Platte Care Center

In the surveyor’s words

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

• Actual harm, isolatedF689Feb 4, 2026

  Based on South Dakota Department of Health (SD DOH) facility reported incident (FRI) review, interview, and record review, the provider failed to ensure one of one certified nursing assistant (CNA) (E) followed one of one resident (1) care plan when she left the resident alone in his room in his wheelchair. Resident 1 transferred himself to the toilet, fell, and experienced increased pain in his right leg. This citation is considered past noncompliance based on a review of the corrective actions the provider implemented following the incident. Findings include:1. Review of the SD DOH FRI revealed that on 1/16/26 at around 11:42 a.m., resident 1 was left alone in his room in his wheelchair after an activity. […]

• Actual harm, isolatedF600Nov 20, 2024

  Based on South Dakota Department of Health (SD DOH) facility-reported incidents (FRI), interview, record review, and policy review, the provider failed to protect one of one sampled resident (11) from abuse by one of one agency certified nursing assistant (CNA) (F) who insinuated she was videoing the resident when providing her care. This citation is considered past non-compliance based on review of the corrective actions the provider implemented following the incident. Findings include: 1. Review of the provider's submitted SD DOH FRI regarding resident 11's incident revealed: *Her Brief Interview for Mental Status (BIMS) assessment score was 15 which indicated her cognition was intact. *On 7/9/24 at 9:00 p.m. […]

• No harm, potential for more than minimal, widespreadF812Nov 20, 2024

  Based on observation, record review, interview, and policy review, the provider failed to ensure the dishwasher temperatures were monitored, recorded, and interventions were documented for temperatures out of range for one of one dishwasher used for the cleaning and sanitization of dishes and items used to prepare and serve residents' food. Findings include: 1. Observation on 11/19/24 at 11:30 a.m. of cook H revealed: *She removed the plates from the serving stack and placed them in the dishwasher. *After the dishwashing cycle was completed, she returned the plates to the serving stack. *She then served the lunch meal on the plates that she had washed. 2. […]

• No harm, potential for more than minimal, isolatedF552Nov 5, 2025

  Based on record review, interview, and policy review, the provider failed to ensure informed consent was signed by one of three sampled resident (10) or a responsible party before administering a psychotropic (drug that affects brain activities associated with mental processes and behavior) medication.Findings include: 1. Review of resident 10's electronic medical record (EMR) revealed:*A diagnoses of hallucinations due to late onset dementia.*His daughter, who was his power of attorney, requested a medication to address the resident's increasing behaviors.*An order dated 8/7/25 to be given Quetiapine Fumarate (Seroquel) 25 milligrams by mouth at bedtime.*His care plan dated 10/22/25 indicated:-I will have no side effects of my psych [psychotropic] med [medication] noted.-My psychotropic… […]

• No harm, potential for more than minimal, isolatedF689Nov 5, 2025

  Based on South Dakota Department of Health (SD DOH) Facility-Reported Incidents (FRI), record review, observation, interview, policy review, and job description review, the provider failed to ensure resident safety by:*One of one social worker (D) who did not provide supervision follow-up when the door alarmed for one of one sampled resident (19) who had eloped (left the facility without staff knowledge) and was outside the building for approximately five minutes without supervision.*Two of two certified nursing assistants (CNA) (G and H) who did not follow the care plan for one of one sampled resident (2) who required to be transferred by using two people, a gait belt, and a walker with manual transfers or one to two people using the sit-to-stand lift and fell. Findings include:1. […]