Tamarack Ridge Health and Rehabilitation

In the surveyor’s words

From the most serious findings on record at Tamarack Ridge Health and Rehabilitation, in the surveyor’s own words.

• No harm, potential for more than minimal, isolatedF684Dec 23, 2025

  Based on record review, observation, interview and facility policy review, the facility failed to ensure Resident #23's skin care was completed as ordered by the physician. This affected one resident (Resident #23) of three residents reviewed for care and services. The facility census was 95.Findings include: Review of the medical record for Resident #23 revealed an admission date of 07/20/23. Diagnoses included paralysis affecting the left non-dominant side, bipolar disorder, depression, muscle weakness, insomnia and respiratory failure.Review of the quarterly Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #23 was cognitively intact. […]

• No harm, potential for more than minimal, isolatedF697Dec 23, 2025

  Based on record review, observation, interview, and review of the facility policy, the facility failed to ensure Resident #96's physician orders were followed and care planned interventions were implemented to administer Resident #96's pain medication timely. This affected one resident (Resident #96) out of three residents reviewed for pain management. The facility census was 95.Findings include:Review of Resident #96's medical record revealed an admission date of 12/22/25 with diagnoses including type two diabetes mellitus with diabetic neuropathy, chronic pain syndrome and restless leg syndrome.Review of Resident #96's admission Assessment and Baseline Care Plan dated 12/22/25 included Resident #96 was a new admission and was alert and oriented. […]

• No harm, potential for more than minimal, isolatedF578Apr 3, 2025

  Based on record review and interview, the facility failed to ensure there were accurate advance directive orders and information in place throughout the medical records for Residents #13 and #68. This affected two (#13 and #68) of 31 residents reviewed for advance directives. The facility census was 83. Findings include: 1. Review of Resident #13's medical record revealed the resident was admitted to the facility on [DATE]. Diagnoses included chronic obstructive pulmonary disease, diabetes mellitus, and depression. Review of the Minimum Data Set (MDS) 3.0 assessment dated [DATE] revealed Resident #13 was cognitively intact. […]

• No harm, potential for more than minimal, isolatedF684Apr 3, 2025

  Based on observations, record review, and resident and staff interviews, the facility failed to ensure a resident had her ace wraps according to physicians' orders. This affected one (#56) of two residents reviewed for edema. The facility census was 83. Findings include: Review of the medical record for Resident #56 revealed an admitted [DATE]. Diagnoses included heart failure, dementia, hypertension, and edema. Review of the quarterly Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #56 had intact cognition. […]

• No harm, potential for more than minimal, isolatedF695Apr 3, 2025

  Based on observations, record review, interview and policy review, the facility failed to ensure Resident #39's oxygen concentrator was administered as physician ordered. This affected one (#39) of one resident reviewed for oxygen administration. The facility identified 13 residents in the facility who were on oxygen therapy. The facility census was 83. Findings include: Review of the medical record for Resident #39 revealed and admitted [DATE]. Diagnoses included heart failure, atrial fibrillation, and hypertension. Review of the physician orders for April 2025 revealed an order for oxygen per nasal cannula continuous every shift at four liters/minute (LPM). […]