Sheridan Memorial Nursing Home

In the surveyor’s words

From the most serious findings on record at Sheridan Memorial Nursing Home, in the surveyor’s own words.

• Immediate jeopardy, patternF689Apr 13, 2022

  IMMEDIATE JEOPARDY On 4/13/22 at 10:58 a.m., the facility CEO, CNO, DON, and RCC were notified that an Immediate Jeopardy existed in the area of F689; Accidents, Hazards, Supervision, and Devices. The Severity and Scope identified for the Immediate Jeopardy was identified to be at the level of K, and upon removal of immediacy lowered to an H. Based on observation, interview, and record review, the facility failed to sufficiently address safety concerns related to falls, elopements, and [CONDITION(S)], to include: - Prevent skin injuries due to [CONDITION(S)] from hot coffee, to include a 2nd degree burn, and with no interventions implemented to prevent further [CONDITION(S)], for 1 (#21); - Failed to prevent repeated elopements and correct safety failures with the alarming door system… […]

• Actual harm, isolatedF600Apr 9, 2026

  Based on interview and record review, the facility failed to ensure a resident was free from abuse and neglect of care needs for 1 (#1) of 3 sampled residents. The deficient practice resulted in the resident feeling worthless, anxious, confused, and feeling like she was being punished. Findings include: Review of a Facility-Reported Incident, dated 3/7/26, showed resident #1 reported she was forced to remain in a recliner in the day lounge rather than in her bed. The resident also stated she was denied water upon request and did not have access to a call light or any other way to summon help if needed. […]

• Actual harm, isolatedF689Jul 30, 2025

  Based on observation, interview, and record review, the facility staff failed to safely use a sit-to-stand lift when transferring a resident, causing injuries to include fractured ribs, and the resident was hospitalized for further evaluation, for 1 (#26) of 4 sampled residents for accidents. Findings include:Review of a facility reported incident, sent to the State Survey Agency, dated 6/20/25, showed resident #26 was found to have a large area of bruising over his right chest wall with swelling. The area was firm and tender to touch. Resident #26 was sent to the ED for further evaluation. The facility investigation concluded the used of the sit-to-stand lift for transferring resident #26 was the cause of the injury. […]

• Actual harm, isolatedF686Jun 7, 2023

  Based on observation, interview, and record review, the facility staff failed to prevent a pressure ulcer for 1 (#19) of 2 sampled residents. This deficient practice resulted in harm for the resident due to surgical intervention, ongoing dressing changes, and a MRSA infection in the wound. Findings include: During an observation on 6/6/23 at 7:45 a.m., resident #19 was sitting in a Broda chair and appeared to be sleeping. During an observation on 6/6/23 at 9:35 a.m., resident #19 was sitting in a Broda chair by the nurse's station. Resident #19 was in the same position that he was in 2 hours earlier in the morning. During an interview on 6/6/23 at 2:17 p.m., NF2 stated resident #19 developed a wound on his coccyx after he was admitted to the facility. […]

• Actual harm, isolatedF675Apr 13, 2022

  Based on observation, interview, and record review, the facility failed to provide the care and services necessary to maintain the highest practible physical, mental, and psychosocial well-being; failed to prevent a severe weight loss with no evalution of the effectiveness of current dietary interventions; no thorough evaluation of persistent dry heaves or effective medication mangagement; no evaluation for a possible decline in the ability to swallow food and fluids or assessmemt of cognition; no follow-up on a documented decline in mood; no evaluation of pain as a possible cause of anxiety and loss of appetite; and no assessments for dehydration and the choice to receive IV fluids, for 1 (#4) of 3 sampled residents. […]