Below average — CMS composite of the measures below.
Past the typical resurvey interval — a standard survey could occur at any time
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Apple Rehab Uncasville during CMS and state inspections, most recent first.
A resident who was cognitively intact and required assistance with toileting was told by a nurse aide to urinate in a diaper if unable to wait, rather than being provided timely help. The resident was left sitting in feces overnight before care was given, and inappropriate language was used by staff, failing to honor the resident's dignity and rights.
Licensed nursing staff left prescribed medications at the bedside for two residents who had not been assessed or authorized to self-administer, failing to observe medication consumption as required by facility policy. In both cases, LPNs exited the room before confirming that the medications were taken, despite having received education on proper medication administration procedures.
A resident with dementia and seizure precautions did not have ordered two-half siderails and padded siderails in place after a bed change, despite nursing staff documenting compliance on the TAR for all shifts. Interviews revealed that staff did not verify the presence of these safety interventions before signing off, and the DNS was unaware that the required equipment was missing until the survey.
A resident with dementia and seizure precautions did not have physician-ordered side rails or side rail padding in place after a bed change, yet nursing staff repeatedly documented on the TAR that these interventions were present. Staff interviews confirmed that documentation was completed without verifying the interventions, and the DON acknowledged a lack of communication and oversight regarding the bed change and required equipment.
A resident with multiple chronic conditions, including stroke and heart failure, did not receive prescribed doses of Losartan and Lexapro via G-tube as ordered. An LPN was identified as having administered incorrect doses, and the DON was notified after another nurse raised concerns. The LPN denied the error and resigned following the incident.
Multiple residents were observed without identification bracelets or visible forms of identification, despite facility policy requiring such identification for all residents. Interviews confirmed that some residents had not received name bands, and the DON was aware of the issue but it remained unresolved at the time of the survey.
The facility experienced delays in administering prescribed Oxycodone for a resident with severe pain due to cellulitis and diabetic chronic kidney disease. Despite a care plan and interventions in place, the resident faced delays in receiving medication, leading to severe pain episodes. Nursing staff encountered challenges in accessing the medication from the pharmacy and automated dispensing system. Communication gaps and documentation discrepancies further complicated timely pain management.
The facility failed to review the infection prevention control program policies and procedures annually, did not conduct quarterly infection control surveillance and safety rounds for several months in 2022 and 2023, and did not complete monthly infection reports or analyze infection trends for 2022 and the first half of 2023. The DNS confirmed these lapses and attributed them to the absence of the previous IP nurse.
The facility failed to ensure that the antibiotic stewardship program, including antibiotic usage and audit tool results, was reviewed and presented at the quarterly medical staff meetings for the periods of 2022 and 2023. The DNS was unable to locate any relevant documentation for these periods, except for the last quarters of 2023, which she completed herself.
The facility failed to maintain a consistent designated Infection Preventionist (IP) with the required specialized training in infection control for 2022 and 2023. The DNS served as the IP from July to December 2023, and there were gaps in having a designated IP during these years. Human Resources did not provide certification or specialized training documentation for the individuals hired as IPs.
A facility failed to develop a comprehensive care plan for a resident with an indwelling urethral catheter. The care plan lacked specific details such as the type of catheter, frequency of changes, and general care instructions. Despite the resident's complex medical needs, the care plan was insufficiently detailed, and monthly physician's orders did not address catheter care.
A facility failed to administer a nicotine patch to a newly admitted resident with a history of smoking due to a lack of stock. Despite a physician's order, the resident did not receive the patch until their significant other brought it to the facility. The facility's policy for interim/stat/emergency deliveries was not followed.
A resident with multiple medical conditions was injured during a transfer via mechanical lift due to the facility's failure to follow manufacturer's recommendations and facility policy. The lift tipped over because the wheelbase was not expanded, causing the resident to fall and sustain a back injury. The incident was not properly documented, and the care card lacked specific instructions for the lift's use.
The facility failed to properly discard a controlled medication by its expiration date. An LPN was unsure why the expired Lorazepam oral liquid was still in the refrigerator, and the DNS mentioned that there is no set schedule for medication destruction. The facility's policy was not followed in this instance.
The facility failed to notify the LTC Ombudsman's office of resident discharges and transfers within a timely manner. Reviews revealed consistent delays in sending notifications for several months, with delays ranging from one to fifty-two days. An interview with the responsible social worker confirmed the delays were due to an oversight.
The facility failed to complete annual performance reviews for three nurse aides and did not complete the background check for an LPN. The HR Director acknowledged the missing reviews and background check, citing recent changes in HR and DNS positions as contributing factors.
The facility failed to protect two conserved residents with severely impaired cognition from sexual abuse. One resident was found in another's room, both naked from the waist down, despite care plans and policies in place to manage behaviors and ensure safety. Immediate intervention and subsequent evaluations found no injuries, but the incident revealed significant lapses in resident protection.
Failure to Provide Dignified Toileting Assistance
Penalty
Summary
A deficiency occurred when a nurse aide instructed a cognitively intact resident, who required assistance with toileting and transfers, to urinate in a diaper if unable to wait for help. The resident, who had diagnoses including bradycardia, pacemaker placement, and high blood pressure, had a physician's order for transfer with assist of one and a rolling walker. Facility documentation and interviews confirmed that the aide used the term 'diaper' and told the resident to relieve themselves in it rather than providing timely assistance or appropriately communicating the need to wait. The resident was left to sit in feces overnight before staff returned to provide care. Facility policy and the resident's care plan required staff to encourage and assist with toileting and to use dignified language such as 'brief' or 'incontinent care products.' The incident report and interviews indicated that the aide's actions and language did not honor the resident's right to dignity and failed to provide care in a respectful manner.
Failure to Observe Medication Administration and Unauthorized Bedside Medication Placement
Penalty
Summary
Licensed nursing staff failed to ensure that residents consumed prescribed medications prepared for them before leaving their rooms. In two cases, medications were left at the bedside of residents who had not been assessed or authorized to self-administer their medications. One resident, with diagnoses including adult failure to thrive, anemia, and atrial fibrillation, was observed receiving medications prepared by an LPN, who then left the medication cup on the bedside table and exited the room without confirming ingestion. The clinical record did not indicate that this resident was assessed for self-administration of oral medications. Another resident, with a history of anxiety disorder, chronic pain, and a parathyroid gland neoplasm, also had medications left at the bedside on multiple occasions. In one instance, the LPN left the medications at the bedside while the resident's family was visiting, assuming the family would ensure the medications were taken. The family later reported the incident, and the LPN acknowledged the error. In a separate incident, another LPN left medications at the bedside because the resident previously refused to take them in her presence, intending to return later to check if they had been taken. The clinical record did not show that this resident was authorized for self-administration. Facility policy and inservice education clearly stated that medications should not be left at the bedside unless a resident is assessed and authorized to self-administer. Both LPNs involved acknowledged awareness of this policy and had received relevant education. Despite this, medications were left unattended at the bedside, and the required observation of medication consumption was not performed.
Failure to Follow Physician's Orders for Bed Safety Interventions
Penalty
Summary
A deficiency occurred when the facility failed to follow physician's orders for a resident with Alzheimer's disease, dementia, impaired vision, hearing loss, and difficulty walking. The physician had ordered two-half siderails and padded siderails for the resident's bed to support mobility, safe transfers, and seizure precautions. Despite these orders, after the resident's bed was switched to a low bed, no side rails or side rail padding were attached or present in the room. Nursing staff continued to document on the Treatment Administration Record (TAR) that the required side rails and padding were in place for every shift, even though they were not. Interviews with nursing staff revealed that they signed off on the TAR without actually verifying the presence of the side rails or padding. Staff admitted to not checking the bed before signing off and were unaware that the interventions were missing until it was brought to their attention during the survey. The Director of Nursing Services (DNS) acknowledged that the change to a low bed required communication with maintenance to install the side rails and padding, but was unsure if this had occurred. The DNS also stated that nursing staff are expected to follow physician's orders and verify interventions, but could not explain why staff had documented compliance when the interventions were not in place. The facility was unable to provide a policy for following physician's orders when requested.
Failure to Accurately Document and Implement Physician-Ordered Bed Safety Interventions
Penalty
Summary
The facility failed to maintain a complete and accurate medical record for a resident when nursing staff documented that side rail and side rail padding interventions were in place, despite these interventions not being present as ordered by the physician. The resident in question had diagnoses including Alzheimer's disease with late onset, dementia with behavioral disturbances, age-related cataract, bilateral sensorineural hearing loss, and difficulty walking. Physician's orders required two-half side rails for mobility and safe transfers, as well as seizure precautions including a low bed with fall mats and padded side rails. The resident's care plan also reflected these interventions. Upon observation, the resident's bed was found to be a low bed without any side rails or side rail padding, and only one fall mat was in place, with the other mat propped against the wall. Interviews with nursing staff revealed that they had signed off on the Treatment Administration Record (TAR) for multiple shifts, indicating that the side rails and padding were in place, even though they were not. Staff admitted to not verifying the presence of these interventions before documenting them as completed, citing being busy or unaware of the missing equipment. The Director of Nursing Services (DNS) acknowledged that the change to a low bed was not properly communicated to maintenance for side rail installation and was unsure why nursing staff continued to document the interventions as present. The facility's policy required all documentation to be factual, complete, and reflective of the resident's current condition and care provided, which was not followed in this instance.
Failure to Administer Medications as Ordered
Penalty
Summary
A deficiency occurred when a resident with a history of cerebral vascular infarction, congestive heart failure, hypertension, and depression did not receive medications as ordered by the physician. The resident, who was dependent on staff for activities of daily living and received nutrition via a gastrostomy tube, had physician orders for Losartan Potassium to treat high blood pressure and Escitalopram (Lexapro) for depression, both to be administered daily through the G-tube. On a specified date, both medications were omitted during the morning medication pass, as documented in the Medication Error Report, and the responsible party and physician were notified of the omission. An investigation by the Director of Nursing (DON) revealed that the wrong dose of both Losartan and Lexapro had been administered by a charge nurse, identified as an LPN. The DON was alerted to the issue by another nurse and, upon contacting the LPN involved, the LPN denied the allegation and subsequently resigned. The facility was unable to interview the LPN further regarding the incident.
Failure to Provide Required Resident Identification
Penalty
Summary
The facility failed to ensure that residents wore identification bracelets or other visible forms of identification as required by policy and professional standards. During observations of the memory care unit, three out of five residents in the dining room were found without any visible identification. Additional observations in the upper and lower resident units, recreation area, common areas, and rehab area revealed multiple residents without identification bracelets or other visible identification. Two residents interviewed confirmed they had not been provided with identification name bands. The Director of Nursing (DON) acknowledged awareness of the issue a week prior and stated that the expectation was for all residents to have identification name bands, which are used by nurses for medication administration. The DON had instructed charge nurses to audit and ensure residents had visible identification, but an audit subsequently found several residents still without name bands. The facility's policy requires that all residents be provided with an identification bracelet at admission, but this was not consistently implemented.
Delayed Administration of Pain Medication for Resident with Severe Pain
Penalty
Summary
The facility failed to administer pain medication as ordered for Resident #236, who was assessed to be in severe pain. Despite having a care plan in place that identified the resident's risk for pain and interventions for pain management, including the administration of Oxycodone for severe pain every three hours, the resident experienced delays in receiving the prescribed medication. Resident #236, who had diagnoses of cellulitis of both legs and Type 2 diabetes mellitus with diabetic chronic kidney disease, was observed crying in bed and expressing severe pain on multiple occasions. Interviews with nursing staff revealed that there were delays in obtaining and administering the Oxycodone, with discrepancies in documentation of medication administration on the MAR. The nursing staff, including LPN #1 and RN #5, were aware of Resident #236's pain but faced challenges in accessing the prescribed medication promptly. LPN #1 mentioned difficulties in obtaining the Oxycodone from the pharmacy and the automated medication dispensing system, leading to delays in medication administration. Despite being notified by the MDS Coordinator about the resident's pain, LPN #1 did not escalate the issue to the Nursing Supervisor when the medication was unavailable, and the resident's pain level remained at a severe level. The facility's policy on receiving interim/stat/emergency medications was not followed, as there were delays in obtaining the necessary medication for Resident #236 in a timely manner. The resident's pain management was further complicated by the lack of documentation of medication administration and communication gaps between staff members. Despite Resident #236's repeated complaints of severe pain and the availability of the prescribed pain medication, there were instances where the medication was not administered as ordered. The facility's failure to ensure timely and appropriate pain management for a resident in severe pain highlights deficiencies in medication administration processes and communication among the nursing staff involved in the resident's care.
Infection Control Program Deficiencies
Penalty
Summary
The facility failed to review the infection prevention control program policies and procedures at least annually, as required. Specifically, the Infection Control Program Policies and Procedure manual was not reviewed in 2022. The DNS, who was the former IP and currently oversees the IP program, confirmed that the manual was reviewed on 7/18/23 and 1/1/24 but could not provide documentation for 2022. The DNS acknowledged that the review should be conducted annually and attributed the lapse to the absence of the previous IP nurse during the required review period. The facility's policy mandates an annual review and updates to the program as necessary to align with national standards changes. Additionally, the facility did not conduct quarterly infection control surveillance and safety rounds for several months in 2022 and 2023, including April, July, and October of 2022, and January and April of 2023. The DNS was unable to locate the documentation for these rounds and indicated that it was the responsibility of the previous IP nurse. Furthermore, the facility failed to complete monthly infection reports or analyze infection trends for the year 2022 and the first half of 2023. The DNS could not find the monthly reports or quarterly infection control reports for the specified periods. The facility's policies require monthly infection reports to compute infection rates and quarterly reports to be presented to the infection control committee for review and recommendations.
Failure to Review Antibiotic Stewardship Program at Quarterly Medical Staff Meetings
Penalty
Summary
The facility failed to ensure that a review of the antibiotic stewardship program, including antibiotic usage and audit tool results, was presented at the quarterly medical staff meetings. Documentation for the period of January 2023 to June 2023 did not include any records of monthly reviews of the antibiotic stewardship program. Additionally, there was no documentation that a quarterly review of antibiotic usage for 2022 and 2023 was presented at the medical staff meetings. The DNS, who was not working at the facility during the time frame in question, was unable to locate any reports related to the antibiotic stewardship program for the specified periods, except for the last quarters of 2023, which she completed herself. The facility's Antibiotic Stewardship policy mandates that all infections be tracked by the IP or designee and reviewed for trends, with findings to be presented quarterly at the medical staff meetings. However, the review of the Medical Staff Meeting agendas for all quarters in 2022 and 2023 showed no topics related to infection control and antibiotic usage/antibiotic stewardship program presented by the Infection Preventionist. The DNS confirmed that it was the responsibility of the previous IP to complete and present these reports, but no such documentation was found in the Medical Staff Meeting binder for the specified periods.
Inconsistent Designation and Training of Infection Preventionist
Penalty
Summary
The facility failed to maintain a consistent designated Infection Preventionist (IP) with the required specialized training in infection control for the years 2022 and 2023. The Director of Nursing Services (DNS) served as the IP from July 2023 until December 2023, after which her role changed to DNS, and she continued to oversee the program until a newly hired nurse completed the required specialized training. Interviews with Human Resources and the Corporate Nurse revealed that three different nurses held the IP position in 2022 and 2023, but none had consistent tenure, and there were gaps in having a designated IP during these years. Additionally, Human Resources failed to provide certification or specialized training documentation for the individuals hired as IPs during this period, despite requests for such information. The facility's Infection Prevention and Control Program policy stated that the facility would designate one or more individuals as the infection control preventionist who had completed specialized training in infection prevention and control. However, the facility did not adhere to this policy, as evidenced by the inconsistent assignment of the IP role and the lack of documentation for specialized training. This deficiency was identified through interviews, review of facility documentation, and examination of employee punch history, which confirmed the absence of a consistently designated and properly trained IP for the specified years.
Failure to Develop Comprehensive Care Plan for Indwelling Catheter
Penalty
Summary
The facility failed to develop a comprehensive care plan for a resident with an indwelling urethral catheter. The care plan did not include specific details such as the type of catheter, frequency of catheter changes, the size of the balloon to be used, and general care instructions for the catheter. This deficiency was identified through observations, review of facility documentation, and interviews with staff. The resident in question had multiple diagnoses, including Type II diabetes mellitus with diabetic polyneuropathy, above the knee right side amputation, neuromuscular dysfunction of the bladder, and renal dialysis. Despite these complex medical needs, the care plan was insufficiently detailed to guide staff in providing appropriate care for the indwelling catheter. The quarterly Minimum Data Set (MDS) assessment confirmed that the resident had an indwelling Foley catheter and was dependent on staff for mobility, transfers, and personal care. However, the care plan dated 3/6/2024 only mentioned the presence of the catheter without providing specific instructions for its management. Additionally, the monthly physician's orders for March 2024 did not address the use or care of the catheter. Interviews with the Director of Nursing Services (DNS) and the MDS coordinator revealed that the initial care plan is typically completed by the admission nurse or MDS coordinator, but in this case, it lacked the necessary details. The facility's Care Planning Policy mandates the development of a comprehensive and individualized plan of care, which was not met in this instance.
Failure to Administer Nicotine Patch to Newly Admitted Resident
Penalty
Summary
The facility failed to administer a nicotine patch to a newly admitted resident with a recent history of smoking. Resident #236, who had diagnoses including cellulitis of both legs, Type 2 diabetes mellitus with diabetic chronic kidney disease, and tobacco use, was admitted with a physician's order for a NicoDerm CQ 24hr 21mg patch. Despite this order, the resident did not receive the nicotine patch due to the facility's lack of stock. Interviews with the resident and staff confirmed that the patches were unavailable over the weekend, and the resident's significant other had to bring the patches to the facility on Monday, which was the first time one was applied. The facility's medication administration record did not document the application of the patch until the evening of March 12th, 2024. The Director of Nursing (DON) confirmed that the facility should have kept at least one box of each dosage of nicotine patches on hand and that orders are typically placed on Fridays and received on Mondays. The DON also noted that if a medication is not available, it should be ordered stat from the pharmacy, although the pharmacy does not usually deliver NicoDerm patches as a stat medication. There was no documentation that the medication was ordered stat on March 9th, 2024. The facility's policy directed immediate notification to the pharmacy for interim/stat/emergency deliveries, which was not followed in this case.
Failure to Ensure Safe Transfer via Mechanical Lift
Penalty
Summary
The facility failed to ensure that Resident #286 was transferred safely via a mechanical lift, leading to an accident. Resident #286, who had multiple diagnoses including type II diabetes mellitus with diabetic polyneuropathy, above the knee right side amputation, and morbid obesity, required a total mechanical lift transfer with the assistance of two staff members. During a transfer from a wheelchair to a bed, the mechanical lift tipped to the right because the wheelbase was not in the expanded position, causing the resident to fall and hit his back on the side rail of the bed. This incident resulted in severe back pain and a subsequent hospital visit where a CT scan showed a small disc protrusion and probable disc bulges/herniations, although detailed assessment was limited due to the resident's obesity. The report indicates that the mechanical lift was not operated according to the manufacturer's recommendations and facility policy, which require the base legs to be locked in the open position for maximum stability. Interviews with staff revealed that the wheelbase was not expanded during the transfer, leading to the lift tipping over. Additionally, the care card for Resident #286 did not specify which mechanical lift or pad to use, contributing to the improper use of the equipment. The facility's policies and the manufacturer's guidelines were not followed, resulting in the resident's fall and subsequent injury. Further interviews and documentation reviews revealed that the incident was not properly documented in the clinical record, and there was a lack of information on how the incident occurred and the injuries sustained. The nursing supervisor on duty at the time of the incident failed to document the resident's refusal for assessment and pain medication. The facility's failure to adhere to proper mechanical lift procedures and inadequate documentation contributed to the deficiency in ensuring a safe environment for Resident #286.
Failure to Discard Expired Controlled Medication
Penalty
Summary
The facility failed to properly discard a controlled medication by its expiration date. During an observation of the medication storage room refrigerator, Lorazepam oral liquid for a resident was found with an opened date and a discard date that had passed. An LPN was unsure why the medication was still in the refrigerator and noted the medication's storage guidelines. The DNS mentioned that staff call her if a medication is expired, and she conducts weekly rounds to check for expired medications, but there is no set schedule for destruction. The facility's policy directed that all expired medications should be destroyed or returned according to guidelines, but this was not followed in this instance.
Failure to Timely Notify Ombudsman of Discharges and Transfers
Penalty
Summary
The facility failed to notify the Long-Term Care Ombudsman's office of resident discharges and transfers within a timely manner. The review of the facility's documentation for several months revealed consistent delays in sending notifications. For September 2023, notifications for eleven residents were sent one day late. In October 2023, notifications for twelve residents were sent six days late. In November 2023, notifications for twenty-six residents were sent fifty-two days late. In January 2024, notifications for sixteen residents were sent thirty-five days late. In February 2024, notifications for twenty-six residents were sent six days late. An interview with the responsible social worker confirmed that the delays were due to an oversight on her part. The facility's policy requires that notifications be made by the 5th of the following month for the previous month. The policy also mandates that for any other types of facility-initiated discharges, the facility must provide notice of discharge to the resident and resident representative along with a copy of the notice to the State Long-term care ombudsman 30 days prior to the discharge. The director of social services is responsible for running the monthly report at the beginning of each month.
Failure to Complete Annual Performance Reviews and Background Check
Penalty
Summary
The facility failed to complete annual performance reviews for three nurse aides (NA #1, NA #2, and NA #3) and did not complete the background check for LPN #5. The employees' files for the nurse aides, hired on various dates between 2012 and 2019, lacked the required performance reviews for 2023. During interviews, the Human Resources Director (HRD) acknowledged the missing performance reviews and the absent background check for LPN #5. The HRD noted that performance reviews are typically conducted annually around the employee's hire date but cited a change in HR and the Director of Nursing Service (DNS) positions as a contributing factor to the oversight. The facility's Performance and Review policy mandates formal and documented performance reviews at the end of the introductory period and annually thereafter.
Failure to Protect Conserved Residents from Sexual Abuse
Penalty
Summary
The facility failed to ensure that two conserved residents, who were unable to provide consent, were free from sexual abuse. Resident #1, diagnosed with dementia and major depressive disorder, was found in Resident #2's room, naked from the waist down, with Resident #2 leaning towards Resident #1's private area. Both residents had severely impaired cognition and were under conservatorship, meaning they could not consent to sexual activities. The incident was discovered by RN #1, who immediately intervened and separated the residents, calling for additional staff assistance. Resident #1 was placed under 1:1 monitoring at the nursing station, and the incident was reported to the MD and Resident #1's family. A subsequent physical examination and hospital evaluation found no injuries or trauma to Resident #1's private areas. Resident #2, diagnosed with epilepsy and adjustment disorder, had a history of inappropriate sexual behavior. The care plan for Resident #2 included interventions to manage this behavior, such as distraction and avoiding conversations that could lead to inappropriate actions. Despite these measures, Resident #2 was found in a compromising situation with Resident #1. Interviews with staff revealed that both residents were last seen in common areas shortly before the incident. The facility's Director of Nursing Services (DNS) confirmed that both residents were placed on 1:1 observation following the event and that Resident #2's room was relocated to a different floor. The facility's Resident Abuse policy and the resident bill of rights were reviewed, both of which emphasize the importance of treating residents with dignity and protecting them from abuse. The facility failed to adhere to these policies, resulting in a situation where two residents were exposed to potential sexual abuse. The report highlights the facility's inability to prevent such incidents, despite having policies and care plans in place to manage residents' behaviors and protect their well-being.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Uncasville
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Norwich Sub-acute And Nursing | 4.1 mi | ★★★★★ | 1 | 0 |
| Greentree Manor Nursing And Rehabilitation Center | 7 mi | ★★★★★ | 7 | 0 |
| Fairview | 8.4 mi | ★★★★★ | 3 | 0 |
| Beechwood Health & Rehabilitation Center | 9.1 mi | ★★★★★ | 3 | 0 |
| Harbor Village North Health And Rehabilitation Cen | 9.8 mi | ★★★★★ | 22 | 0 |
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