Aperion Care Kokomo

In the surveyor’s words

From the most serious findings on record at Aperion Care Kokomo, in the surveyor’s own words.

• Actual harm, isolatedF686Feb 5, 2026

  Based on observation, interview and record review, the facility failed to ensure a resident who entered the facility without a pressure ulcer did not develop a pressure ulcer and a wound assessment was completed when the wound was discovered for 1 of 3 residents reviewed for pressure ulcers. (Resident C) This deficient practice resulted in Resident C developing a pressure ulcer which was not discovered until it was a stage III (a serious full-thickness skin injury appearing as a deep, crater-like wound which exposes subcutaneous fat) The deficient practice was corrected on 12/2/25, prior to the start of the survey, and was therefore past noncompliance.Findings include:During an observation, on 2/3/26 at 9:52 a.m., Resident C was lying in his bed. His coccyx dressing was dated 2/3/26. […]

• Actual harm, isolatedF600Sep 29, 2023

  Based on observation, interview and record review, the facility failed to ensure a resident was free from mental and verbal abuse and intimidation, failed to ensure a staff member intervened while a resident was being mentally and verbally abused and intimidated, and failed to provide 72-hour psychosocial follow-up for 1 of 3 residents reviewed for abuse. (Resident B) Resident B indicated while being abused by the Executive Director, she thought she was going to be hit, her personal space was invaded, she was in fear for her life, and following the incident she thought the Executive Director (ED) sent an unidentified man hit man into the facility to harm her in retaliation for the ED being suspended. […]

• Actual harm, isolatedF689Apr 5, 2022

  Based on observation, interview and record review, the facility failed to ensure a resident's plan of care was followed while ADL (Activities of Daily Living) care was being provided for 1 of 1 resident being reviewed for accidents. (Resident C) Resident C sustained a laceration, the size of a pea, on the left side of her forehead just above a raised knot approximately the size of a quarter and an acute displaced oblique fracture of the right fifth finger (a broken right fifth finger). Finding includes: A document, titled Facility Reported Incident, dated 4/1/22, indicated on 4/1/22 at 1:01 p.m., CNA 1 was providing personal hygiene care for Resident C when the resident slid from the bed and was unable to stop herself and CNA 1 was unable to completely stop the resident. […]

• Actual harm, isolatedF692Mar 4, 2022

  Based on record review and interview, the facility failed to identify a significant weight loss, notify the physician of the weight loss and implement interventions to prevent further weight loss for 1 of 6 residents reviewed for nutrition. (Resident F) Resident F had a 17% weight loss in 14 days. Finding includes: The record was reviewed on 3/3/22 at 12:25 p.m. diagnoses [MEDICAL RECORD OR PHYSICIAN ORDER] . A physician's orders [MEDICAL RECORD OR PHYSICIAN ORDER] . A physician's orders [MEDICAL RECORD OR PHYSICIAN ORDER] . A physician's orders [MEDICAL RECORD OR PHYSICIAN ORDER] . A physician's orders [MEDICAL RECORD OR PHYSICIAN ORDER] . A care plan, dated 1/11/22, indicated the resident was at risk for nutritional problems. […]

• Actual harm, isolatedF760Mar 4, 2022

  Based on interview and record review, the facility failed to ensure the correct dose of an opioid was administered to a resident for 1 of 3 residents reviewed for medication administration (Resident B). Resident B had two emergency room (ER) visits and required the administration of [MEDICATION(S)] (a medication to reverse the effects of opioids). Finding includes: During an interview, on 3/3/22 at 4:06 p.m., a friend of the resident indicated a concern regarding the resident had been overdosed on medication and the medication error was not reported. The record for Resident B was reviewed on 3/3/22 at 11:58 a.m. diagnoses [MEDICAL RECORD OR PHYSICIAN ORDER] . A physician's orders [MEDICAL RECORD OR PHYSICIAN ORDER] . […]