Washington County Nursing Home

In the surveyor’s words

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

• Actual harm, isolatedF689Sep 1, 2026

  Based on observations, record review and interviews, the facility failed to ensure three (#13, #2 and #35) of six residents reviewed for accidents out of 26 sample residents received adequate supervision to prevent accidents. Resident #13 was admitted on [DATE] with a diagnosis of dementia. Resident #13 was identified as a high fall risk. On 8/23/26 at approximately 4:27 a.m. Resident #13 awakened and a motion sensor in her room alerted certified nurse aide (CNA) #5 of Resident #13's movement. CNA #5 recognized that Resident #13 was restless, but did not assist the resident to the restroom at the time, which was a care planned fall intervention for the resident. […]

• Actual harm, isolatedF692May 17, 2023

  Based on observations, record review and interviews, the facility failed to implement appropriate nutritional interventions for one (#26) out of 20 sample residents to maintain acceptable parameters of nutritional status. Resident #26, age 90, was admitted to the facility on [DATE] with diagnoses of heart failure, type 2 diabetes mellitus, chronic obstructive pulmonary disease (COPD), peripheral vascular disease, history of falling and anxiety. Resident #26 sustained a weight loss of 10.6% (20.5 lbs) from admission on 1/13/23 through 1/31/23, which was considered significant. […]

• No harm, potential for more than minimal, patternF656Sep 25, 2024

  Based on record review and staff interviews, the facility failed to develop and implement a comprehensive care plan for three (#38, #24 and #3) of five residents reviewed for care plans out of 19 total sample residents. Specifically, the facility failed to: -Ensure Resident #38 had a care plan for the use of an anticoagulant medication; -Ensure Resident #24 had a care plan for the use of supplemental oxygen; and, -Ensure Resident #3 had a care plan for the use of a diuretic medication. Findings include: I. Facility policy and procedure The Care Plan policy, revised 8/12/24, was provided by the nursing home administrator (NHA) on 9/25/24 at 2:53 p.m. […]

• No harm, potential for more than minimal, patternF689Apr 14, 2021

  Based on record review and interviews, the facility failed to ensure a safe environment and adequate supervision to prevent accidents for three (#3, #1 and #2) residents out of the five sample residents reviewed. Specifically, the facility failed to: -Ensure new, person centered, appropriate, and effective interventions were continuously initiated for Resident #3, #1 and #2 after each fall; -Ensure fall interventions were care planned and implemented for Resident #3, #1 and #2; and, -Ensure neurological checks were accurate and completed entirely for Resident #3, #1 and #2 when required after a fall. These failure resulted in Resident #3 having nine falls in four months, Resident #1 having 11 falls in six months and Resident #2 having four falls in four months. Findings include: I. […]

• No harm, potential for more than minimal, isolatedF695Sep 1, 2026

  Based on observations, record review and interviews, the facility failed to provide necessary respiratory care and services consistent with professional standards of practice for one (#35) of one resident reviewed for respiratory services out of 26 sample residents. Specifically, the facility failed to ensure Resident #35 received oxygen therapy in accordance with the physician's orders.Findings include:I. Professional referenceAccording to the National Library of Medicine, National Center for Biotechnology Information, update 1/22/25, retrieved on 9/2/26 from https://www.ncbi.nlm.nih.gov/books/NBK551617/, Oxygen therapy is a critical medical intervention that ensures adequate oxygen delivery to the body's cells, supporting essential functions and preventing life-threatening conditions. […]