Based on records reviewed and interviews for one of three sampled residents (Resident #1), who in the morning on 3/31/26 exhibited signs of acute pain in his/her right shoulder and arm, and had a new Physician's order for a STAT (without delay, immediately) x-ray, the Facility failed to ensure that he/she was provided with radiology services consistent with his/her Physician's Orders, when nursing did not follow up on the order and a STAT x-ray was not obtained, as a result he/she had to be transferred to the Hospital Emergency Department the following day to obtain an x-ray.Findings Include:Resident #1 was admitted to the Facility in March 2025, diagnoses included Alzheimer's, dementia, lack of coordination, difficulty walking, and history of falling.Review of Resident #1's Incident… …
F777 citations in Massachusetts
Administration Deficiencies
Provide or obtain x-rays/tests when ordered and promptly tell the ordering practitioner of the results.
Data as of , released by CMS on October 8, 2026. Source: CMS Provider Data Catalog.
Against expectation — 2025
Massachusetts cites F777 more often than its own record predicts
1.55 times the share F777 takes of citations nationally.
Of every deficiency written in Massachusetts in 2025, this is the portion that was F777.
Each state is measured against its own expected share, not against other states.
In the surveyor’s words
What Massachusetts surveyors wrote
F777 findings written in Massachusetts, 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.
The short window
Recent years
| Year | Share of Massachusetts citations | vs expected |
|---|---|---|
| 2023 | 0.04% | 1.62× |
| 2024 | 0.03% | 1.06× |
| 2025 | 0.04% | 1.55× |
Shares of citations, not counts: earlier years hold fewer inspections.
What else Massachusetts surveyors cite →
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