Sardis Community NH

In the surveyor’s words

From the most serious findings on record at Sardis Community NH, in the surveyor’s own words.

• Actual harm, isolatedF600Dec 23, 2025

  Based on resident and staff interviews, record review, and facility policy review, the facility failed to ensure a resident was free from abuse for one (1) of five (5) residents reviewed (Resident #1), when staff engaged in abusive conduct by pulling the resident from his seated position onto the floor, verbally berating him, and spraying him with an aerosol substance. This failure resulted in actual psychosocial harm, including fear, distress, and compromised dignity. Findings Include:Cross-Reference F610Review of the facility policy titled Incident Investigation & Reporting, revised 5/24, revealed, .1. […]

• Actual harm, isolatedF610Dec 23, 2025

  Based on resident and staff interviews, record review, and facility policy review, the facility failed to ensure an allegation of abuse was thoroughly investigated for one (1) of five (5) residents reviewed. (Resident #1) Findings Include:Cross-Reference F600Review of the facility policy titled Incident Investigation & Reporting, revised 5/24, revealed, .6 The facility will thoroughly investigate all alleged violations under the direct supervision of the Administrator. The facility will take all necessary steps to prevent occurrence and/or further potential abuse.Record review revealed an allegation of abuse involving Resident #1 was reported on 9/17/25 after staff responded to the resident screaming for help and observed the resident on the floor following an altercation with Nurse Aide… […]

• No harm, potential for more than minimal, patternF656Jul 1, 2025

  Based on staff and resident interviews, record reviews and facility policy review, the facility failed to develop a comprehensive care plan for a resident taking an anticoagulant (Resident #32) and failed to implement an Activities of Daily Living (ADL) care plan (Resident #257) for two (2) of 26 resident's care plans reviewed. The scope for F656 was increased to E to indicate a pattern of noncompliance due to a prior citation during the last recertification survey 7/23/24. Findings include: Review of the facility policy titled, Care Plan Process with review date 12/24, revealed, .the facility shall develop and implement .care plan .for each resident that includes the instructions needed to provide effective and person-centered care of the resident that meets professional standards of… […]

• No harm, potential for more than minimal, patternF677Jul 1, 2025

  Based on observation, interviews, record review and facility policy review, the facility failed to ensure that assistance with Activities of Daily (ADL) was provided to a resident that required assistance with bathing for one (1) of 26 sampled residents. Resident #257 Findings Include: Review of the facility's policy titled, Activities of Daily Living with a revision date of 11/24, revealed under Policy: Activities of Daily Living will be documented on a daily basis by the CNA (Certified Nursing Assistant) to reflect actual care rendered to the resident. The ADL shall become a permanent part of the residents' chart . 2. ADLS shall include, but are not limited to .bathing . On 6/29/25 at 4:58 PM, an observation of Resident #257 revealed a foul odor. […]

• No harm, potential for more than minimal, isolatedF656Mar 19, 2026

  Based on record review, interview, and facility policy review, the facility failed to develop and implement a comprehensive, person-centered care plan to address a newly identified skin breakdown to the sacrum for one (1) of three (3) residents reviewed (Resident #1).Findings included:Record review of facility policy titled, Care Plan Process, revised 12/24 revealed .The Care Plan must include measurable objectives and time frames and must describe the services that are to be furnished to attain or maintain the resident's highest practicable physical, mental, and psychosocial well-being. […]