Average — CMS composite of the measures below.
A standard survey is most likely before around February 2027
Estimate from public CMS data, current as of October 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Utuqqanaat Inaat during CMS and state inspections, most recent first.
Failure to Restrict Visitor Access When Financial Abuse Was Suspected: The facility did not have written visitation procedures for safety restrictions and did not limit a visitor’s access to a resident when financial abuse was suspected. A resident with schizoaffective disorder, dementia, and cognitive impairment repeatedly went out with a friend who had access to the resident’s bank card, PIN, and cash, and the resident’s account became overdrawn with a social security check seized by the bank. Staff discussed the issue with the resident and the friend, but no restriction on the visitor’s contact was implemented.
Failure to Report Suspected Misappropriation of Resident Property: Facility leadership identified concerns that a resident with schizoaffective disorder and cognitive impairment was giving a friend access to bank cards and money, leading to an overdrawn account and seizure of a Social Security check, but the Administrator, SW, and DON did not report the suspected abuse to the State Agency. Record review showed repeated outings with the friend and multiple notes documenting the friend’s access to the resident’s funds. The facility’s abuse reporting policy also did not match CFR requirements for immediate reporting and did not clearly identify the State Survey Agency or APS.
A resident was discharged without a written transfer/discharge notice, discharge order, or documented discharge planning, and the record did not show where the resident went. Staff and leadership acknowledged the resident was told to leave, was not given appeal rights information, and the LTC Ombudsman notice inaccurately listed the discharge destination. The facility’s policy also lacked required regulatory elements for notice timing and appeal information.
Failure to involve a resident in care planning: A resident with multiple chronic conditions and a BIMS of 14 had no admission paperwork in the record, no documented initial care conference, and no progress or IDT notes showing participation in the person-centered plan of care. The Administrator confirmed the missing admission documents and stated no other care conferences were held, while the resident did not recall being invited to attend care conference meetings.
A resident was not shown to have been informed, orally and in writing, of resident rights upon admission. The admission packet included a Resident Rights and Facility Responsibilities document and an acknowledgment form, but the medical record had no completed acknowledgment, no documentation that the rights were explained orally, and no note that the resident understood or acknowledged them. The Administrator stated the admission paperwork, including the Resident Rights and Resident Handbook acknowledgments, could not be located.
A resident who was Medicaid-eligible did not have written admission notices in the chart showing which items and services were covered under the State Medicaid plan and which services could be charged out of pocket, including the charge amounts. Although the facility’s admission packet included a Consent to Treat, admission agreement, and Explanation of Charges, the resident’s record lacked signed or dated copies, and the Administrator and DON acknowledged the missing documentation.
Failure to Investigate Suspected Financial Exploitation: A resident with schizoaffective disorder, cognitive impairment, dementia, and other mental health concerns was repeatedly taken out by a friend who had access to the resident’s bank card and money. Staff and leadership identified ongoing concerns that the friend was taking the resident’s funds, the resident’s account became overdrawn, and the resident’s Social Security payment was applied to the delinquent balance, but the DON, SW, and Administrator stated no investigation was completed. The resident also reported wanting to save money for grandchildren and had to borrow money from a family member for personal needs.
Failure to Complete Safe Discharge Planning and Documentation: A resident with chronic pain, falls, incontinence, and ADL dependence was discharged without documented ongoing discharge planning, a provider discharge order, a clear discharge destination, or written discharge notice and appeal rights. The resident refused housing help, but staff had no documentation of re-authorization attempts or a coordinated interdisciplinary plan. After leaving, the resident reported unstable living conditions, poor access to food, falls, worsening pain, fear, depression, and major weight loss.
Care Plan Did Not Match ADL Needs A resident with low back pain, depression, recurrent falls, urinary incontinence, and significant hand/foot deformities had provider and MDS documentation showing need for 1-person assist or supervision/touch support with multiple ADLs, transfers, and mobility. However, the care plan listed the resident as independent with bathing, dressing, toileting, and transfers, and included inaccurate interventions that did not reflect the resident’s assessed functional limitations.
Staff did not consistently perform hand hygiene or change gloves between tasks during personal care and medication administration for several residents with complex medical needs. Observations included a nurse preparing and administering insulin injections without changing gloves or performing hand hygiene, and CNAs assisting with toileting and perineal care while wearing the same gloves and not performing hand hygiene between tasks. Staff interviews confirmed awareness of protocols, but lapses occurred, contrary to facility policy.
Three residents with significant fall risks experienced repeated unwitnessed falls, including incidents resulting in fractures and hospitalizations. Despite care plan updates requiring staff assistance, use of mobility aids, and frequent safety checks, there was no documentation that these interventions were consistently implemented. Staff interviews confirmed a lack of documentation and inconsistent application of fall prevention measures, and facility leadership reported that certain interventions, such as bed and chair alarms, were not used.
Two residents with Type 2 Diabetes Mellitus received insulin after meals instead of before, as per physician orders, leading to medication errors. The facility's staff, including an LPN and the DON, acknowledged the errors, citing concerns about hypoglycemia. The physician indicated flexibility in timing, but orders were not updated to reflect this.
The facility failed to notify the State LTC Ombudsman of transfers for two residents, one with multiple hospitalizations and another with a hospital admission for serious conditions. The facility only began notifying the Ombudsman in January 2024, missing earlier notifications. The Administrator admitted a resident was omitted from the January notification form despite a new process being in place.
A resident's care plan failed to include their prescribed anti-platelet medication, Clopidogrel Bisulfate, which increases bleeding risk. This omission led to inconsistent care, as evidenced by an incident where the resident's eye became bruised, likely due to the medication and aggressive eye rubbing. The DON acknowledged the oversight, noting the medication was still active in the resident's orders.
Failure to Restrict Visitor Access When Financial Abuse Was Suspected
Penalty
Summary
The facility failed to develop written policies and procedures for visitation rights that included procedures for safety restrictions or limitations, and it failed to implement reasonable safety restrictions or limitations when abuse by way of misappropriation of resident property was suspected involving one resident and a visitor. The report states that the facility policy on visitation rights addressed the resident’s right to receive visitors of choice, but it did not provide guidance on the regulatory obligation to place safety restrictions or limitations when concerns such as abuse, exploitation, coercion, criminal activity, disruptive behavior, or illegal substances were identified. The resident involved was admitted with diagnoses including schizoaffective disorder and other symptoms and signs involving cognitive functions and awareness. The PASRR Level II assessment dated 6/10/26 documented a history of schizoaffective disorder, grave disability, moderate cognitive impairment, unspecified depression, dementia, and cerebral ischemia, and noted the individual had been identified as being at risk for acute safety concerns and would be unable to care for himself/herself outside the facility. The Administrator stated the resident had a friend who routinely checked the resident out of the facility and took the resident to the bank to obtain money. Facility staff and leadership identified concerns that the friend was taking the resident’s money, but the report states the facility did not restrict the friend’s access to the resident. The Administrator described the situation as financial abuse and stated the resident’s bank account became overdrawn, the resident had no money available for personal use, and the resident’s social security check was seized by the bank to cover delinquent funds. Staff reported they talked to the friend and to the resident about the money, encouraged the resident to keep the bank card in the facility, and considered obtaining a conservator, but no restriction on the friend’s contact was implemented. The resident’s leave-of-absence log showed the friend took the resident out of the facility 25 times, including 11 outings after leadership identified the potential abuse concern, and progress notes documented repeated access to the resident’s bank card, debit card, PIN, cash, and withdrawals, including an episode where the resident returned from an outing appearing under the influence and stating he/she was high.
Failure to Report Suspected Misappropriation of Resident Property
Penalty
Summary
The facility failed to report an allegation of abuse to the State Agency as required under CFR 483.12(c)(1) after it identified suspected misappropriation of a resident’s property. The resident involved had diagnoses including schizoaffective disorder and cognitive impairment, and a PASRR level II assessment documented a history of schizoaffective disorder, grave disability, moderate cognitive impairment, unspecified depression, dementia, and cerebral ischemia. The assessment also noted the individual had memory difficulty and would be unable to care for himself or herself outside the facility. Facility leadership and multiple staff members described concerns that a friend repeatedly took the resident out of the facility and obtained money from the resident. The Administrator stated the concern escalated in May 2026 after the resident’s bank account became overdrawn and the resident had no money available for personal use, and then in June 2026 the resident’s social security check was seized by the bank to cover delinquent funds. The Administrator, Social Worker, and DON each acknowledged they were mandated reporters, but none reported the concern. The Administrator stated the facility talked to the friend several times, talked to the resident about not giving the friend money, and encouraged the resident to keep the bank card in the facility, but the concern was not reported because the resident said the friend was not taking advantage of him or her. Record review showed repeated documentation that the friend had access to the resident’s bank card, PIN, cash, and outings from the facility, including entries showing the resident gave the friend the bank card to withdraw funds, the friend returned with cash or the card on some occasions, and the resident returned from outings with little or no money. The leave-of-absence log showed the friend took the resident out of the facility 25 times, including 11 absences from May through July after leadership identified the potential abuse concern. The facility’s abuse reporting policy also did not align with regulatory requirements because it directed reporting within 24 hours rather than immediately, but no later than 2 hours when abuse was involved, and it did not clearly identify the State Survey Agency or APS as the reporting entities.
Failure to Provide Required Discharge Notice and Appeal Rights
Penalty
Summary
The facility failed to provide Resident #12 with a written transfer/discharge notice at least 30 days before discharge, and the record did not contain a discharge order, discharge planning progress notes, or a notification of discharge form. The resident was admitted with diagnoses including major depressive disorder, history of falling, hypertension, hyperlipidemia, urinary incontinence, anemia, and benign prostatic hyperplasia, and was discharged from the facility on 2/27/26. The care conference summary documented that the resident did not want to leave, wanted to stay longer, and refused assistance with housing applications, while staff noted the resident did not meet criteria to remain. The medical record contained a handwritten discharge summary signed by Provider #7, but it did not explain why the resident was discharged or where the resident went. The summary stated the resident had improvement in ADL status and labs and did not meet requirements for long term care, but there was no documentation of the discharge destination or disposition. Leadership acknowledged during interviews that there was no documentation to support why the resident was discharged, no way to know where the resident went, and no discharge notification paperwork in the record. The Administrator stated the facility normally completed discharge notifications verbally and did not have a notification of discharge form. The resident stated staff told him/her on a Friday to leave that weekend and pack belongings, and that he/she asked for more time because there was no plan for where to go. The resident said the discussion about housing never happened and that staff told him/her to gather belongings and leave, with belongings to be retrieved later. The facility also faxed the LTC Ombudsman office a discharge notice stating the resident discharged home on 2/27/26, but leadership acknowledged that was not accurate and that they could not identify where the resident actually went. The facility’s transfer/discharge policy did not include the regulatory requirements for 30-day notice, appeal rights information, or the required contact information for appeal-related agencies.
Failure to Involve Resident in Care Planning
Penalty
Summary
The facility failed to ensure Resident #12, who was admitted with diagnoses including major depressive disorder, history of falling, primary hypertension, hyperlipidemia, urinary incontinence, anemia, benign prostatic hyperplasia, and lower back pain, was afforded the opportunity to participate in the development and implementation of his/her person-centered plan of care. Record review showed the resident had clear speech, could make self-understood, understood others, and had a BIMS score of 14, indicating normal cognitive level with no impairments. However, the medical record contained no admission paperwork, including consent for treatment, the admission agreement, explanation of charges, acknowledgement of resident rights, or acknowledgement of the resident handbook. The record also showed only one care conference note, which was the discharge care conference, and there was no documentation of an initial care conference or other progress or interdisciplinary notes showing the resident was involved in care planning during the stay. The Administrator stated the facility could not provide the admission paperwork and confirmed there were no other care conferences held for the resident during the admission. The resident stated he/she did not recall attending or being invited to care conference meetings. The facility policy stated residents or responsible parties would be invited to participate in the scheduled care conference.
Failure to Provide and Document Resident Rights Acknowledgment
Penalty
Summary
The facility failed to ensure that Resident #12 was informed, both orally and in writing, of the resident's rights upon admission. A review of the admission packet showed a document titled Resident Rights and Facility Responsibilities stating that each resident has the right to be informed, orally and in writing, in a language the resident understands, of rights and the rules and regulations governing conduct and responsibilities during the stay. The packet also included a Resident Rights acknowledgment form stating that the resident had read or had the rights read to them and understood them. Resident #12's medical record did not contain a completed acknowledgment of resident rights. There was no documentation showing that Resident #12 signed to acknowledge receipt of the resident rights, no documentation that the rights were provided orally, and no note indicating the resident understood or acknowledged them. During interview, the Administrator stated that leadership was unable to locate Resident #12's admission paperwork, including the acknowledgment of receiving the Resident Rights and the Resident Handbook.
Missing Admission Notice and Charge Disclosure Documentation
Penalty
Summary
The facility failed to ensure that one Medicaid-eligible resident was informed in writing, at the time of admission or when the resident became eligible for Medicaid, of the items and services included under the State Medicaid plan that could not be charged to the resident and the items and services offered by the facility that could be charged, including the amount of those charges. The deficiency was identified during record review and interview for Resident #12, who was the only Medicaid-eligible resident reviewed. Review of the facility’s admission packet showed a Consent to Treat signature page, an admission Agreement stating that the resident had received an explanation of charges, and an Explanation of Charges document listing items and services covered in the daily room rate and those that could result in out-of-pocket charges. However, Resident #12’s medical record did not contain a signed or dated consent for treatment, admission agreement, or explanation of charges. During interviews, the Administrator stated leadership was unable to locate the admission paperwork, the DON acknowledged the missing documentation, and the past Administrator could not explain why the resident did not have the admission notices in the chart.
Failure to Investigate Suspected Financial Exploitation
Penalty
Summary
The facility failed to investigate an allegation of suspected financial abuse/exploitation involving one resident with schizoaffective disorder, moderate cognitive impairment, unspecified depression, dementia, and cerebral ischemia. The resident’s PASRR level II assessment identified a history of grave disability and acute safety concerns, and the resident acknowledged memory difficulty and inability to care for himself/herself outside the facility. Facility leadership and multiple staff members described ongoing concerns that a friend repeatedly took the resident out of the facility and obtained access to the resident’s money and bank card. The Administrator stated that staff identified a greater concern in May 2026 after the resident’s bank account became overdrawn, and later the resident’s Social Security payment was applied by the bank to the delinquent balance. The Administrator also stated the resident had no money to do what he/she wanted to do, and the resident reported wanting to save money for grandchildren. The Social Worker stated she believed the friend was manipulating the resident to take money, that this concern had been present since shortly after admission, and that the resident had to borrow money from a family member because of insufficient personal funds. Progress notes documented repeated instances of the friend retrieving the resident’s bank card, accompanying the resident to the bank, receiving cash, and returning with the resident’s money depleted or at zero. Notes also documented the resident giving the friend a debit card and PIN, leaving the facility with cash and bank cards, and returning with significantly less money. Staff interviews reflected that concerns about financial misappropriation were repeatedly raised, but the Administrator, DON, and Social Worker each stated that no investigation had occurred to determine whether the allegation was confirmed or ruled out. The facility’s abuse policy defined misappropriation of resident property and required immediate notification and investigation of such allegations.
Failure to Complete Safe Discharge Planning and Documentation
Penalty
Summary
The facility failed to implement an effective discharge planning process for one resident who had been admitted with low back pain, major depressive disorder, a history of falls, urinary incontinence, progressive mobility problems, hand and foot deformities, chronic pain, and functional dependence for multiple activities of daily living. The resident’s admission documentation described unsafe living conditions, frequent falls, inability to walk well, difficulty opening medication bottles, and need for one-person assistance with bathing, dressing, toileting, and transfers. The record also showed the resident was admitted for long-term placement with documented needs for 24-hour supervision, meal preparation, medication administration, safety support, and transportation. The record did not show ongoing discharge planning throughout the admission. There was no initial care conference, no documented interdisciplinary discharge planning progress notes, and no evidence that the resident was involved in developing a discharge plan beyond a single discharge conference summary. That discharge conference documented that the resident did not want to leave, wanted to stay longer, refused help with housing applications, and asked staff to lie on the authorization so he/she could remain longer. The facility’s own staff stated there was no documentation of attempts to work with the resident on housing applications, no documentation of re-authorization efforts, and no discharge notification form or appeal rights information was provided. The discharge itself lacked documentation of the basis and reason for discharge, a provider discharge order, and a clear discharge destination. The handwritten discharge summary stated the resident did not meet requirements for long-term care, but it did not explain where the resident was discharged to. The facility’s discharge notification to the Ombudsman listed discharge to home, but leadership acknowledged the resident did not go home and they could not identify where the resident went. Staff interviews showed confusion about the discharge process, including the social worker stating she did not know what discharge notification was and the DON stating the resident should have had an AMA discharge but did not. The resident later reported being told to pack and leave with no plan, having no safe place to go, experiencing unstable living conditions, inadequate food, two falls after discharge, worsening pain without assistance for medications and topical treatment, fear and depression, and significant weight loss after leaving the facility.
Care Plan Did Not Reflect ADL Assistance Needs
Penalty
Summary
The facility failed to develop and/or implement a comprehensive person-centered care plan for Resident #12 that accurately reflected the resident’s functional abilities and need for assistance with ADLs. The resident was admitted with diagnoses including low back pain, major depressive disorder, history of falling, and urinary incontinence, and the provider’s admission note described progressive difficulty with mobility, inability to walk, frequent falls, pain in the feet and hands, claw-like fingers and toes, and difficulty with self-hygiene and opening medication bottles. The provider also documented that the resident required 1-person assist for bathing, dressing, toileting, and transferring, with high fall risk. The admission MDS dated 12/22/25 documented that the resident had a BIMS score of 14 and needed supervision/touch support for oral hygiene, upper body dressing, lower body dressing, putting on/taking off footwear, personal hygiene, chair/bed-to-chair transfer, toilet transfer, care transfer, and walking certain distances. The MDS also documented partial/moderate assistance for toileting hygiene, showering/bathing, and tub/shower transfer. A later provider note documented the resident as needing 1-person assist for bathing, dressing, toileting, and transferring, being independent with feeding, and being urine incontinent and using diapers. The care plan reviewed on 12/29/25 did not match these assessments and notes. It listed the resident as independent in bathing/showering with setup, dressing, oral care, toileting, and transfers, and included inaccurate interventions/tasks that did not reflect the resident’s documented need for assistance. During interview, the Administrator acknowledged that the resident needed assistance in most ADLs and stated the care plan did not reflect what the MDS captured and should have.
Failure to Follow Hand Hygiene Protocols During Resident Care and Medication Administration
Penalty
Summary
Staff failed to follow accepted standards of practice for hand hygiene during personal care and medication administration for five residents. In multiple observed instances, a licensed nurse prepared insulin injections while wearing gloves, then pushed residents in their wheelchairs to their rooms without changing gloves or performing hand hygiene before administering the injections. This occurred with residents who had diagnoses such as Type 2 Diabetes Mellitus. Certified Nursing Assistants (CNAs) were observed entering resident rooms without performing hand hygiene, assisting residents with toileting and perineal care while wearing the same gloves throughout multiple tasks, and failing to perform hand hygiene between glove changes or after removing gloves. In some cases, CNAs assisted residents with pulling up pants and moving them to common areas without offering hand hygiene to the residents or performing it themselves. These actions were observed with residents who had conditions including dementia, chronic kidney disease, heart failure, and fractures. Interviews with staff confirmed knowledge of hand hygiene protocols, but lapses were attributed to forgetfulness. The facility's own hand hygiene policy required hand hygiene before patient encounters, after contact with patient skin, between tasks on the same patient, after glove removal, and after handling patient equipment or toileting. These requirements were not consistently followed during the observed care activities.
Failure to Provide Adequate Supervision and Accident Hazard Prevention Resulting in Multiple Resident Falls
Penalty
Summary
The facility failed to ensure adequate supervision and accident hazard prevention for three residents with a history of falls, resulting in repeated incidents and injuries. One resident with a history of cerebrovascular accident and limited mobility experienced three unwitnessed falls over a three-month period, including one that resulted in a major injury—a cortical fracture of the left femoral greater tuberosity. Despite care plan updates requiring staff assistance, use of a walker, and implementation of 15-minute safety checks, there was no documentation of these checks being completed, and no physician orders were found for the interventions. The resident was not listed on the CNA report sheet for 15-minute checks, and staff interviews confirmed a lack of documentation and inconsistent implementation of fall prevention measures. Another resident with dementia and poor balance had multiple unwitnessed falls, including incidents where required safety interventions such as anti-slip mats and gripper socks were not consistently included in the care plan or documented as being used. After a fall resulting in a suspected fracture, the care plan was updated to require line-of-sight supervision when out of the room and 15-minute checks while in bed, but again, there was no documentation that these interventions were consistently performed. Staff interviews revealed that 15-minute checks were not documented, and care plan updates were not always reflected in practice. A third resident with dementia and a high risk for falls experienced four falls, including one that resulted in a right hip fracture requiring surgical intervention. The care plan was updated to include 15-minute safety checks and supervision during transfers, but there was no documentation of these checks being completed. The facility's fall prevention strategy relied on updating care plans and increasing safety checks, but lacked consistent documentation and follow-through. Interviews with facility leadership confirmed that interventions such as bed and chair alarms were not used, and that the QAPI committee was not actively addressing fall prevention at the time of the survey.
Insulin Administration Errors for Diabetic Residents
Penalty
Summary
The facility failed to adhere to insulin administration orders for two residents diagnosed with Type 2 Diabetes Mellitus, leading to medication errors. The insulin orders specified that the medication should be administered before meals, but observations revealed that the insulin was given after meals. For Resident #5, the insulin was administered after lunch despite a blood sugar level of 290, which is significantly higher than the normal range of 70-100. Similarly, Resident #10 received insulin after lunch with a blood sugar level of 153. Licensed Nurse #1 acknowledged administering insulin after meals, contrary to the physician's orders. The Director of Nursing and the Administrator confirmed these were medication errors, citing concerns about potential hypoglycemic episodes if insulin was given before meals. The physician stated that the timing of insulin administration was flexible and could be adjusted based on the residents' eating patterns, although the orders were not updated to reflect this flexibility. The facility's policy on medication administration emphasizes adherence to the 'eight rights' of medication administration, which were not followed in these instances.
Failure to Notify Ombudsman of Resident Transfers
Penalty
Summary
The facility failed to ensure that transfer notices for two residents were sent to the Office of the State Long Term Care Ombudsman, which is a requirement to provide residents with added protection and advocacy. Resident #8, who had diagnoses including dementia, epilepsy, stroke, and a history of falls, was hospitalized multiple times with anticipated returns. However, the facility did not notify the Ombudsman of these hospitalizations, as they were unaware of the requirement until the current year. The Director of Nursing confirmed that the facility had only started notifying the Ombudsman in January 2024, and thus, notifications for December 2023 hospitalizations were not made. Additionally, the facility did not notify the Ombudsman of a March hospitalization because the resident was in observation status in the emergency department. Resident #12, who had diagnoses including dementia, mild cognitive impairment, chronic obstructive pulmonary disease, hypertension, and a history of myocardial infarction, was admitted to the hospital for sepsis, pneumonia, and acute kidney injury. The facility's notification to the Ombudsman for January 2024 did not include Resident #12's hospital discharge. The Administrator acknowledged that the facility had implemented a new monthly notification process in January 2024, but Resident #12 was inadvertently omitted from the notification form. The facility's policy requires that upon receiving a physician's order for transfer or discharge, the patient and their representative must be notified, and a written notice including appeal rights and Ombudsman contact information must be provided.
Failure to Include Anti-Platelet Medication in Care Plan
Penalty
Summary
The facility failed to develop and implement a comprehensive care plan for a resident who was prescribed Clopidogrel Bisulfate, an anti-platelet medication. This medication, which inhibits platelet clumping and increases the risk of bleeding, was not documented in the resident's care plan. The omission of this critical information had the potential to result in inconsistent care due to the medication's risk factors. The resident, who had a history of falls and was diagnosed with dementia, epilepsy, stroke, and anemia, experienced an incident where a black and swollen eye was observed, likely due to the blood-thinning effects of the medication and aggressive eye rubbing. During interviews, the Licensed Nurse recalled the incident and noted that the physician attributed the bruising to the blood thinners and the resident's actions. The Director of Nursing acknowledged that the medication should have been included in the care plan, especially since it was still active in the resident's physician's orders. The facility's policy on care planning emphasized the need for individualized care plans to ensure continuous and consistent care, which was not adhered to in this case.
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