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F0563
E

Failure to Establish and Communicate Visitation Rights Policy

Lewistown, Missouri Survey Completed on 11-17-2025

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.

Summary

The facility failed to have written policies and procedures regarding visitation rights, including the management of restrictions placed on two residents' visitors. The Administrator confirmed that there was no policy in place addressing visitation rights, and staff were not provided with clear guidance or communication about the reasons for visitor limitations. The facility's existing Resident Rights policy required informing residents and their representatives of their rights and responsibilities, but did not address the process for restricting visitors or communicating such restrictions to staff. For one resident with severe cognitive impairment and a legal guardian, the guardian provided a list of individuals who were not allowed to visit. This list was included in the resident's care plan and posted at the nurse's station, instructing staff to deny access to those individuals and contact authorities if necessary. However, staff interviews revealed confusion and lack of awareness about the restrictions, with some staff only discovering the list after incidents occurred. The rationale for the restrictions was not discussed with the guardian, and there was no documentation of official reasons or supporting court documents for the exclusions, despite allegations of past financial exploitation and family discord. Another resident, who was cognitively intact and had no guardian, was also affected when a family member was barred from visiting after an incident involving another resident. The family member was told by law enforcement not to return to the facility, which caused distress for the resident who had previously received frequent visits. Staff interviews indicated uncertainty about the authority and process for restricting visitors, and the chain of command was not consistently followed. The lack of a formal policy and clear communication led to inconsistent application of visitor restrictions and confusion among staff and visitors.

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