Based on interview, record review, review of the facility's document, and review of the Emergency Medical Services (EMS) run report, it was determined the facility failed to ensure physician's orders for the resident's immediate care was obtained at the time each resident was admitted for one (1) of thirty-three (33) sampled residents (Resident #821). The facility failed to obtain admission orders for Resident #821 when the resident was readmitted to the facility on [DATE] with a heparin lock (intravenous [V] catheter that could be used to give medicine or fluids intermittently). Review of Resident #821's Progress Notes revealed the facility sent the resident to the emergency room (ER), on 04/14/2023, related to blood clots in his/her urinary catheter. …
F635 citations in Kentucky
Resident Assessment and Care Planning Deficiencies
Provide doctor's orders for the resident's immediate care at the time the resident was admitted.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2023
Kentucky cites F635 more often than its own record predicts
4.82 times the share F635 takes of citations nationally.
Of every deficiency written in Kentucky in 2023, this is the portion that was F635.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Kentucky surveyors wrote
F635 findings written in Kentucky, one from each severity band recorded here, most serious first.
Severity is as the surveyor wrote it. Some findings had already been corrected before the survey.
What else Kentucky surveyors cite →
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