared to other nursing homes. Staff turnover is 55%, compared to the Mississippi average of 46%.
What Have Inspectors Found at Reginald P White Nursing Facility?
State health inspectors documented 13 deficiencies at REGINALD P WHITE NURSING FACILITY during 2022 to 2025. These included: 4 Immediate Jeopardy (the most serious level, indicating potential for serious harm or death), 8 with potential for harm, and 1 minor or isolated issues. Immediate Jeopardy findings are rare and represent the most serious regulatory concerns. They require immediate corrective action.
Who Owns and Operates Reginald P White Nursing Facility?
REGINALD P WHITE NURSING FACILITY is owned by a government entity. Government-operated facilities are typically run by state, county, or municipal agencies. The facility operates independently rather than as part of a larger chain. With 70 certified beds and approximately 63 residents (about 90% occupancy), it is a smaller facility located in MERIDIAN, Mississippi.
How Does Reginald P White Nursing Facility Compare to Other Mississippi Nursing Homes?
Compared to the 100 nursing homes in Mississippi, REGINALD P WHITE NURSING FACILITY's overall rating (3 stars) is above the state average of 2.6, staff turnover (55%) is near the state average of 46%, and health inspection rating (2 stars) is below the national benchmark.
What Should Families Ask When Visiting Reginald P White Nursing Facility?
Based on this facility's data, families visiting should ask: "What changes have been made since the serious inspection findings, and how are you preventing similar issues?" "What safeguards and monitoring systems are in place to protect residents from abuse or neglect?" "Can I visit during a mealtime to observe dining assistance and food quality?" "How do you handle medical emergencies, and what is your hospital transfer rate?" These questions are particularly relevant given the facility's Immediate Jeopardy citations and the substantiated abuse finding on record.
Is Reginald P White Nursing Facility Safe?
Based on CMS inspection data, REGINALD P WHITE NURSING FACILITY has documented safety concerns. The facility has 1 substantiated abuse finding (meaning confirmed case of resident harm by staff or other residents). Inspectors have issued 4 Immediate Jeopardy citations (the most serious violation level indicating risk of serious injury or death). The facility has a 3-star overall rating and ranks #1 of 100 nursing homes in Mississippi. Families considering this facility should ask detailed questions about what corrective actions have been taken since these incidents.
Do Nurses at Reginald P White Nursing Facility Stick Around?
REGINALD P WHITE NURSING FACILITY has a staff turnover rate of 55%, which is 9 percentage points above the Mississippi average of 46%. Moderate turnover is common in nursing homes, but families should still ask about staff tenure and how the facility maintains care continuity when employees leave.
Was Reginald P White Nursing Facility Ever Fined?
REGINALD P WHITE NURSING FACILITY has been fined $10,364 across 2 penalty actions. This is below the Mississippi average of $33,183. While any fine indicates a compliance issue, fines under $50,000 are relatively common and typically reflect isolated problems that were subsequently corrected. Families should ask what specific issues led to these fines and confirm they've been resolved.
Is Reginald P White Nursing Facility on Any Federal Watch List?
REGINALD P WHITE NURSING FACILITY is not on any federal watch list. The most significant is the Special Focus Facility (SFF) program, which identifies the bottom 1% of nursing homes nationally based on persistent, serious quality problems. Not being on this list means the facility has avoided the pattern of deficiencies that triggers enhanced federal oversight. This is a positive indicator, though families should still review the facility's inspection history directly.