Caring House

In the surveyor’s words

From the most serious findings on record at Caring House, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689Sep 18, 2025

  Based on observation, interviews, and record review, the facility failed to provide adequate supervision and follow its elopement policy for 1 of 1 resident (R1) reviewed for supervision. This failure resulted in R1 remaining alone outdoors for approximately 4 hours in extreme heat conditions (100 Fahrenheit (F) - 111 F, with a heat index of up to 114 F). (Heat index is defined as a measurement that combines air temperature and relative humidity to determine how hot the air actually feels to the human body.) The deficient practice placed the resident at risk for heat exhaustion, heat stroke, and/or death and resulted in a situation of immediate jeopardy.On [DATE] at 5:30 PM the Administrator and Assistant Administrator were notified of an Immediate Jeopardy determination for [DATE] for 42… […]

• Actual harm, isolatedF697Nov 8, 2024

  Based on observations, interviews, review of the [NAME] Drug Guide, and review of records and policies and procedures, the facility failed to provide services to manage the pain for one of two residents sampled for pain (Resident [R]46) consistent with professional standards, the comprehensive person-centered care plan, and the residents' goals and preferences. Specifically: 1) Staff did not follow facility policy and procedures for assessment and recognition of R46's pain failing to identify location, intensity, frequency, pattern, and severity for each reported pain occurrence. […]

• No harm, potential for more than minimal, patternF628Sep 4, 2026

  Based on interview and record review, the facility failed to ensure required written discharge/transfer notification was provided for 2 of 2 sampled residents (R91 and R2) reviewed for discharge and hospitalization, respectively. The facility failed to: (1) provide R91 with written notice of the discharge and did not provide a copy of the discharge notice to the State Long-Term Care Ombudsman; and (2) provide the State Long-Term Care Ombudsman with a copy of R2's transfer notice following R2's transfer to the hospital. These failures resulted in R91 not receiving written information regarding the reason for discharge, effective date, discharge location, appeal rights, and information regarding the State Long-Term Care Ombudsman. […]

• No harm, potential for more than minimal, patternF812Sep 4, 2026

  Based on observation, interview, record review, the facility failed to ensure food and dishware were maintained under safe and sanitary conditions when the facility failed to: (1) ensure cleaned bowls were adequately dried and were not stored with standing water; (2) maintain a unit refrigerator at 41 F or below; and (3) ensure opened food items were appropriately dated and food items past their expiration date were removed from 2 of 3 unit refrigerators/freezers (Unit E and Unit F) reviewed. These failures placed all 86 residents who received meals prepared by the kitchen at risk for food-borne illness. Findings: During an interview on 8/31/26 at 8:55 am Food Services Director FSD stated that all residents in the facility received their meals from the kitchen. […]

• No harm, potential for more than minimal, patternF880Sep 4, 2026

  Based on interview and record review, the facility failed to implement its Water Management Program when water temperatures were repeatedly below the facility-established control limits for Unit B, one of four units reviewed, and corrective actions were not implemented when monitoring results fell outside the established control limits.This deficient practice had the potential to create conditions conducive to the growth and transmission of Legionella and other waterborne pathogens, placing residents on Unit B at risk for waterborne illness. Findings Include: Review of the facility's Legionella Water Management Program policy, revised May 2026, revealed the facility was committed to the prevention, detection, and control of waterborne contaminants, including Legionella. […]