Wyatt Manor Nursing and Rehab Ctr, Inc

In the surveyor’s words

From the most serious findings on record at Wyatt Manor Nursing and Rehab Ctr, Inc, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689Sep 24, 2025

  Based on observation, record reviews and interviews the facility failed to have an adequate system in place to ensure residents at risk for elopement are supervised to prevent elopement from the facility for 1 (#1) of 2 (#1 and #2) residents at risk for elopement. This deficient practice resulted in an Immediate Jeopardy for Resident #1 on 9/12/2025 at 2:15a.m. Resident #1 was last observed in the facility on 09/12/2025 at 1:55 a.m. The facility was notified by S3Maintenance Supervisor on 09/12/2025 at 7:30 a.m. when Resident #1 was observed at a gas station approximately 5 miles from the facility via a four lane highway. The local sheriff's office returned Resident #1 to the facility at 7:45 a.m. without injury. […]

• Actual harm, isolatedF600Oct 28, 2024

  Based on record reviews, observations and interviews, the facility failed to protect the resident's right to be free from physical abuse by another resident for 1 (#1) of 3 (#1, #2, and #3) sampled residents. The facility failed to protect resident #1 from physical abuse by resident #2. The deficient practice resulted in an actual harm for resident #1 on 10/05/2024 at 6:37 p.m. when resident #1 sustained injuries to the right and left side of his face from resident #2. Resident #1 was sitting outside when he was hit by resident #2 with an object across the left side of his face. Resident #1 stood up, backed away, raised his hands and attempted to walk away from resident #2. At this time, resident #2 hit resident #1 on the right side of the face. […]

• Actual harm, isolatedF686Mar 22, 2022

  Based on record review and interview the facility failed to ensure a resident with pressure ulcers received necessary treatment and services, consistent with professional standards of practice, to promote healing, prevent infection and prevent new ulcers from developing for 1 (#1) of 5 (#1-#5) sampled residents by: 1. Failing to timely report to the physician when Resident #1's sacral area pressure ulcer began to deteriorate and show signs of infection and 2. Failing to identify an unstageable pressure ulcer to Resident #1's right heel. This failed practice resulted in an actual harm for Resident #1 on 02/25/2022 at 6:03 PM when Resident #1's sacral area pressure ulcer was found to have a moderate amount of yellow drainage, an odor present and painful. […]

• No harm, potential for more than minimal, widespreadF925Jul 8, 2021

  Based on interviews and observations, the facility failed to maintain an effective pest control program by failing to ensure the facility was free of flies. This deficient practice had the potential to affect all 50 residents residing in the facility. Findings: During the initial tour of the facility on 07/06/2021 at 9:30AM, there were multiple flies in every resident room. There were also multiple flies in the hallways, whirlpool room, and dining room. Further observation in the dining room revealed the air fan at the exit door where the residents exit to one of the smoking areas was off. There was one fly strip in the facility located in the dining room. […]

• No harm, potential for more than minimal, patternF604Jan 8, 2025

  Based on observations, record review and interviews, the facility failed to ensure residents were free from physical restraints that were not required to treat a resident's medical symptoms for 1 (#32) of 2 (#5, and #32) residents reviewed for restraint use. Findings: Review of the medical record for resident #32 revealed he had diagnoses which included mood disorder, difficulty walking, muscle wasting and atrophy, seizures and severe intellectual disabilities. On 01/06/2025 at 9:30 a.m. and on 01/07/2025 at 10:10 a.m., resident #32 was observed in a geri-chair with a lap tray. Review of the Pre-Restraining assessment summary dated 11/19/2024 indicated resident #32 could remove the lap tray from the geri-chair. […]