Signature Healthcare of McCreary County Rehab and

In the surveyor’s words

From the most serious findings on record at Signature Healthcare of McCreary County Rehab and, in the surveyor’s own words.

• Actual harm, isolatedF656May 14, 2026

  Based on observation, interview, record review and facility policy, the facility failed to ensure its staff implemented and provided care in accordance with the resident's written care plan interventions for 1 of 26 sampled residents (Resident (R47). R47 sustained a tibial (bone in the lower leg) fracture.The findings include:Review of the facility's policy titled, Comprehensive Care Plan last reviewed 01/31/2026, revealed the facility would develop and implement a comprehensive person-centered care plan for each resident. Per review that care plan was to include measurable objective and time frames to meet a resident's medical, nursing, mental, and psychosocial needs that were identified in the comprehensive assessment. […]

• Actual harm, isolatedF689May 14, 2026

  Based on observation, interview, record review and facility policy review, the facility failed to ensure its staff provided adequate supervision and assistance to prevent injury for 1 of 26 sampled residents (Resident (R47), which resulted in the resident sustaining a fracture. The findings include: Review of the facility's policy titled, Accidents and Incidents last reviewed 01/31/2026, revealed the intent was to ensure the facility provided an environment that was as free from accidents and incidents that were avoidable, the facility investigates these occurrences with applicable documentation and appropriate reporting, as applicable. […]

• Actual harm, isolatedF609Aug 18, 2022

  Based on observation, interview, record review, review of the facility investigation documentation, and facility policy, it was determined the facility failed to ensure an allegation of abuse was immediately reported for two (2) of ten (10) sampled residents (Resident #2 and Resident #3). Resident #2 sustained a proximal tibia-fibula (area just below knee) fracture of the right leg on 12/01/2020, during a transfer from his/her bed to a wheelchair. The facility was unaware how the inury of unknown origin occurred and failed to report the injuries to state agencies. Resident #3 sustained a fractured index finger on 06/14/2022, when he/she was having a Covid test performed. […]

• Actual harm, isolatedF656Aug 18, 2022

  Based on interview, record review, and review of the facility's policy, it was determined the facility failed to develop a Comprehensive Person-Centered Care Plan for each resident to assist in attaining or maintaining the residents' highest practicable quality of life for one (1) of ten (10) sampled residents, (Residents #4). Resident #4 had an indwelling Foley catheter. The resident had Physician's Orders for the Foley catheters to be changed monthly and as needed (PRN). However, the facility failed to care plan Resident #4 for his/her ordered Foley catheter changes. […]

• Actual harm, isolatedF689Aug 18, 2022

  Based on observation, interview, record review, review of the facility's investigation documentation, and facility policy, it was determined the facility failed to provide adequate supervision and assistance to prevent accidents for one (1) of ten (10) sampled residents, (Resident #2). The facility assessed Resident #2 as cognitively intact, and to be dependent on two (2) or more staff with transferring. However, Resident #2 sustained a proximal tibia-fibula (long bones of the leg below the knee) on 12/01/2020, during a transfer performed by only one (1) staff person, from his/her bed to the wheelchair. […]