F0912 F912: Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
B

Single Resident Room Below Minimum Size Requirement

Golden Age ManorAmery, Wisconsin Survey Completed on 04-10-2025

Summary

The facility failed to ensure that a single resident room met the required minimum size of 100 square feet, as specified in the State Operations Manual, Appendix PP- Guidance to Surveyors for Long Term Care Facilities. During the survey, it was observed that one resident was occupying a room measuring only 96.5 square feet. The Nursing Home Administrator confirmed that the room was smaller than the regulatory requirement and stated that no remodeling had been done to address the deficiency. The administrator also indicated that the facility has limited private rooms and reviews the use of this undersized room annually, placing only smaller, ambulatory residents in it after informing them and their Power of Attorney about the room size. The resident occupying the room was admitted with multiple diagnoses, including atrial fibrillation, anxiety, depression, malnutrition, an unspecified mental disorder, and attention deficit hyperactivity disorder. The resident was assessed as severely cognitively impaired but able to make herself understood and ambulate independently. During an interview, the resident expressed satisfaction with the room, describing it as comfortable and appreciating features such as a large window. The surveyor attempted to contact the resident's Power of Attorney but did not receive a response.

Penalty

No penalty information released
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The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

Resources

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Single Resident Rooms Below Required Square Footage
B
F0912 F912: Provide rooms that are at least 80 square feet per resident in multiple rooms and 100 square feet for single resident rooms.
Short Summary

Six residents were found to be living in single rooms that did not meet the minimum required 100 square feet of living space, with room sizes ranging from 91.50 to 97.75 square feet, as confirmed by facility records and administrator interview.

No penalty information released
tooltip icon
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.

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